Meeting of the Parliament (Hybrid) 19 May 2020
Part of the difficulty—I mentioned this early in my statement—is that the care home sector is primarily delivered by private business. Some 70-odd per cent of care homes are private businesses, whether they are individual small businesses or part of a much larger chain. There are also, of course, independent, third sector and public authority care homes, but they are in the minority. In such circumstances, my capacity—or any health secretary’s capacity—to direct and instruct is limited in a way that it is not in the health service.
As Jackie Baillie will recall, some time ago—in early March, I think—I put the national health service in Scotland on an emergency footing in order to ensure that, regardless of individual board opinion, I could be sure that it was doing the things that I thought that it needed to be doing in a consistent way across the country. The care home sector is not like that, so there is, of necessity, a different approach. Whether that is the right place for us to be and whether we want to be in a different place in the medium to longer term are important issues for debate for a different day. I have to deal with the current reality of the sector.
I would not dispute any of the points about the reluctance of providers to send staff for testing and PPE in cupboards. The point of the significantly enhanced clinical guidance, direction and intervention is to overcome those problems as best I can.
The Care Inspectorate took the view—as it was entitled to—that, in the face of the pandemic, it was safest for residents of the care homes for it to undertake inspections and engagement with care homes that did not involve its directly appearing in the home. It has now changed that position in order to directly inspect what is happening in those care homes, and I am glad that it has done that. That is a welcome change of decision.