John Swinney insists he did not ‘conceal information’ over Covid inquiry mass resignations

JOHN Swinney has insisted he has not “tried to conceal information” over the chaos surrounding Scotland’s Covid inquiry following a string of resignations.

Lady Poole quit as chairwoman of the inquiry while it later emerged that four counsel have also resigned before the inquiry has even begun taking evidence.

The Deputy First Minister told MSPs that placing bereaved families at the centre of the inquiry would be “a condition of appointment” for Lady Poole’s replacement.

But Mr Swinney refused to say whether the inquiry will be delayed or not as a result and would not be drawn on whether Lady Poole’s resignation had been sparked by losing four of the counsel.

Addressing MSPs at Holyrood, Mr Swinney insisted that the Scottish Government “wants the inquiry to be delivered at speed” so that “we can learn and benefit form lessons as early as possible”.

He added: “This is why arrangements for appointing a new judicial chair for the inquiry are being taken forward urgently to ensure a successful transition.

“The Scottish Government remains committed to the vital work of the inquiry, as is the independent inquiry team.

“Lady Poole will continue as chair during her notice period of up to three months.”

But Labour health spokesperson Jackie Baillie, raised concerns that Mr Swinney “never mentioned the resignation of four senior and junior counsel when he hosted the cross-party briefing meeting on Monday”, adding that “not a word passed his lips”.

She added: “This is a material consideration which should have been disclosed and I regret the lack of transparency from the Government on such an important issue.

“Some more cynical than I might say that there’s a pattern of secrecy here with the Government. I hope this doesn’t spill over into the inquiry itself.”

But Mr Swinney claimed that the law “gives an inquiry chair alone, rather than ministers, responsibility for deciding how an inquiry operates”.

Lady Poole has resigned as chairwoman of Scotland's Covid inquiryJohn Swinney

He added: “I considered carefully what I should share with members of parliament when I telephoned them on Monday evening to share the information because I was mindful of my legal obligation to respect the independence of the inquiry.

“At no stage have I tried to conceal information, I’ve simply respected the legal framework under which I must operate.”

Mr Swinney told MSPs that he spoke to Lady Poole on Friday morning when she told him of her decision to “step down for personal reasons”.

He added: “In the course of that call she indicated to me that four members of counsel had resigned the previous day from the inquiry.

“That was news to me as were the circumstances that led to Lady Poole’s resignation when I heard that on Friday morning.”

Ms Baillie warned “there will be huge disappointment” for the bereaved families over the situation, adding that “they have been patient in waiting for the inquiry to start”.

She added: “Lady Poole was appointed in December, the day before Baroness Hallett was appointed to lead the UK-wide inquiry.

“The UK-wide inquiry has started and they’ve made clear that the people affected are at the heart of their considerations.”

Ms Baillie pressed the Deputy First Minister over the new timetable for the inquiry and whether costs have been revised.

But Mr Swinney accused the Labour MSP of calling on him to “interfere in the running of the inquiry”, adding: “I simply will not do it.”

He said that the concerns of bereaved families “must be at the heart of the inquiry”.

Mr Swinney added: “I can insist, when I secure the appointment of judicial leadership for the inquiry, that the point that Jackie Baillie has put to me will be taken on board.

“It will be a condition of appointment for the judicial leadership that comes in place that bereaved families must be at the heart of the inquiry.

“Their issues and their concerns must be properly aired and must be properly addressed. They must have answers.”

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Covid Scotland: Number of people in hospital with virus increases 12 per cent in a week

The number of people in hospital with Covid-19 increased by 12% last week, according to the latest figures.

In the week ending October 2 there were on average 744 patients in hospital with coronavirus, up from 664 the previous week, Public Health Scotland (PHS) data shows.

There was also a rise in admissions to intensive care units with a laboratory confirmed test of Covid-19, with 19 in the week to Sunday – up eight on the week before.

The PHS report states that “following a fall in cases since mid-July, the average number of patients in hospital with Covid-19 has been increasing slightly in recent weeks”.

In the week to Sunday there were 206 new Covid-19 admissions to hospital, according to provisional figures, with no data available for three NHS boards.

Of the 414,819 people vaccinated for Covid-19 as part of the winter 2022 vaccination programme by the week ending October 2, PHS data shows 93.9% were vaccinated for flu at the same appointment.

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We must take a holistic approach to health inequalities

The statistics show that average life expectancy at birth for males is 76.6 years and 80.8 years for females, a fall of 11 weeks and eight weeks, respectively. These figures continue the decrease of the previous year, the sharpest since 1980-82.

That Covid-related deaths contributed significantly to the latest fall is no cause for complacency. Drug-related deaths also contributed to the most recent decline while prior to the pandemic there had been scarcely any improvement overall since around 2012.

