This morning, Gordon Brewer opened with:
The man who represents Scotland’s private care homes says new government guidelines in homes which don’t have coronavirus are just wrong and that there was a spike of admissions to care homes in March as hospital cleared beds to be used with patients with covid-19.
As it transpires, he does appear to agree with the first point but not the second. Brewer tries to pressurise him into agreeing. It becomes one of the worst examples of unethical, bad, journalism I’ve seen and certainly the worst from a supposedly grown man.
Brewer, like any 18 year-old thinks he knows what the answer is and just needs someone in authority to agree with him, after someone in authority, last week, Jeane Freeman, wouldn’t give in and treated him like a 16 year-old.
This week, he had clearly not forgotten and in an astonishingly excited interview, with a reluctant Donald McAskill, CE of Scottish Care, he repeatedly tried to force words into his mouth.
Here is what he wanted confirmed. The Scottish Government’s guidelines for care home managers were unclear, hospitals were dumping untested patients on the homes to clear beds, this cause a spike in admissions of infected patients and so the Scottish Government is to blame for the surge in deaths. There is no evidence for this claim and it may turn out that the practice of staff moving between homes, the bussing in of temporary staff from as far away as Kent and the UK Government-delayed lock-down were more significant.
I should make clear a few things. First care home managers can decide who to accept into the home. Care homes have been dealing with viral and bacterial infections for decades and should have well-tested procedures in place including isolation of new arrivals and strict hygiene. They should also have a stock of PPE at all times. For many older patients, especially those with dementia, the mental trauma of attending critical care and the infection risks in hospitals may outweigh the risk of remaining in the care home. Finally, all admissions had to have had at least one negative test result.
Brewer opens with:
As the majority of coronavirus deaths continue to take place in care homes, tensions between providers and the Scottish Government are growing.
From the NRS: 45% of COVID-19 deaths registered to date related to deaths in care homes. 48% of deaths were in hospitals and 7% of deaths were at home or non-institutional settings.
It is 72% in care homes in England.
Here are Brewer’s questions:
One of the concerns, wasn’t it, was that there was a presumption almost that people from care homes who had coronavirus should not be admitted to acute care. That was one of the concerns. I mean, I don’t know if it’s possible to assess this but do you think that people who should have gone to hospital under the current guidelines have not being going to hospital over the last couple of months because of the previous guidelines?
There is also a view. It was put by one columnist in a newspaper this morning very bluntly that at the beginning of this there was an understandable desire to clear out acute wards in hospitals in order to make room for what was expected to be a possible overwhelming surge in coronavirus patients and that in effect elderly people were dumped out of hospitals into care homes! Now there is a letter from NHS England but that wouldn’t apply up here which talked about getting 30% clear-out rates in hospitals. Did that happen here? Was there a spike in admissions to care homes in the middle of March?
Macaskill will not play along and insists that no such claims can be made. He goes on to assert the ability of the care home manager to decide who can be admitted.
With particular regard to the alleged spike, he says:
I think I would describe it as a significant increase on normal admissions to care homes for a very brief period of time but we’ve got to be careful in assuming that that resulted in a universal spiking of coronavirus in the care home sector. There may have been instances. Those will be explored
So, there was not ‘a spike of admissions to care homes in March.’
Brewer’s thesis that Scottish Government initiatives to clear space in acute care, lack of testing and unclear guidance on admissions may have caused mass care home deaths does not hold up. At the same time as increased transfers might have been made of patients with at least one negative test result from hospitals into care homes, family members were still visiting until the middle of March, staff were still travelling between homes, temporary staff were being bussed-in from all over and infection controls may not always have been yet running fully. In England, 21 care homes were failed for infection control inadequacies in the early part of 2020. So far, in Scotland, only the Skye home has been exposed.