The people most at risk during this crisis should be the priority – Prof Ian Welsh & Andrew Strong

Efforts should be concentrated on the concerns of those most likely to be affected say Prof Ian Welsh and Andrew Strong

Professor Ian Welsh OBE, Chief Executive, Health and Social Care Alliance Scotland (the ALLIANCE)

This is a time of unimaginable pain and uncertainty for individuals and families across Scotland, the UK and the world. A global pandemic is a threat which none of us will have ever lived through, and which has seen unprecedented changes to all of our ways of life.

Only a few weeks ago, the narrative of some media outlets and sections of social media was not to worry, as “most people will be OK” – a discriminatory attitude which suggested that many older people and people living with long-term conditions were in some way expendable. As the Equality and Human Rights Commission notes: “COVID-19 does not discriminate, but it does impact people differently.” For people living with long-term conditions, disabled people and unpaid carers the threat is particularly acute.

Equally, the British Gerontology Society has called on the Government to to reject the formulation and implementation of policy based simply on chronological age, asked for caution in use of language and highlighting the need to foster generational and societal cohesion.

Andrew Strong, Assistant Director (Policy and Communications), Health and Social Care Alliance Scotland (the ALLIANCE)

As an organisation representing some of these groups, and the organisations who work with them on a daily basis, we recognise that special measures are being taken during this public health emergency to ensure people are safe and the pandemic is addressed. But those of us most at risk should be prioritised and their rights and needs assessed. It is also critical that contingency planning arrangements are made fairly and transparently. Crucially, these must be made publicly available in accessible formats which meet the various requirements of disabled people up and down the country.

The emergency steps taken by the UK Government have also seen the passing of the Coronavirus Act 2020, rushed through the UK Parliament, with consent offered by Scotland’s MSPs at Holyrood. The far-reaching legislation outlines duties related to the Community Justice System, food supply, social security, transport, elections, gatherings, schools and childcare, as well as the health and social care system. It is an Act which would be weighty and in need of considerable deliberation at the best of times.

Some provisions can be welcomed, and strongly supported, for example the emphasis placed on greater capacity for volunteering efforts and Emergency Volunteering Leave for workers and employees who wish to help.

This should aid the UK Government’s efforts as it aims to engage the hundreds of thousands of people who have come forward offering their support in the fight against COVID-19. Moreover, The Scottish Government’s national volunteering campaign Scotland Cares allowing people to return to the NHS, support public services and volunteer with charities is welcome

All this must, however, come hand-in-hand with new resource for Scotland’s third sector to use its considerable wealth of experience in training, supporting and assessing volunteers against agreed standards. After all, some of our members, including Chest, Heart and Stroke Scotland, have launched their most successful volunteering drives in decades and must be supported to do so.

Other parts of the emergency legislation are, frankly, more alarming.

Mental health legislation has been changed at short notice to allow for the extension of certain orders which can lead to forced detention. Duties have been relaxed on local authorities to assess and identify social care needs. Both these provisions have the potential to cause significant distress and unintended consequences for many people and families reliant on support to achieve their human rights. We are already hearing concerning reports that in some local authorities social care support is being cut in order to mainline efforts to help people home from hospital. We are pleased that the Cabinet Secretary for Health and Sport, Jeane Freeman MSP, subsequently announced more financial support to avoid these desperate actions.

In addition to these immediate challenges, we are concerned that in the coming months and years more people than ever before will need access to rehabilitation support for respiratory conditions. It is imperative that the Scottish Government’s forthcoming Respiratory Care Action Plan, takes this into account, recognising the potential rise in demand for community-based support for these conditions and advising on how statutory organisations should respond, with support from charities.

One thing that has been proved by these extremely trying circumstances is Scottish society’s ability to show flexibility despite overwhelmingly trying circumstances. The ALLIANCE has been encouraged to see more of a focus on realising digital healthcare consultations, a greater role for pharmacists in working with communities to manage demand for medication, and people coming together to show their support for our health and social care staff like never before. It has shown that rapid scaling of activity is possible in a health and social care system that is often slow to change and haphazard in deployment of innovation.

Much of this will be transformational and put us in good stead for the future beyond where we are today.

Finally, there is no doubt there will come a time when questions are asked about the UK’s approach in the lead-up to the pandemic. How prepared should our various health systems have been? What approaches may have saved more lives? What happens next? But that time is not now. Instead, we should concentrate our efforts on ensuring that our approach is addressing the concerns of those most likely to be affected and those around them, and what support the rest of society can offer.

Professor Ian Welsh OBE, Chief Executive and Andrew Strong, Assistant Director (Policy and Communications), Health and Social Care Alliance Scotland (the ALLIANCE)