Coronavirus care-home scandal reveals the shocking truth about hospital bed-blocking – Neil Findlay MSP

Elderly people were left stuck in hospital beds, delaying operations for others, at a cost to the tax-payer tens of millions of pounds. The coronavirus outbreak has shown how they could have been moved into care homes instead, writes Neil Findlay MSP.

How is it that places were suddenly found in care homes for elderly people previously stuck in hospital beds, asks Neil Findlay (Picture: John Devlin)

As the Covid crisis continues, more revelations are unearthed, with information dragged out of the Scottish Government which illuminates the background to decisions made and the mindsets which underpinned them.

Through the work of journalists, MSPs and researchers, it is now clear that our older people – our mums and dads, grannies and grandas – have been treated as, at best, second-class citizens.

Shipping untested patients out of hospitals and into care homes is now widely recognised as a disaster which has led to large numbers of elderly lives being cut short. Less attention has been paid to the connection with the longer term scandal of bed-blocking.

Indeed, the Health Secretary, Jeane Freeman, responds petulantly to criticism of the hospital-to-care-home “traffic” by saying it was in line with what had been long demanded – an end to bed-blocking – so shouldn’t we all be grateful? On the contrary, one scandal has shone light on another.

We now know that Scottish intensive care beds were increased to 700 to deal with the expected influx of Covid patients. At peak, 221 patients were in an ICU bed. This means at the highest occupancy level, around 480 ICU beds were vacant. Meanwhile, half of Scotland’s 3,911 deaths were occurring in care homes while three-quarters of deaths have been of over 75s.

So why is it that only one-in-five Covid patients taken to intensive care was over 70? Why were patients sent to care homes untested? And why were those who then became ill not taken from that care home to be treated in all those vacant intensive care beds, instead of being left to die?

Was this a deliberate policy decision? If so, who made that decision? And if not, then why were they not hospitalised to give them the best chance of living? Why were older citizens treated differently from other age groups?

We also now know that in March and April the number who were discharged from hospital untested was around 1,300. They were cleared from hospital beds on instructions from the Cabinet Secretary for Health, Ms Freeman.

These older people were classified as “delayed discharge” cases. That is the term for those who are stuck in hospital for extended periods – over a year in some cases – because no care home place or package of care at home is available.

It has been a stubborn problem which successive Scottish Governments have failed to resolve. Families were repeatedly told that the reason their loved ones remain in hospital is that “no care package is available”.

Just prior to the Covid crisis, Scotland’s hospitals were experiencing record delayed discharge rates. So where did all these extra social care places suddenly appear from in March and April?

Did we overnight see hundreds of new bedrooms built in care homes or an army of new care workers recruited and trained for home care?. Of course not. This is just not possible, so how was this capacity created?

According to Ms Freeman, this miraculous transformation was largely achieved because of “improved digital technology”, changed procedures and “best practice”.

Are we really to believe that years of “delayed discharge” in the NHS was eradicated overnight by two computers talking to each other and some procedural tweaks? The reality is somewhat different and exposes the second, underlying scandal.

The simple fact is these care home places and home care packages have existed all along.

The most recent Scottish care home survey showed 5,000 vacant places. The reason they were able to be commissioned and filled quickly was because of one major change – money.

In a crisis situation, the Scottish Government thought the NHS would be overwhelmed so they paid Integrated Joint Boards (IJBs), NHS boards and councils to buy care home places and then shipped out patients to them untested.

Rather than these places not having existed, the reality is they simply were not funded prior to Covid. And they weren’t funded because councils, who jointly fund the IJBs, have had their budgets savaged year after year by the SNP Government, with disproportionate reductions that have taken Tory cuts then doubled and sometimes tripled them.

When your mum or dad or granny or grandad has been stuck in hospital, waiting on “a care package”, the places were in fact available all along. For years, these families have been lied to.

But it gets worse. A care home place in say, Inverclyde – where a block booking was ordered in an effort to empty the local hospitals – has been funded at around £713 per week by the Scottish Government from March.

In other areas, this will be as much as £1,000. However, it costs between £300 and £400 a night to keep someone in hospital.

This means that, while starving Scotland’s councils of funding, the Scottish Government has been costing the taxpayer tens of millions of pounds through “delayed discharges” while misleading families about the reason their loved ones were stuck in hospital.

Furthermore, it is because of people being left for weeks and months in hospital when they could be home that others have been left in pain and discomfort, languishing on growing waiting lists for operations and procedures.

This a very real and tragic scandal which extends far beyond the current epidemic and for which those responsible must be called to account once it is over.

Neil Findlay is a Scottish Labour MSP for Lothian

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