Scotland's health watchdog sought to delay publication of Covid-19 care home deaths report until after Holyrood election

Scotland’s public health watchdog sought to delay the publication of a report into Covid-19 care home deaths until after the election that it then never published, The Scotsman can reveal.

Public Health Scotland (PHS), which was embroiled in controversy after it emerged part of its remit is to shield Scottish Government ministers from criticism, was set to publish a report into care home mortality data around Covid-19 on March 24.

This publication date for the care home Covid-19 mortality report was later changed to “TBC” alongside a note stating “delay until after election being explored”, documents obtained by The Scotsman show.

The report was never published.

Care home deaths caused by Covid-19 have been at the centre of controversy since the start of the pandemic. Picture: PACare home deaths caused by Covid-19 have been at the centre of controversy since the start of the pandemic. Picture: PA
Care home deaths caused by Covid-19 have been at the centre of controversy since the start of the pandemic. Picture: PA
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PHS officials emphatically denied any suggestion there was external pressure placed on the agency to block publication from any organisation, including the Scottish Government, and said pre-election civil service rules explained the exploration of the delay.

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However, the Scottish Conservatives said questions must be answered about potential pressure “exerted by SNP ministers” and whether it was intended to “suppress criticism” ahead of the Holyrood election.

Scottish Labour said the failure to publish the report before the election was “despicable” and raised questions about PHS’s “murky” relationship with the SNP.

Documents obtained by this newspaper detail how the agency’s public relations and communications department approached any report or paper published since November 2020, including whether it had the potential to generate media interest or become politicised.

In the notes of the organisation’s “Forward Look” documents, PHS officials said of the release of the care home mortality data report, there was “likely to be significant media interest in topic”.

The never-published report was set to be a one-off publication of “an analysis to describe Covid-19 deaths within care home settings”, including mortality data from the start of the pandemic until mid-February 2021.

Nick Phin, PHS’s clinical director and director of health protection, is named as the official leading the exploration of a potential delay to publication.

It was initially set for a March 24 publication date before appearing on the ‘Forward Look’ document every week, last appearing on the document covering publications for the next month from April 12.

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PHS said the pre-election period, previously known as ‘purdah’, when the publication of data that was not pre-announced tends to be avoided by public bodies, was the main driver behind seeking a delay to the report.

In its weekly Covid-19 statistical reports published in April of this year, however, PHS states that despite this period, “statistics relating to Covid-19 will continue to be published”.

It adds: “The need to provide relevant and timely statistics relating to it [Covid-19], there may be a need to publish new statistics … during the pre-election period that have not been pre-announced.”

The guidance adds the head of profession for statistics at PHS would make the final decision on any such publication.

However, PHS said the publication of a revised report into the impact of discharges from hospitals into care homes during the early stage of the pandemic was viewed by officials as covering the topic in enough depth, and the mortality data report was never published.

The Scottish Conservative’s health spokesperson, Sandesh Gulhane, said “urgent answers” were required as to why the report was never published.

He said: “Grieving families will be appalled by this latest revelation. It raises further questions over what sort of pressure was exerted by SNP ministers to suppress criticism ahead of the election and whether public health officials bowed to their demands.

“Those who lost loved ones as a result of grave errors made by SNP ministers at the height of the pandemic in relation to care homes need to know if they can still have full trust in Public Health Scotland.

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“Urgent answers must be given over why this report has never seen the light of day. Not for the first time, it suggests an SNP Government agency are all too keen to shield those responsible from criticism, rather than giving families the honest answers they deserve.”

Jackie Baillie, Scottish Labour’s deputy leader and health spokesperson, said the failure to publish the report pre-election was "despicable”.

She said: “These astounding revelations raise yet more questions about Public Health Scotland’s murky relationship with the SNP.

“We were told that Covid data would be published through the election, but it seems there has been some cherry picking going on.

“It is despicable that the public were kept in the dark while going to the polls – and it is even worse that this is still being hidden from them now.

“We cannot let the culture of secrecy at the heart of the SNP bleed into our public bodies.

“Public Health Scotland must be set free from any and all spin duties imposed on them by the SNP.”

The revelation follows the controversy that erupted when then-health secretary, Jeane Freeman, turned to PHS in 2020 to commission an “independent” analysis as to whether the discharge of untested and positive Covid-19 patients into care homes had caused outbreaks of the virus in those institutions.

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Following its publication, PHS was forced to add additional detail and change the wording around its conclusion, warning it could not rule out a link between the discharges and Covid outbreaks.

This led to criticism around its agreement with the Scottish Government that it must manage “risk”, including the potential for “sustained or widespread criticism of the Scottish Government” and “ministers being pressed to make a statement to Parliament”.

The ‘Forward Look’ documents detail how this worked in practice during the winter of 2020 and throughout 2021.

They show the agency also worked closely with the government on how to handle a report on the effectiveness of shielding during the pandemic, on the spread of Covid-19 among students, and on the number of cancer patients in Scotland’s NHS.

Despite actively evaluating the efficacy of minimum unit pricing of alcohol in Scotland, a key SNP policy, PHS also had a policy of referring every inquiry on drug deaths to a pre-written statement or the Scottish Government.

However, care home deaths data was closely guarded by the Scottish Government and other public bodies ahead of the election in May.

Prior to the election, the only data published had been released by the Crown Office to the BBC following a Freedom of Information request, but did not cover all registered deaths.

The National Records of Scotland and the Care Inspectorate published their mortality data on May 26 after a transparency battle with The Scotsman and other media outlets.

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Earlier this year, The Scotsman revealed how an intervention by two SNP ministers led to a delay in the publication of care home death data until after the election.

Former economy and health cabinet secretaries Fiona Hyslop and Ms Freeman both intervened around the publication of the number of deaths in individual care homes, leading to the National Records of Scotland publishing the information in late May.

Both ministers were keen to see additional consultation with care home operators and other external stakeholders to “minimise impact” of the figures.

Despite the intervention, the Scottish Information Commissioner ruled the NRS had acted unlawfully in blocking the release of the data and it was published after the election.

A spokesperson for Public Health Scotland said: “Only one report had been published as it was considered that it dealt with all of the issues under consideration.

“The report was not published in the immediate period leading up to the election period in line with long-standing practice.”

A Scottish Government spokesperson said: “Public Health Scotland have no duty to advise Scottish ministers on communication. Public Health Scotland functions entirely independently of ministers – as, of course, is right and proper – and any suggestion to the contrary is absolutely wrong.

“Clearly, it is important for the Scottish Government and PHS to share information effectively, particularly during a pandemic.

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“Throughout the pandemic PHS staff have been working tirelessly to provide data that has been vital for decision making and no one should call their integrity into question.”

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