In a few hours (at the time of writing) the consultation on the remit of the inquiry into all aspects of the Covid pandemic will be closed. The continued revelations about how Public Health Scotland broke the law in its attempts to, let’s say, minimise the political impact of information on Covid gives me reason for concern about this inquiry.
It concerns me because this became an issue which affected me deeply. I have edited I don’t know how many policy papers in my life but Nick Kempe’s The Predictable Crisis stands out in terms of how painful I found it to read. It is a study of what happened in the care homes during the first lockdown – and it is disturbing.
It is calmly written but brutal to read, painful to think about and difficult to come to terms with. During the very early stages of the pandemic, in a rush to free up beds, lots of vulnerable elderly people were moved out of hospitals and into care homes.
This left them in a sort of health no-man’s-land. They didn’t have proper access to NHS services but the care homes are not generally medical providers and even the best of them struggled to get access to equipment like PPE or oxygen.
If they had Covid, they likely weren’t cared for by the NHS and they couldn’t be cared for properly by the care homes. And with the speed at which things were happening, the suspension of spot checks by the Care Inspectorate, the sudden lockdown and the inability of families to see the conditions in which loved ones were living, we don’t really know for sure what happened.
But we know what probably happened given all of the above. It is very likely that vulnerable elderly people died without sufficient palliative care, which is just a clinical way to say they were left alone to suffer a horrible disease with little or nothing to reduce the suffering.
They had limited pain medication, they lacked respirators and oxygen, they had very limited contact with staff who were not themselves protected properly from the disease. Doors were often locked to contain residents who might have wandered and spread illness. And inevitably some would have been suffering from different degrees of dementia.
To stop and think about this for a second is to feel horror. If at the end of my life I was to be confused, uncertain, forgetful. If I was to then be locked in a room and to see a carer only a few times a day and behind a mask I didn’t understand the purpose of.
If I was separated from my loved ones and to be alone. And if my fate was to die slowly in pain and without the assistance to take my final breaths with any comfort, I struggle to imagine what kind of end that would be. But it fills me with fear.
I am of the Hutton generation that observed a hand-picked establishment figure carry out a whitewash
At the UK level there has been widespread discussion of whether there is criminal liability involved in this, that a case of criminal neglect might be brought against the government. This is because the UK Government knowingly sent patients into care homes without testing them, knowing a virulent disease likely to prove fatal to them was reaching pandemic stage.
The situation in Scotland isn’t the same as this – it’s worse. In Scotland we did test some of the people who were decanted from hospital to care homes. And some of them tested positive – but we sent them to the care homes anyway. And we kept doing it until it was uncovered in the media weeks later.
It is false to say that there was no knowledge of asymptomatic transmission as the WHO had already alerted governments to this. It is false to fall back on the claim from Public Health Scotland that this was unconnected to care home deaths, a clearly distorted claim they have now withdrawn.
I have never had much time for ‘scalp hunting’ in party politics. It is an element of the personalisation of politics that I don’t like. On the whole, failures like that of the care homes during Covid cannot be claimed as the responsibility of one person. In fact a large part of the message of Nick’s paper was that the state of the provision of residential care for end of life made something like this almost inevitable.
But that does not excuse anyone from the decisions that were made or the attempts to disguise those decisions and their consequences. There must be accountability.
That is only one of many concerning questions which have never really been answered. From failing to tell Scotland about the first Covid case in Scotland onwards there is much which must be interrogated.
I am of the Hutton generation that observed a hand-picked establishment figure carry out a review of the run-up to the Iraq war and then publish a report which seemed to ignore completely the extensive evidence of malpractice that was presented to him. It was almost universally recognised as a whitewash and it took another 12 years before the Chilcot Inquiry produce a true and damning assessment.
I remember that during the evidence sessions Hutton held, commentators said that the evidence was so clear, so blatant and so damning that there was no way this could be swept under the carpet. I agreed with them. They were wrong, I was wrong.
That cannot happen this time. That cannot be the legacy of Covid. For the sake of the dead and for the sake of the living, for the horror of the last days of an elderly dementia sufferer who died alone in pain and bewilderment, we must have full transparency on what happened and full accountability for what was done. Nothing less than that can be acceptable.