John Swinney: Ministers under 'cross-party pressure' to discharge hospital patients during Covid

He said care home residents were discharged from hospital to be in a more supportive and "safer environment" during the Covid pandemic.

And he added that ministers made decisions based on scientific advice and any decision to discharge a patient was based on "clinical assessment".

Mr Swinney said the Scottish government faced cross-party pressure to discharge patients and free up space in hospitals.

"It was a difficult period for ministers to meet the right judgement where the scientific view was formulating. I think that's the best way I could describe it. And scientists were doing their level best and clinicians were doing their level best to give us clear information as as they possibly could do," he said.

"I think what's important to reflect is that back in the spring of 2020, all political parties were arguing that the government should encourage the discharge of individuals from hospitals, which I think generally were viewed to be the places that were going to be most seriously affected by Covid, into care homes. 

"And there was cross party pressure on the government to ensure that was the case so that individuals who were in hospital with no clinical reason why they should be there, these people who are defined as delayed discharge patients, could be in a more supportive surrounding of a care home and in the context of Covid a safer environment."

Mr Swinney, the cabinet secretary for Covid Recovery since 2021, spoke after the High Court in London ruled on Wednesday that ministers in the UK government had acted illegally by transferring elderly people into residential care in England without taking into account the danger from the asymptomatic transmission of the virus.

He said the ruling related to circumstances that were 'similar but not identical' to the approach in Scotland.

Senior figures, including the UK Government’s chief scientific adviser for England, Sir Patrick Vallance, said very early on, that it was quite likely Covid could be caught from someone without symptoms.

Mr Swinney added: "Now, obviously, we were taking judgments based on the clinical advice that we were receiving, and any decision to discharge a patient was similarly being undertaken after clinical assessment.

"So all of these questions were being looked at very carefully by clinicians and by ministers, but ultimately, the decision as to whether a patient left a hospital to go to a care home was fundamentally a decision for clinicians to be undertaken in consultation with care homes home with families."

Fears have emerged that an inquiry into the handling of the pandemic could take years to conclude - leading to worries that families of the bereaved could end up being time-barred from taking court cases for negligence.

Last week, Nicola Sturgeon refused to say if the Scottish Government broke the law by discharging untested patients from hospitals to care homes at the start of the Covid pandemic.

The Scottish Government has committed to beginning a public inquiry into the pandemic this year. But the Conservatives has been calling on SNP ministers to “publish an interim report of the Scottish Covid public inquiry as soon as possible to inform our recovery”.

Asked if after the English high court findings whether he accepted the same things happened in Scotland, Mr Swinney said: "The ruling relates to the situation and the circumstances that pertain within England and we took an approach in Scotland, which was similar but not identical.

"And it's important that all of these issues that have been raised, the experience, the traumatic experience that people have had, throughout the pandemic, and particularly the experience of families who lost loved ones, and especially those who have lost loved ones in care homes are properly and fully examined. And that's exactly why we've made this a fundamental part of the remits of the public inquiry."

Asked in a BBC interview  if that meant, that while there was a divergence in some areas in the Scottish Government approach, whether it was fair to say criticism can be applied up here over a failure to take into account the risks to residents through asymptomatic transmission, he said it was "absolutely fundamental" that ministers address that.

But he said the significance asymptomatic testing was an evolving affair at the start of the Covid pandemic and did not get "to a point of certainty" until late spring in 2020.

He said: "At the time what was trying to be achieved was to try to create the safest environment possible for everybody concerned because we knew from international experience that our hospitals were going to come under enormous pressure with Covid infection."

He said it was in the context of "enormous risk of infection in our hospitals" that there were attempts to find the "safest environment possible for individuals, who had no reason for them to be still in hospital because they were clinically safe to be supported either in a care home or in their own home."

"So these judgments were being made and that was explicit within the the health secretary and the chief medical officer's letter of the 13th of March. It explicitly indicates that individual cases should be assessed before any discharges are made from a hospital to make sure that's the right outcome and approach to be taken," he said.

He added: "What the public inquiry has got to do is to explore and examine all of those issues to determine whether things could have been done better."

Asked if it would take years to get results from an inquiry he said "that doesn't necessarily need to be the case".

He added: I've listened with enormous care to the bereaved families and I have the greatest of sympathy for them, and I hope that they feel I've listened with care to their perspectives. From that I've made sure that the remit of the inquiry is as broad as it possibly can be to cover all eventualities and all circumstances so that people do get the proper and full answers about what happened in the Covid pandemic."

Concerns emerged about failings through lack of testing, and not taking into account whether care homes were properly prepared when at the start of the pandemic, in February and March over one in three patients (1500) on delayed discharge were moved to care homes and 2,800 went home.

Analysis showed the number of patients who had delayed discharges fell by 28% as demand for beds soared during the pandemic.

Mr Swinney said that there had been different Covid advice on a host of different questions at the start of the pandemic.

"This was of the greatest and gravest of seriousness. And that period in March, April, May of 2020 was was an extraordinarily difficult period for everybody involved."

Craig Hoy, the Scottish Conservatives' shadow minister for social care and mental health urged ministers to make sure that families of the bereaved "get the answers as quickly as possible".

He told the BBC's The Sunday Show: "We're now more than two years into the pandemic and those who lost loved ones are looking for answers, they're looking to see who was responsible for taking those decisions, because only by getting those answers and getting those facts, will they get the justice and then ultimately the closure that they want so they can go on and properly grieve the family members that they lost.

"The Conservative Party in the UK, obviously grappling with the same levels of advice. But what is quite clear is that something very, very serious went wrong. And I think when you look back and see the images that we saw coming from Spain and Italy, we should have been thinking at that point that we needed to put a very protective system around care rooms, they bore the brunt of this pandemic, and lessons quite clearly need to be learned.

"All parties should have been thinking about that. But it was quite clear to me know that when you look at the situation, that what those families, the families that are campaigning want, is they want to know what decisions were taken by whom and when. And it's quite clear that there were serious issues, there were serious failings and they didn't just carry on for a few days or a few weeks."

Plans to extend coronavirus testing to all care home staff were announced by the Health Secretary on May 18. Jeane Freeman said all care home staff in Scotland would be offered routine tests in a bid to curb following evidence from health officials that workers were the main vectors of the disease.

Before that, guidance in March said that people admitted to care homes should be isolated in their rooms for 14 days.