By Bill Heaney
Labour leader Richard Leonard told the Scottish Parliament today that while the marked decline in the number of deaths from Covid-19 gives the country hope for the future, safely restarting national health services is a national priority – “but our NHS is stuck”.
He told FM Nicola Sturgeon: “The restart of services cannot begin unless we are sure that our hospitals are safe. We now know that there have been almost 1,800 suspected cases of hospital-acquired Covid-19. That raises questions again about personal protective equipment and testing. Families and NHS staff need answers.
“We understand that a Scottish Government review group is now examining the data, but families who lost loved ones as far back as March and April feel that the process has been too slow and too secretive.
“For the sake of public confidence, ahead of the reopening of our NHS, will the First Minister agree to publish details of the group’s work, including its minutes and all its recommendations? Will she agree to appoint an independent chair to review that work urgently?”
Ms Sturgeon said that she agreed “absolutely” that we should never forget the human lives lost behind the statistics – “I never, ever will forget—every one of the numbers that I have had to read out daily will be engraved on my heart forever, and I think that that will be true for all of us.”
But she denied that the NHS was any way stuck and set about defending Jeane Freeman, whose resignation has been called for a number of times over the past two weeks.
She said: “I turn to the issue of nosocomial infection, which is infection that may be acquired in hospitals. Let me be very clear about this, just as the Cabinet Secretary for Health and Sport has been very clear about it.
“We have published unvalidated data, and we did so in an attempt to be open and transparent about the data.
“It is very important that we understand the limitations of that data before it is validated. I welcome the fact that Richard Leonard used the word ‘suspected’, because it would be wrong to say that we know that all those infections were acquired in hospital.
“Many of them may well have been acquired in hospital, but it is also possible, given the incubation period for the virus, that some were acquired in the community but were diagnosed only when a patient or member of staff was in hospital. It is very important to understand that.
“There is now a process under way to validate that information. NHS Scotland is working to apply the European Centre for Disease Prevention and Control international case definitions for hospital-associated Covid-19.
PPE controversy reared its head again in the Scottish Parliament.
“When that work is complete and the information is validated, it will be published in a validated form. As the health secretary has said, we hope that the work will be completed by the end of this month, and the data will be published.
“The nosocomial review group was established in early May. It is an expert group that is currently chaired by Professor Jacqui Riley, who is nurse director and healthcare-associated infection executive leader with NHS National Services Scotland; I think that she is an appropriate chair for that work.
“The group is looking at a range of things just now, including the extension of routine testing of care home staff—as we have just been talking about—to front-line NHS staff. It will also develop further proposals and recommendations to ensure that everything possible that can be done in hospitals is being done to reduce the possibility of hospital-acquired Covid-19.
“We will look at what we can publish from that work and make sure that the group’s recommendations are publicly known so that we can be very clear about how they are being taken forward.”
The Labour leader said that many families and NHS staff would be disappointed that she was not prepared to consider the case for greater independent scrutiny of what has happened.
He added: “Scottish Labour first called for an NHS recovery plan five weeks ago. When we did so, we called for a guarantee of access to both testing and PPE for all NHS and care workers in every part of Scotland. I thought that the First Minister agreed to that.
“Today, we have again been told that phase 2 of the easing of the lockdown is likely to start as early as next week.
“However, the health secretary admitted in Parliament just yesterday that there is still no plan for testing NHS staff, and still no plan to ensure the standard and supply of PPE across different NHS settings.
“I have been raising workers’ concerns about PPE since March. We know that, as far back as 2018, exercise iris concluded that: ‘Amongst frontline staff there is unease at the lack of clarity on PPE availability, training and testing.’
“We are two years on from that planning exercise, but now the pandemic is real and that unease remains. Staff tell me that their PPE is sub-optimal and that they are still being instructed to use PPE that is out of date, including critical equipment such as FFP3 respiratory masks.
“Will the First Minister give NHS and care staff a guarantee that PPE guidance and supplies will be enhanced, that out-of-date PPE will be withdrawn immediately, and that regular and routine testing will be rolled out without further delay?”
The First Minister batted away these “important issues” – “Very clear guidance is in place across all four UK nations on the circumstances in which PPE should be used. That guidance was informed by clinical groups and expert organisations.
“Ultimately, it says that if any member of staff—the member of staff themselves, not Government or their bosses—risk assesses that they should be using PPE, they should use PPE.
“We have also been working extremely hard to make sure that we have adequate supplies of PPE, and at no point during this crisis has Scotland run out of any pieces of PPE kit—in fact, we have been able to give mutual assistance in some respects to England.
“We have ensured those supplies and we are working to make sure that the distribution lines are as quick and effective as possible. We have put in place additional distribution lines—not just for healthcare workers but for social care workers. We have also been building a domestic supply chain for PPE, so that we have greater resilience for the future.
“To be clear on expiry dates—because we have covered the issue before on several occasions—the only circumstance in which PPE that has gone past its expiry date should be used is if it has been re-validated by the relevant authorities as being safe to use. If that has not been done, it should not be used.
“All those arrangements are in place. The health secretary speaks to trade unions regularly and if any concerns are raised, they are acted on.”