As Covid raged, were our elderly deemed to be expendable?

IT WAS an admission as startling as it was galling. Outgoing SNP Health Secretary Jeane Freeman last week told a BBC podcast she had failed to do her job properly over the transfer of patients from hospitals to care homes in the early days of the pandemic.

She said to Nick Robinson: ‘We didn’t take the right precautions to make sure that older people leaving hospital going into care homes were as safe as they could be and that was a mistake.’

Ministers should not be discouraged from reflecting on their decisions but the best time to reflect is when there is still an opportunity to alter them. There is no need to seek absolution through podcasts if you implement the correct policies in the first place.

The policy of clearing the wards of older patients without first testing them for Covid-19 remains one of the most illconceived of the pandemic.

Last May, Freeman claimed that the number of untested patient transfers was 300, only for the Scottish Government to later concede it was 900. Later still, the true number emerged: 1,431.

Gary Smith, Scottish head of the care workers’ GMB union, has accused the Scottish Government of ‘not only a failure, but a cover-up’ and branded Freeman’s remarks ‘a new low’.

Culpable

George Hillhouse, whose mother died of suspected coronavirus at a care home in Drumchapel, told a Sunday newspaper: ‘Jeane Freeman should be explaining these mistakes to the police. The Government is culpable for this tragedy and it needs to take responsibility.’

The Health Secretary has come under fire from opposition politicians but none of their words could sting like those of Mr Hillhouse and others like him.

For them, Freeman’s media confessional will have been an agonising reminder that, one year on, no one has given them definitive answers and no one has fallen on their sword.

It is hard not to wonder whether elderly patients were wheeled out of hospitals and into care homes, not for their own health and wellbeing but because their health and wellbeing were judged to be less of a priority than other patients and hospital staff. If that was the calculation, then it is one that was applied, consciously or otherwise, to the other residents of care homes these untested patients were transferred to.

It’s easy to run the rule over decisions made one year after the fact and outside the context of a hectic health bureaucracy facing a deadly pandemic.

But it is because these decisions were made by people in positions of power, people tasked with keeping us all safe, that questions about the policies they adopted are so urgent. There have been more than 10,000 fatalities in Scotland linked to Covid-19, with roughly onethird accounted for by deaths in care homes. It is exceedingly difficult to establish what effect any one policy decision might have had, but the questions must be asked.

The families who lost loved ones deserve answers. They may consider that the only way to get them is via a Scotland-specific public inquiry into the patient transfers and other bureaucratic and corporate decisions, such as on PPE provision and routine testing of care home staff and residents.

Robert Kilgour, who owns the Renaissance Care chain, says: ‘We all need to learn lessons from our national Covid journey. An urgent independent public inquiry must underpin steps to help us work better together as we rebuild our economy and adapt to the new normal.

‘We all owe those who have tragically lost their lives in the last year, their families and friends, nothing less.’

There are many lessons to learn but not all of them can be reached by panels and hearings and heavily footnoted reports. We have to scrutinise our collective conscience and ask whether our prejudices about older people were a contributing factor to the dreadful death toll.

Would any other age group have been treated like this? Would any other demographic have been deemed expendable?

There is a callousness to how some think and speak about older people. They are regarded not as a source of wisdom and experience but as a burden.

Their advanced years are resented as an imposition on younger generations rather than the conclusion of hard-worked lives that built the world we all inherited. Their frailties draw impatience and their values contempt.

I would like to believe that those who think like this are very much in the minority but even if they are, their attitudes can have an impact. How else to explain the general unwillingness to fund decent care and support for people in their final years?

We need a 180-degree culture change, a reorientation of our values to something more compassionate, more empathetic, more humane. We need to cherish the aged, to take time to be with them, listen to them, hug them, benefit from their insights, and thank them for a life’s work raising families and contributing to communities. We should take pride in respecting older people and learning from them.

It is not a coincidence that the world leaders of the future – India, China, Indonesia – are countries in which reverence for older generations is hardwired into the culture.

If we want to preach about our commitment to human rights, the human rights of the elderly must be among them. If we want to boast about raising the pay of frontline workers, an average rate of £8.50 an hour for those who care for the most vulnerable will have to change.

To make these improvements, we need leadership. Freeman will not be that leader. She has one foot out the door and will leave someone else to clean up her mess. Christina McKelvie is unlikely to step up. The Minister for Older People reportedly failed to contact even one care home during the first 11 months of the pandemic.

Dysfunction

Will the First Minister be the leader we need? She ought to be, since responsibility for the failures of the last year ultimately lies with her, but given what happens to a policy brief when Nicola Sturgeon declares it her priority, supporters of care reform might prefer her to stay out of it altogether. This level of dysfunction, this degree of failure, is shameful.

Quite apart from a public inquiry and changes in policy, Scotland’s care home residents and the families of those lost to Covid-19 deserve an apology from the First Minister. Older people in general deserve reassurance that, whether they require care or can live independently, whether they need to be in a residential facility or can be supported at home, their wellbeing will never again be fed into a cold-hearted calculus of lives worth saving versus lives of lesser import.

We have learned a lot about ourselves since the pandemic arrived on our shores, and much of it has been uplifting.

The healthy agreed to be confined to their homes to protect the sick and vulnerable. Student nurses signed up to work on Covid wards, the front line in the war against the virus. Friends and neighbours and strangers showed through acts of kindness small and extraordinary that the community spirit is still alive.

But we also saw the consequences of a particular way of thinking about the elderly, a mindset as narrow as it is harsh, in which the aged are a problem in need of a solution, rather than people in need of fairness, dignity and love.

We have to break free from this cynical outlook on human worth and build a community of respect in which all people and all lives are cherished.