In the session of the UK Covid Inquiry held on 29th January which considered evidence from the former Scottish Cabinet Secretary for Health, Jeane Freeman, there were no less than 24 references to “Dr”, “Mr” or “Donald” Macaskill, the Chief Executive of Scottish Care. This was twice the twelve references made to Dr Catherine Calderwood, the Chief Medical Officer and lead adviser to the Scottish Government on responding to the pandemic, and far more than any of the other named senior health staff providing advice to Ms Freeman.
Mr MacAskill had also presented evidence to the inquiry and while a significant number of the references to him were made or prompted by the KC questioning Ms Freeman, a significant number weren’t. In fact, when giving examples of people she had sought advice from on social care during the pandemic, the only person Jeane Freeman ever named was Mr MacAskill.
By contrast, Ms Freeman gave two references to nameless “health” Trade Union Leaders and not a single reference, named or not, to anyone with social care expertise working in the public or voluntary sector. The Chief Social Work Officer, the Chief Executives of the Care Inspectorate and Scottish Social Services Council responsible for regulating the sector, the Chief Executive of the Coalition of Care and Support Providers, representing the voluntary sector, none merited a mention in Ms Freeman’s memory.
Moreover, Ms Freeman made just two references to COSLA in her evidence, despite stating that “local authorities have a significant responsibility for commissioning that service [care homes]” and despite the KC noting that the cabinet minutes of 10th March recorded that “COSLA had been invited to provide a co-ordination role across Scottish local authorities”. Had the Scottish Government been effectively working with councils one might have expected several references to either the Leader or Chief Executive of Cosla and maybe their counterparts in a selection of local authorities.
Three of Ms Freeman’s statements are particularly revealing. In the first she claimed “the data that Scottish Government held was limited, about the exact number of care homes, and
I believe we actually for the first time got the information from Dr Macaskill in Scottish Care about his membership and about the size and spread of those care homes, in other words the number of residents they might have, their staffing levels and so on.”
This is quite extraordinary. The Cabinet Health Secretary appears to have been quite unaware of the extensive information held by the Scottish Government, both in the form of the statistics which it produces annually and through the Care Inspectorate’s data store which any member of the public can access. But she then thought it appropriate to approach Scottish Care, who primarily represent the private sector and not even all of that. Unfortunately, the KC never asked Ms Freeman why Scottish Care would have better information than that care homes are legally required to submit to the Care Inspectorate or what Mr Macaskill advised about this.
Ms Freeman’s second very revealing statement was in response to a question about advice on management of Covid symptoms: “So the symptoms of Covid, from memory, came to us from
the four CMO [Chief Medical Officer] discussions, and I don’t think -I certainly didn’t feel competent to question whether it was a cough or not a cough, or a sense of smell or whatever, but I did discuss with Mr Macaskill prior to June 2020……….”. In other words, it appears the Cabinet Secretary for Health chose to listen to Dr Macaskill, the voice of the private sector, who has a doctorate but is not a medical doctor, before her own public sector experts.
Third, “as soon as it was made clear to me that that pre-pandemic position was struggling to produce the level of PPE in the quantity or of the type that was required, by Dr Macaskill and
others, then we acted ………………”. What this appears to be saying is Ms Freeman sought advice from Dr Macaskill and it was his members “requirements” (not the Trade Unions) that drove the Scottish Government’s response.
Unfortunately, the UK Inquiry has not investigated how this extraordinarily close relationship between the Scottish Government and Scottish Care was able to develop, how it influenced the handling of the pandemic or the implications for the future.
What was confirmed was this relationship between the Jeane Freeman and Mr MacAskill was not new: “Dr Macaskill and I had previously worked together before the pandemic…………… and we did converse frequently over the whole period of the pandemic.” Just why Jeane Freeman appears to have felt so happy talking to and relying on advice from someone who represented the private is a question that deserves an answer at the Scottish Covid Inquiry.
Having established more about the nature of the relationship, there is then a long list of questions that deserve to be asked about how it affected other aspects of the Scottish Government’s handling of the Covid-pandemic. For example, what influence did Mr MacAskill have on the amount of money the Scottish Government threw at certain private care homes to get people, some of whom were infected, out of hospital?
Finally, on the implications for the future, it should be no surprise that a government that turned to senior NHS managers and the private sector for social care advice during the Covid pandemic produced proposals for a National Care Service that removed care from local authorities and did nothing to address the needs of the workforce. While Cosla has now forced the Scottish Government to include local authorities in the NCS, instead of resourcing them to design how care is delivered, Scottish Ministers have taken on an army of staff who know very little about social work or care and commissioned reports from large private sector management consultancies like KPMG to design the NCS.
It is no wonder the National Care Service Bill is completely unfit for purpose. What Jeane Freeman’s advice to the UK Covid Inquiry tells us is that reform needs to start with the Scottish Government. For a blistering critique of Jeane Freeman’s evidence to the UK Covid Inquiry see also https://robinmcalpine.org/the-covid-excuses-simply-dont-stack-up/