CARE HOMES: WHY IS GOVERNMENT DRAGGING ITS FEET ON PUBLIC INQUIRY?

Richard Leonard, Nicola Sturgeon, Donald Macaskill and Jeane Freeman.

By Bill Heaney

Why have the human rights of many of Scotland’s elderly and vulnerable care home residents been violated – and why is the Government dragging its feet on bringing forward a public inquiry into this which was promised by First Minister Nicola Sturgeon.

Scottish Labour leader Richard Leonard told parliament: “Back in July, the Scottish Human Rights Commission questioned whether what had happened in our care homes was a violation of the human rights of their residents: of the right to be free from inhuman and degrading treatment, of the right to non-discrimination, and even of the right to life itself.”

The Commission said that a public inquiry was needed, and that it should be independent, prompt, determine responsibility and subject to public scrutiny.

Mr Leonard asked: “The Government agreed with that. Why, six months later, are care home residents and their families still waiting?”

This was the debate that followed:

The First Minister (Nicola Sturgeon):   We work every single day with those on the front line and those who are working so hard in our care homes to keep their residents as safe as possible. As it is for businesses, this continues to be an incredibly difficult time for those in care homes and for their families.

We have given a clear and unambiguous commitment to an independent public inquiry, with human rights at its heart. We will pursue the implementation plans for a public inquiry as quickly as is feasible.

I made this point yesterday, and it is a really important one. Right now, particularly in the light of what we are facing with the new strain of the virus, my principal responsibility and the principal responsibility of the Deputy First Minister, the Cabinet Secretary for Health and Sport and every single minister in the Government is to focus on taking decisions now, on learning lessons and on changing policy where we can to ensure that we get through the next phase of the pandemic.

I referred to this yesterday: I noticed that the chief executive of Scottish Care, Donald Macaskill, when asked about this a few weeks ago, said that the organisation wanted an inquiry, but realised that “we cannot take staff away from the front-line duties of fighting a virus”.

If that happened, it would be, to use his words “a dangerous distraction which will cost lives”.

There is no doubt about the commitment to a public inquiry. I may be wrong, and events may have overtaken me, but I believe that we may still be the only Government in the UK that has given that clear and unambiguous commitment to a public inquiry.

However, we must focus on saving lives now. The virus is not done with us, unfortunately; it has just learned how to spread itself faster. The responsibility that I and my Government owe to the people of Scotland is to keep our focus on what we must do now, every single day.

Richard Leonard:  It is not just the Scottish Human Rights Commission that is making that call. Just this week, the Equality and Human Rights Commission in Scotland also called for a public inquiry into Covid deaths in Scotland’s care homes. It said that that was urgent, and it reported:

“We were told of situations where there were reduced or no visits by GPs and community nurses … Residents were not being transferred to acute settings and people nearing the end of their lives were not receiving palliative care.”

We know that, until mid-May, the Scottish Government guidance advised that anyone who was a long-term care home resident should not be admitted to hospital. Why on earth, 10 months into the pandemic, does the First Minister think that the EHRC still finds it necessary to recommend that Scotland’s care home residents must have “full and equal access to … healthcare”?

The First Minister:  I am sorry, but I just do not accept that characterisation of the Scottish Government’s advice. We have had this exchange before. Government often puts in place policy frameworks in the shape of advice on such matters, but the issue of whether or not an individual—whether in a care home or living in their own home or anywhere else—is admitted to hospital is a decision for clinicians, as is right and proper. It should never be for politicians to second-guess that.

The guidance makes the point that, for older people, particularly those nearing the end of their life, the best place for them to receive appropriate care is often in their own homes. For many older people, a care home is their own home. However, if a clinician thinks that they should be in hospital, that is exactly where they should be.

I do not disagree with what the Equality and Human Rights Commission is saying or with any of the calls for a public inquiry. It is not a question of whether there will be a public inquiry; on behalf of the Scottish Government, I can say that there certainly will be a public inquiry. It is a question of when it will be sensible and safe to have that inquiry.

My judgment, with which people are absolutely entitled to disagree—I appreciate that some in the chamber do—is that my responsibility right now is to focus on the immediate challenge of getting us through the next phase of the pandemic. We are perhaps at the most dangerous juncture now since February or March and my focus has to be there.

There will be a full public inquiry into not just care homes but all aspects of the handling of the pandemic. That is right and proper. Right now, however, the most important thing is to keep steering us through the pandemic as carefully and as safely as possible.

Richard Leonard:  The First Minister says that the advice is clinical and not governmental, but the letter that was issued on 13 March was from the Cabinet Secretary for Health and Sport, Jeane Freeman. I have the letter here—it is on Scottish Government-headed notepaper.

To go back to the situation that is affecting people in care homes, let me describe what daily life has been like in our care homes for the past ten months. Both of Angela’s parents live in the same care home in Livingstone. Angela said that “since March, they have been isolated, every day on their own, in their small rooms, almost imprisoned for being old. My mother is isolated, her health deteriorating, and she is losing the will to live because there are not enough staff to support the restrictions. For her, Covid has meant that she has lost the right to see her husband and family, to practise her chosen religion and to leave her home for even a bit of fresh air.”

We understand that the virus is highly contagious and that we must protect the most vulnerable, but care home residents deserve better than this.  In 2020, we have seen a record number of Covid-related deaths in Scotland’s care homes and the violation of the human rights of care home residents. Families have been torn apart from their loved ones. Will the First Minister work with all parties across the Parliament in 2021? Will she listen to the Scottish Human Rights Commission and the EHRC? Will she set up the long-awaited public inquiry and listen to the voices of people such as Angela, so that all our older people are finally treated with the dignity and respect that they deserve?

The First Minister:  Before I come to the really important matters, I will clear up something from Richard Leonard’s question. I did not say that the guidance was clinical advice rather than Scottish Government advice, but questioned Mr Leonard’s characterisation of what the advice said.

The guidance is Scottish Government advice, but I made the point that it does not countermand the decisions of clinicians, if the latter think that an older person should be in hospital. Those are important issues; let us not mischaracterise what we are each saying on the matter.

All of us understand that the pandemic has possibly affected no group in our society more, or harder, than the people who live in care homes and their families. I had occasion this past week to write, for the first time in my experience, to somebody whom I knew personally, who had lost their husband in a care home. Thousands of families across the country will have had the experience of dealing with the pandemic in a care home setting.

Our hearts break for them every day. I will not wait until 2021 to listen to people such as Angela; I listen to those voices, views and opinions literally every single day. I cannot always find the perfect balance for everybody in that situation, because there is no perfect balance: the virus is not fair, neither for people in care homes nor for anybody else.

We have to juggle all those difficult factors every single day and come to the safest possible outcomes for people. We will try to do that as best and as well as we can every day. In 2021, I hope that we will see the start of a public inquiry, because I hope that we will then be out of the acute phase of the pandemic at least, so that we can turn our attention to the inquiry.

I come back to the point that I would not do any favours or any good at all to people in care homes, families or anybody else across the country right now if I—with my Government and all the people with whom we have to work, including the care home sector—do not focus 100 per cent on trying to deal with those issues day in and day out. That is what we will continue to do.

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