Meeting of the Parliament (Hybrid) 04 November 2020
Covid-19 is the biggest public health crisis that we have faced in our lifetime, and the impact on care homes across the world has been profound. Every life lost to the virus is a tragedy and a loss that will be deeply grieved by loved ones. I send my condolences to anyone who has experienced the loss of a loved one to this serious virus. I also thank care home staff for their valuable work.
As I listened to the speeches so far, I reflected on where I was, and where we all were, at the start of the pandemic. We did not know a lot about the virus. I was one of those folks who was eager to return to the NHS front line and to help with what Alex Cole-Hamilton has just called the “tsunami of Covid cases” that we expected to receive in hospitals across Scotland.
I am clear that the Public Health Scotland analysis does not find statistical evidence that hospital discharges were associated with care home outbreaks. As a direct response to the Conservative motion, I can say that the First Minister and the health secretary have confirmed that a public inquiry will be held that will look into every aspect of the crisis, including what has happened in care homes. However, we are in the midst of an increase in cases—a second wave of the virus—and right now is simply not the time for a public inquiry, although I agree that one is needed and I welcome the commitment that it will happen.
It is important to note the point that we have got to. The health secretary commissioned the Public Health Scotland report in August
“to identify and report on discharges from NHS Hospitals to care homes during the first wave of the COVID-19 Pandemic.”
The report was commissioned because it is right that residents, families, staff and the Parliament have accurate data on and independent analysis of the transfer of patients to care homes and the impact on care homes.
The report states on page 42 that
“The analysis does not find statistical evidence that hospital discharges of any kind were associated with care home outbreaks.”
It also states that PHS
“cannot statistically exclude the presence of a small risk from hospital discharge. By comparison though, the risk of an outbreak associated with care home size is much larger than any plausible risk from hospital discharge.”
The cabinet secretary has already described that.
The report notes that 3.7 per cent of care homes with fewer than 20 registered places had an outbreak over the period. In comparison, 90.2 per cent of care homes with more than 90 places had an outbreak over the same period. The report noted that hospital discharge was
“associated with an increased risk of an outbreak when considered on its own. However, after accounting for care home size and other care home characteristics, the estimated risk”
was not “statistically significant.”
The Scottish Government will take forward the recommendations that PHS makes in its report, and PHS will now carry out further work to give a more detailed understanding of Covid-19 outbreaks in care homes. The Scottish Government will act on the areas in which the report’s conclusions highlight the need for additional measures.
I welcome the steps that the Scottish Government has already taken to ensure that additional safeguards, such as testing when clinically appropriate, are in place when discharge from hospital into care homes takes place.
Guidance has been clear—