First Minister Nicola Sturgeon and Tory leader Ruth Davidson clashed over care homes in the Scottish Parliament.

By Bill Heaney

Fiery stand-in Tory leader Ruth Davidson is keen to make a significant mark before she goes to Westminster to take up her seat in the House of Lords.
Davidson returned to the vexed subject of care homes and how they were treated by the SNP government at the start of the Covid pandemic.
She told First Minister Nicola Sturgeon that she had not received a satisfactory answer when she last raised the matter – “Let me ask again: when was the First Minster first informed that Covid-positive patients had been transferred into care homes? Was she first told in March, April, May, June, July or August?”
However, the FM continues back sliding when it comes to the question everyone wants a definitive answer to.
She said: “We are still waiting for the analysis from Public Health Scotland of the numbers of people discharged from hospital into care homes who may have had the virus, whether they had been tested and what the circumstances were. We will make that information available fully as soon as it is available.
“Ministers set the policy. The guidance was clear from 13 March about the need to clinically assess patients being discharged from hospital before being admitted to care homes. Neither I nor any other minister would expect to know the individual details of the clinical risk assessment that was undertaken in respect of any patient.
Of course, ministers were clear—indeed, we made it clear to the Parliament—that it was our objective, as it has been for many years, to reduce the numbers of people in delayed discharge in our hospitals. We set an initial target of doing that by 400. We then said that we had exceeded the target.”
This suggested that the decision was based more on the ongoing problem of bed-blocking that dealing with Covid-19.
The FM added: “Ministers have been clear about the policy objectives that we set and about the guidance that has been put in place. However, ministers in this Government—I am pretty sure that this will have been the case in previous Governments and in other Governments across the United Kingdom—are not party to the clinical risk assessments that are done on individual patients.”
No one asked why Ministers were asked to make assessments when they did not have the full details about patients’ medical state to hand.
Ruth Davidson looked angry. She said: “We will get on to the policy objective in a minute, but that is the fourth time that that question has been asked at First Minister’s question—twice by me last week, once by Richard Leonard and once by me again today—and it is the fourth time that the First Minister has ducked it.
“I cannot work out why. She keeps on saying that the Government will be open about its mistakes. Putting people with Covid into care homes was clearly a mistake, and part of fixing mistakes is working out who knew what when.
Either the situation happened and the Government knew that it had happened and that informed its later decision making, or the situation happened without the Government knowing and it found out, as the rest of us did, only through a newspaper report last week. Which is it?”

The First Minister replied: “Ruth Davidson has asked the question and I am answering the question. I do not know the clinical condition of patients who are being discharged from hospital to their homes, community settings or care homes. That is not information that ministers would have.”

No one asked why this was the case.

Ms Sturgeon added: “We have asked Public Health Scotland—I think that I am correct in saying that we are the only Government in the UK so far to ask for this information—to look in detail at the situation with patients being discharged from hospital to care homes, whether they were Covid positive, whether they had been tested and, if not, what the rationale for that was. When we have that information, we will, transparently and fully, make it available to Parliament, and I am sure that we will have further exchanges on that.

“It is the responsibility of Government to set the guidance, and the first guidance on Covid was issued to care homes on 13 March. I think that we have talked about the contents before. The guidance was updated as appropriate.

Of course, we very openly and transparently set an objective of reducing delayed discharge. It is interesting that Opposition politicians are now trying to suggest that they did not know that that was the case, because we set that out to Parliament.

“The Cabinet Secretary for Health and Sport [Jeane Freeman] set it out on 17 March, I talked about it on 1 April and the health secretary talked about it again in Parliament on 1 April.”

But Davidson would not be put off. She said: “I am well aware that individual discharges are clinical decisions, but I do not understand why the First Minister will not say when she was first informed that discharges had occurred.

“Perhaps we should recap on what has changed between last week, when I asked the same questions, and now.

“We have learned that NHS Scotland wrote to health boards on 6 March—more than two weeks before lockdown—to tell them to move patients out of hospital.

“We know that a target was set to move 900 patients out of hospital by the end of April. We have learned that, in early April, the Cabinet Secretary for Health and Sport congratulated health boards on their tremendous progress in doing so.

“Despite the First Minister’s previous protestations, which have changed today, we have learned that the Government was driving the policy, yet it appears that we are also supposed to believe that the Government knew nothing about how the policy was being achieved and was not aware of the decision to move Covid-positive patients into care homes. Is that really credible?”

Health Secretary Jeane Freeman and Castleview care home in Dumbarton.

The First Minister continued to insist that it was announced in parliament on March 17 that a policy statement by Jeane Freeman on March 17 – “If it is the case that Ruth Davidson learned about the policy only in the past couple of weeks, that raises more questions about her attention to the situation than about anything else. On 17 March, the health secretary stood up in Parliament and said: ‘“I have set a goal of reducing delayed discharges by at least 400 by the end of this month.”

She added: “If the Conservatives did not know that the policy objective was to reduce delayed discharge—for years, Opposition politicians have rightly been pressuring the Government to do that—for the additional objective of freeing up hospital capacity because of what we thought was about to happen to our hospitals, I have to wonder where they were and what they were paying attention to, because it was not what was going on with Covid.”


Ruth Davidson observed: “The First Minister is clearly irked by this line of questioning. We have spoken to a number of families who have been affected, and they want to know why, when and how many Covid patients were put into the care homes in which their loved ones died. Nearly 2,000 people have died in Scottish care homes throughout the crisis.

“We have called for the public inquiry into care homes to start immediately, because it is not right, and nor is it fair on families, to have information emerge bit by bit, piece by piece. Families deserve answers now. It should not be left to freedom of information requests or newspaper investigations to find out what happened, one piece of correspondence at a time.

“If the First Minister will not start the public inquiry now—she has said that she will not—will she at least commit today to publish all the correspondence between herself, the health secretary, NHS boards and care homes throughout the pandemic in order to give families the clarity that they deserve?

The First Minister said the information sought would be available for inspection by the end of September – “I am happy to make any relevant information available, but I am going further than that, as the Cabinet Secretary for Health and Sport has already set out.

“I happen to agree that it is right that families get answers to any questions that they have. That is why, unlike our counterparts in any of the other Governments in the United Kingdom as far as I am aware, this Government has asked Public Health Scotland to specifically consider those questions and whether patients who were discharged from hospitals to care homes were tested.

“If they were not, why not; and whether they had Covid. We have asked that the exercise be completed by the end of September, and we will publish it in full. We will have the information here and, when it is available, not only can the questions be answered but the answers can be scrutinised by the Opposition.

It is not the case that policies were not in place—we had guidance in place for care homes, which included a requirement to do a risk assessment for patients. We also had guidance in place on infection prevention and control in care homes. Those are the appropriate things that we should have done, and we will continue to ensure that such matters are subject to scrutiny and transparency as we learn lessons and continue to navigate our way through the pandemic.”

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