Welsh Government insists it acted on scientific advice when releasing patients to care homes in Covid crisis
Martin Shipton
The Welsh Government has doubled down on its disputed narrative that it was following scientific advice when it continued discharging untested patients to care homes during the pandemic.
The delay in halting such discharges has been blamed for causing many avoidable deaths, but Nageena Khalique KC, representing the Welsh Government, told the UK Covid Inquiry: “On hospital discharge, [former Health Minister] Vaughan Gething, in his evidence, explained that the discharge framework dated March 13 2020 was underpinned by the need to manage the risk that Wales as a whole was facing, at that time, of the potential catastrophic collapse of the health and social care system.
“In this, and in all other decisions during the pandemic, as noted by Mr Gething, the Welsh Government considered the balance of harms inherent in one decision as against the alternative.
“Decisions had to be taken at pace, and were based on, to quote Mr Gething’s words, ‘the best understanding of the scientific and medical evidence available at the time.”
“You also heard from [Chief Social Care Officer for Wales] Albert Heaney. He accepted that, with the benefit of hindsight, it would have been better to test upon discharge from the beginning of the discharge framework being in place, but that approach was not in the scientific or medical advice at the time.
“Mr Gething confirmed in his evidence that decisions on asymptomatic testing were similarly based on the scientific advice available at the time, and not based on testing capacity. However, you heard from Mr Gething that had the advice to engage in asymptomatic testing come earlier, the reality is that the government would have faced the very practical challenge of delivery and how to prioritise the tests available.
“In May 2020 targeted asymptomatic testing was introduced in care homes. General asymptomatic testing in care homes was not introduced before May 16 because the advice received up to that point by the Welsh Government was that the scientific evidence did not support it.
“You also heard in evidence that the advice relating to asymptomatic testing of all care home residents, that was referred to by [former UK Health Secretary] Matt Hancock in a Health Ministers’ meeting on May 5 2020 was never shared with the Welsh Government at any level, nor were its contents reflected in SAGE [Scientific Advisory Group for Emergencies] advice at that time.
“ … Overall, and to conclude, throughout the pandemic the Welsh Government was committed to protecting the people living and working in the care sector, and balancing the protection of the health and well-being of recipients of care and the need to save lives.”
Testing in care homes
Responding to Ms Khalique’s closing statement to Module 6 of the Inquiry, covering care homes, the Covid Bereaved Families for Justice Cymru campaign group issued a statement that said: “Yesterday we explained to the Inquiry that the Welsh Government knew full well of the scientific evidence in favour of testing in care homes, and we quoted from a Welsh Government document from April 18 2020 that stated as follows: ‘Evidence suggests that this approach results in asymptomatic Covid-19 individuals, many of whom will go on to develop symptoms, not being identified and a source of ongoing risk to residents and staff…International evidence suggests that increasing testing in care homes for asymptomatic staff will provide added protection against the virus.’
“Incredibly, today at the Inquiry the Welsh Government denied knowledge of their own document and continued to claim that the advice they received at this time was that scientific evidence did not support testing in care homes.”
‘Fallacious’
Robin Allen KC, for the Welsh Local Government Association (WLGA), told the Inquiry: “Despite the evidence to the contrary from the former Minister for Health and Social Services, Vaughan Gething, any assumption that social care settings are safer than hospitals must be rejected as a fallacious generalisation. No future policy should be built on this assumption. Policy must be built on the recognition of the many and varied constraints on delivering residential care.
“ … The WLGA emphasises the importance of investing in the workforce. It is not enough for the Chief Social Care Officer for Wales, Albert Heaney, to have noted how the system is very fragile, with problems of high turnover of staff, and a very low-paid workforce.
“It is obvious that such fragility, if continued, will cost lives in a future pandemic. So the WLGA emphasise, this is the time for urgent meaningful action to improve the resilience and quality of the social care sector, and to rebuild public confidence.”
‘Poignant’
In one of the final pieces of evidence given to Module 6, Cate Griffiths, whose father Group Captain Harold Griffiths died after being one of 45 residents of a care home in north Wales who tested positive for Covid-19 during a cluster outbreak, said: “I appreciate this chance to have my voice heard. I’m speaking on behalf of the many thousands who no longer have a voice, as well as the bereaved families in Wales.
“In the summer, during a lucid moment on the phone before my dad died, he asked me if I felt that the Welsh Government was looking after us, if it was making good decisions for us. Poignant and prescient, in retrospect.
“Care home residents were and remain, as we know, a singularly vulnerable group. These precious people, people who have contributed both societally and fiscally to our country throughout their lives, needed to be protected.
“From what I’ve heard over these last weeks, none of the institutions responsible for the protection of Welsh care home residents did that. It is heartbreaking and it compounds our grief.
“If we’re lucky, we will grow old. But age does not diminish the value of our one wild and precious life, to quote the American poet, Mary Oliver. My father was old. My father deserved better. We all deserve better.”
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Labour’s victory in the post-COVID elections, propped up by their shameless slogan “we kept Wales safe,” is infuriating—because it simply isn’t true! Anyone with a shred of sense could have seen the disaster looming: transferring vulnerable patients from hospitals into care homes was a reckless gamble, one that put the most fragile lives directly in harm’s way. The outcome was tragically predictable, and it is enraging to see such decisions brushed aside as if they were prudent or heroic. How can anyone defend such recklessness? Care homes—supposed sanctuaries for the vulnerable—became battlegrounds where profit mattered more than people. The staff,… Read more »
For balance, this is the English administration’s view on this approach:
“Hancock: Moving patients from hospitals to care homes was least-worst decision.