Poverty continues to have a marked impact on life expectancy. In Scotland’s most deprived areas, average male life expectancy was 13.7 years lower than in the least deprived areas. For females, the difference was 10.5 years.

This gap has widened in recent years and Scotland has the lowest life expectancy in Western Europe and is falling behind some Eastern European countries.

This is the context in which a review of health inequalities in Scotland, commissioned by the Health Foundation, will be reporting its findings over the coming months.

In parallel, the Scottish Parliament’s Health, Social Care and Sport Committee has been conducting its own inquiry. The committee’s report notes the absence of an overarching health inequalities strategy and invites the Scottish Government to set out what steps it intends to take to improve cross-government and cross-sectoral efforts.

No one can be in any doubt about the scale of the challenge – exposed and exacerbated first by the pandemic and now further at risk from the cost of living crisis.

Scotland has seen no shortage of policy ambition over the last two decades. But closing the gap cannot be, and is not, for government alone.

While there are some areas where government and its agencies can lead, it should also be prepared to follow – and work alongside industry, civil society, and local communities. It therefore matters significantly what people across Scotland think.

In contrast to the life expectancy figures, British Social Attitudes data released on the same day offers cause for optimism that a radical approach would be popular.

The data shows that 60 per cent of people in Scotland recognise that poverty is a major cause of poor health while 64% think it is unfair that wealthier people can afford better health care.

The Health Foundation’s review will capture the story of public health and socio-economic trends since devolution. It will also draw on dialogue with key actors from across sectors – and the public.

The immediate economic fallout from the actions of the UK Government is focusing minds right now. But tackling the growing health inequalities gap is more complicated still – and a healthier nation is essential for economic recovery.

There is no magic wand, but we do have knowledge and experience of what can work if we are bold enough to commit to a holistic long-term response.

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NHS Scotland: Overseas recruitment drive to save health services this winter

HEALTH Secretary Humza Yousaf has unveiled a £600 million winter resilience package for the NHS amid spiralling A&E waiting times and warnings that the service faces a looming “humanitarian crisis”.  

The package includes £8m to recruit up to 750 nurses, midwives and other workers from overseas, plus 250 support staff for hospitals, primary care and mental health.  

Health and social care partnerships will receive £124m to expand care-at-home capacity, with £45m earmarked for the ambulance service.  

GPs practices will be expected to provide pre-bookable appointments alongside same-day face-to-face and remote appointments. 

The plan was laid out as hours after statistics revealed that a record 4,967 patients had spent more than 12 hours in A&E during August waiting to be seen, treated, and subsequently admitted or discharged–- an all-time high. The target is four hours.  

Worsening delays are believed to have contributed to hundreds of excess deaths over the past six months, with NHS Greater Glasgow and Clyde confirming it had launched an investigation into the deaths of two patients who had suffered fatal cardiac arrests in September while waiting to be seen by A&E doctors at its flagship Queen Elizabeth University Hospital in Glasgow.  

The plan was laid out as hours after statistics revealed that a record 4,967 patients had spent more than 12 hours in A&E during AugustPA

It comes days after the case of a 96-year-old former headmistress with pneumonia, Evelyn Gaw, was raised in parliament after she spent more than 40 hours on a trolley in a draughty corridor at Crosshouse Hospital in Kilmarnock due to a lack of beds.  

Her son, Dr Norrie Gaw, a GP and former head of Glasgow’s out-of-hours service, said his mother had been left “frightened, crying, breathless and disorientated”. 

He added: “The staff were clearly utterly exhausted but fantastic and very apologetic, but she had to be taken on a trolley to wait in a corridor because of the lack of beds. 

“It was absolutely lined with patients, and this is not an exception — this is now the norm.’ 

On Saturday, NHS Grampian issued an appeal to the public via social media on Saturday only to attend if their condition was life-threatening, warning of “extreme pressure” at Aberdeen Royal Infirmary.  

Dr Sandesh Gulhane, a GP and Scottish Conservative health spokesman, said: “August’s A&E waiting times are the worst on record across every category, seeing tens of thousands of patients suffering excess delays despite the best efforts of overwhelmed frontline staff. The fact that these figures cover the height of summer is frankly terrifying – and it’s chilling to imagine the state of our A&Es come winter.” 

Jackie Baillie, Scottish Labour health spokeswoman, warned that without urgent action, Scotland’s A&E departments “risk a humanitarian crisis”this winter.  

Mr Yousaf acknowledged that A&E performance “is not where I or this Government wants it to be”, but insisted that the £600m winter package would help the NHS to cope with “what we expect to be an extremely challenging season”.  

He said: “Too many people are waiting far too long for urgent care and treatment. Our A&E departments are working under significant pressure and as with health services across the UK , the pandemic continues to seriously affect these services.  “We’re determined to improve and stabilise performance, working very closely with boards on measures to reduce pressure on our acute sites.  