Appearing before the inquiry on Wednesday, Mr Hancock acknowledged the discharge policy was an “incredibly contentious issue”, but he added: “Nobody has yet provided me with an alternative that was available at the time that would have saved more lives.”
https://www.standard.co.uk/news/politics/matt-hancock-simon-stevens-nhs-ppe-government-b1235989.html
THE SECOND WAVE When the Welsh Government was fully in control, Wales had a higher death toll than England and a strong narrative has developed that the Welsh Government, though caution and care, protected Wales from the worst of the pandemic. It is often compared to the UK Government’s handling in England. Without underplaying the serious errors made by the UK Government the data simply doesn’t bear up the idea that the Welsh Government handled this pandemic well. A good way to assess the Welsh Government’s performance is to look at the second wave of the pandemic. Unlike the first… Read more »
Gentle reminder that Sunak’s irresponsible Eat Out To Help Spread The Virus campaign was forced on Wales by Whitehall.
Sounds like even more desperate covering of arses going on in high places. Maybe these people would be best advised to come clean and admit that guesswork and blind panic were the main characteristics of their behaviours during the early stages of the Covid crisis.
So science is different in Wales from Sweden? In Sweden the Covid response was led by a panel of scientists not politicians. Asymptomatic transmission was known early in the pandemic prior to availability of fast turnaround testing. The approach was to quarantine existing care homes, and pop-up ones for hospital discharges, concurrent with less stringent generalised lockdowns. The result was half the ‘excess deaths’ during the pandemic. We all knew mortality in the young was low but very high in older age groups. Gething was not acting on scientific advise, but cowardice. Not wanting to be out of step with… Read more »
Two big differences. First, Sweden is a more socially responsible country because they didn’t have a Thatcher replacing society with individualim. Guidance and policies always reflect what people can be expected to do. Second, governance across the UK struggles with learned helplessness because it’s traditionally been highly centralised and run by a small cabal of privately educated duffers that couldn’t get real jobs who were much better at gaslighting than governance. This got even worse when Thatcher neutered local government. Devolution is the fix for this but it has a long way to go.
Am not convinced the rural estate in Dorset that Vaughan Gething grew up in was necessarily a ghetto or that Atlantic College which Eluned Morgan went to in the Vale of Glamorgan was necessarily a rough school. Thatcher was terrible for Wales but important to note that Wales has been run by labour for the last 25 years.
The point was about low quality governance from Whitehall who are still responsible for the majority of governance in Wales. But specifically on the covid response it’s worth pointing out that Johnson ripped up an established and rehersed set of protocols for effective intergovernmental working during an emergency, and replaced it with the Coronavirus Act. The reasons for this have not been satisfactorily explained so we can only speculate that the architect of muscular unionism didn’t want to see the English administration working as a team with the devolved administrations and instead wanted to dump a tonne of extra responsibilities… Read more »
“So science is different in Wales from Sweden?” This is a tired easy thing to say. I remember many in Wales who wanted us to blindly follow what Johnson did in England saying a similar thing – England must be right Wales always wrong. Boris Johnson, the new Winston Churchill, was infallible.
Yes, but the key (and unclear) point here is the status of the document of 18 April 2020? Was it advice put to Gething and other Welsh Ministers or an email exchange between civil servants which never went up the hierarchy? Something in between? Important to be clear because very different conclusions can be drawn depending on the answer.
But it’s all a distraction if there was no real alternative. Isn’t Mr Hancock right to say “nobody has yet provided me with an alternative that was available at the time that would have saved more lives”. The only thing that might have changed the outcome is the extra 5000 tests per day from Roche that were stolen by England.
I tend to agree that there was no obvious alternative at the time. The reality is that in all sorts of circumstances social care is seen as a lesser priority than the NHS – and the panic at the time was that hospitals would be overwhelmed. However, the point of my original post was to establish who is telling the truth here. The answer seems to rest upon the nature/status of that document, perhaps others. Either there was scientific evidence or there wasn’t?
This wouldn’t be the first time in human history that the left hand didn’t know what the right was doing, but what does proving that achieve if it was inconsequential? What matters now is improving the way social care is managed and prioritised, and understanding why 5000 tests were promised then unpromised. Because it should be clear to everyone that if testing was unlimited everyone including in social care settings would’ve been tested from the start. So this clearly was a consequential event.
I think it is important to get to the truth (a) because the bereaved need closure; and (b) if the Welsh government claims are false, then what credibility does the rest of their pandemic decision making have? I have no doubt that there was a shortage of testing capacity early in 2020; but the public need to know whether decisions are made on real evidence or convenient general assumptions. As for improving social care, we have a long wait. The UK and devolved governments kicked it into the long grass 15 years ago by not acting on the Dilnott report.… Read more »
This inquiry has limited resources. Every minute spent understand matters that everyone agrees couldn’t have been done differently is a minute that isn’t spent understanding that could have been. 5000 extra tests per day could have saved lives. It’s difficult to see how families can achieve closure without understanding how that happened.
Senedd is acting on scientific advice over climate change, anybody really checked that out? What it is costing the economy for no real global change, and to be completed within the next ‘ magic’ 5 to 25 years, anybody?