“However, as winter arrives, those pressures will have an undoubtedly detrimental effect on already stretched services, but we will do what we can to mitigate the worst effects.” 

The plan was laid out as hours after statistics revealed that a record 4,967 patients had spent more than 12 hours in A&E during AugustPA

It comes amid growing anger over the situation among NHS staff, with the Royal College of Nursing (RCN) set to open its ballot on strike action tomorrow in protest over their five per cent pay offer, with nurses encouraged to vote in favour.  

It will be the first time that its members in Scotland have been balloted to strike.  

Doctors are also continuing to weigh up possible industrial action, after eight in 10 BMA members in Scotland said they would consider it.  

Dr Lailah Peel, an emergency medicine doctor and the outgoing chair of the BMA’s Scottish junior doctor committee, warned that the NHS was on the brink of a “workforce catastrophe” after a BMA survey of junior doctors in Scotland found that half (49.8%) of those who responded were thinking about quitting their jobs in the next two years.  

Junior doctors account for 44% of all the doctors employed by health boards.  

Dr Peel said: “We are already desperately short-staffed – we need more doctors across the entire system from primary care through to the highest levels in secondary care – we cannot afford to lose valuable junior doctors who are the future of our senior workforce. 

“Urgent action must be taken to make junior doctors feel valued in their workplace and [to] want to stay in Scotland’s NHS for the majority, if not entirety, of their careers.” 

Some 90% of the 320 respondents said issues and challenges of working as a junior doctor in the health service over the past year have lowered their morale, with 52% having told the survey it has significantly lowered their morale. 

Dr Peel said: “There are many factors contributing to this feeling of discontentment among the workforce, but this year’s pay award, which is essentially a pay cut in real terms, certainly hasn’t helped matters and has led to many junior doctors re-evaluating their futures within our NHS.” 

She added that while pay must be resolved there were “other things the Government can do as quick fixes to make the working lives of junior doctors easier” such as uninterrupted breaks at work, a locker to store belongings, and access to hot food while working long shifts out of hours. 

“If I can make one final plea to the Scottish Government before I stand down as chair of SJDC, it’s this: act now, please. Do something before it’s too late,” she said. 

Mr Yousaf said the government at Holyrood has “already delivered record levels of staffing in NHS Scotland”, with the number of doctors in training, as of June this year, is up 14.3% from September 2006.  

He added that 2022 “is set to be the most successful year of medical trainee recruitment in Scotland in the last five years, with a 95% fill rate so far”. 

Despite the strain on services during August, there was evidence of an uptick in elective activity.  

The total number of planned operations carried out – 21,218 –was the highest since February 2020, and up 19% compared to July 2022. This coincided with a push to clear waiting list backlogs. 

In July 2022, the Scottish Government set a target to eradicate two-year waits for outpatients in most specialities by the end of August 2022, and by the end of September for inpatient and day case procedures.  

By the end of August, 76% of outpatient specialities had no or fewer than 10 patients on their lists who had been waiting more than two years. Inpatient data is not yet available, but activity in August, while up, remains 16% below pre-pandemic levels.  

There was also a spike in cancellations. One in 10 procedures scheduled to take place during August were called off on the day, or the day before, including 890  cancelled for “non-clinical/capacity” reasons such as lack of theatre space, staff or beds –the highest number since 2018.  

The plan was laid out as hours after statistics revealed that a record 4,967 patients had spent more than 12 hours in A&E during AugustPA

Dr Gulhane said Mr Yousaf had “offered no solutions to the crisis in our A&E departments”. 

He added: “Scotland’s NHS is already at breaking point, and if this is all the Health Secretary can muster, then we are in for a terrifying winter.” 

Scottish LibDem leader and health spokesman, Alex Cole-Hamilton, said: “So much of this relates back to staffing. It’s been staring this government in the face for years. Last week, a whistleblower told me that the Edinburgh Royal Infirmary operates routinely with 80 fewer nurses than it needs on every shift.” 

Mr Yousaf said: “NHS Scotland’s staffing and funding is already at historically high levels, but as we approach the winter period it is crucial that we look to maximise, and enhance where we can, the capacity of the NHS.  

“Given the scale of the escalating cost of living crisis, combined with the continued uncertainty posed by Covid and a possible resurgence of flu, this winter will be one of the most challenging our NHS has ever faced.” 

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20,000 excess deaths in Scotland linked to Tory austerity policies

More than 300,000 deaths have been attributed to Tory austerity policies that slashed billions of pounds from social security payments and public services.

Scots researchers have calculated that between 2012-2019, almost 335,000 more people died than would have been expected across the UK based on previous trends between 1981 and 2011.

The analyses, led by Glasgow Centre for Population Health and the University of Glasgow, adds to the existing evidence of a worrying stagnation of improvements in life expectancy since the early 2010s.

However, it is the first to quantify the effects of austerity policies implemented by the UK Government in 2010 on excess death rates. In Scotland, around 20,000 more deaths than expected occurred.

Without support, researchers said, “people have been dragged under by decreased income, poor housing, poor nutrition, poor health and social isolation – ultimately leading to premature death.”

READ MORE: How blue spaces could play a part in making our cities safer 

The researchers were trying to establish if women were more adversely affected overall and the study produced mixed results.

More than a one third of those who died were under the age of 65 and the majority (66% in Scotland) were men.

Expressed as the percentage of the total ‘observed’ deaths, the excess was 9.0% and 3.7% for males and females respectively in England & Wales, with the equivalent figures for Scotland being 4.0% and 2.6%. Changes were seen in just about every cause of death.

However, in the 20% most deprived areas, mortality rates rose to a greater degree among women.

Cuts to social security payments and eligibility, as well as services, have been shown in a number of analyses to affect women more than men.

This is said to be because women make up the majority of social security recipients in the UK while some individual social security cuts have disproportionately affected particular groups which are predominantly female including lone parents and single pensioners.

READ MORE: ‘Morally indefensible’: Going without food or heating now ‘endemic’ in Scotland 

Women are also more likely to be poorer and on lower incomes due to inequalities in the labour market and in the division of caring responsibilities. 

Dr David Walsh, said: “The overall message is that irrespective of gender there has been this horrific change and the additional number of deaths are about a third more than we had from Covid.

“Given what is happening at the moment with the UK Government considering more restrictions on social security it is obviously important that we learn what previous restrictions have done as the effects have been calamitous.

“Not only should we not be having further restrictions to social security but there is a need to reverse what has been done to try to protect the income and therefore the health of the poorest in society.”

READ MORE: Groundbreaking dementia study finds treatment is best in person 

He said there was quite a lot evidence that showed that austerity may have contributed to a rise in drug deaths in Scotland.

He said: “Although they were already going up, around about 2012 they increased massively. If you have a population with drugs issues and you take away their income, they will seek oblivion.”

The study authors said comparisons of projected and observed rates are subject to a number of uncertainties, and
“thus we must be cautious in our interpretation of the precise figures”.

However they said the figures were likely to be a conservative estimate of the number of excess deaths.

Co-author Prof Ruth Dundas, Professor of Social Epidemiology at the University of Glasgow said: “This study shows that in the UK a great many more deaths are likely to have been caused by UK Government economic policy than by the Covid-19 pandemic. 

“We need to reverse the austerity policies and protect the income, and therefore the health, of the poorest and most vulnerable in our society.”

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Analysis: Is our entertainment worth more than head injury sports risks for players?

When Professor Willie Stewart published research in 2019 showing that footballers had a five-fold risk of Alzheimer’s Disease, his research team were inundated with inquiries from understandably concerned ex- players.

He is acutely aware that rugby players, retired and currently playing, will be waking up to the news today that they may be at higher risk of developing Motor Neurone Disease (MND), a horrendous life-shortening illness for which there is no cure.

He said discussions had already taken place with those overseeing the sport in advance of the report to ensure they had access to support and advice.

The latest phase of the University of Glasgow’s ground-breaking study looking at the risks of brain injury in sport found that former international players had a 15-fold risk of MND compared to members of the general population.

The numbers who developed the disease were small and Prof Stewart is keen to stress that at this point researchers don’t know conclusively what is behind the figures.

New research by the University of Glasgow suggests rugby players may have a higher risk of developing Motor Neurone Disease (MND)Newsquest

However, he said they were concerning enough to merit “rapid action” by the sport.

He has suggested that rather than increasing the number of tournaments, rugby should be seeking to reduce play as well as potentially reviewing the number of individual matches each player takes on to limit head trauma.

He knows this advice may not be well received by rugby authorities or by fans of the sport.

However, it should come as no surprise when we consider that it is coming from the doctor tasked with examining the brains of former footballers and rugby players that have been ravaged by dementia and other neurodegenerative diseases.

The consultant neuropathologist is keen to point out that all sport, including rugby, remains beneficial for health and the study showed that rugby players were more likely to live longer lives.

While players were also two-and-a-half times more likely to develop dementia, he stresses that head trauma is only one of 12 modifiable risk factors and says focussing on the other preventative aspects could form part of the approach in keeping players of contact sport well.

Scottish Rugby say it is taking the issue seriously. A Brain Health Clinic has been set up at Murrayfield to improve the understanding of concussion and contact in rugby through head impact sensor technology in mouthguards.

However, Prof Stewart believes the sport has been slow to act, given the well-established link between head trauma and brain injury and says it may now be time to re-consider whether men and women should be putting themselves at risk, “week in week out for our entertainment”.

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