Welsh Government insists it acted on scientific advice when releasing patients to care homes in Covid crisis

Martin Shipton

The Welsh Government has doubled down on its disputed narrative that it was following scientific advice when it continued discharging untested patients to care homes during the pandemic.

The delay in halting such discharges has been blamed for causing many avoidable deaths, but Nageena Khalique KC, representing the Welsh Government, told the UK Covid Inquiry: “On hospital discharge, [former Health Minister] Vaughan Gething, in his evidence, explained that the discharge framework dated March 13 2020 was underpinned by the need to manage the risk that Wales as a whole was facing, at that time, of the potential catastrophic collapse of the health and social care system.

“In this, and in all other decisions during the pandemic, as noted by Mr Gething, the Welsh Government considered the balance of harms inherent in one decision as against the alternative.

“Decisions had to be taken at pace, and were based on, to quote Mr Gething's words, ‘the best understanding of the scientific and medical evidence available at the time."

“You also heard from [Chief Social Care Officer for Wales] Albert Heaney. He accepted that, with the benefit of hindsight, it would have been better to test upon discharge from the beginning of the discharge framework being in place, but that approach was not in the scientific or medical advice at the time.

“Mr Gething confirmed in his evidence that decisions on asymptomatic testing were similarly based on the scientific advice available at the time, and not based on testing capacity. However, you heard from Mr Gething that had the advice to engage in asymptomatic testing come earlier, the reality is that the government would have faced the very practical challenge of delivery and how to prioritise the tests available.

“In May 2020 targeted asymptomatic testing was introduced in care homes. General asymptomatic testing in care homes was not introduced before May 16 because the advice received up to that point by the Welsh Government was that the scientific evidence did not support it.

“You also heard in evidence that the advice relating to asymptomatic testing of all care home residents, that was referred to by [former UK Health Secretary] Matt Hancock in a Health Ministers’ meeting on May 5 2020 was never shared with the Welsh Government at any level, nor were its contents reflected in SAGE [Scientific Advisory Group for Emergencies] advice at that time.

“ … Overall, and to conclude, throughout the pandemic the Welsh Government was committed to protecting the people living and working in the care sector, and balancing the protection of the health and well-being of recipients of care and the need to save lives.”

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Testing in care homes

Responding to Ms Khalique’s closing statement to Module 6 of the Inquiry, covering care homes, the Covid Bereaved Families for Justice Cymru campaign group issued a statement that said: “Yesterday we explained to the Inquiry that the Welsh Government knew full well of the scientific evidence in favour of testing in care homes, and we quoted from a Welsh Government document from April 18 2020 that stated as follows: ‘Evidence suggests that this approach results in asymptomatic Covid-19 individuals, many of whom will go on to develop symptoms, not being identified and a source of ongoing risk to residents and staff…International evidence suggests that increasing testing in care homes for asymptomatic staff will provide added protection against the virus.’

“Incredibly, today at the Inquiry the Welsh Government denied knowledge of their own document and continued to claim that the advice they received at this time was that scientific evidence did not support testing in care homes.”

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'Fallacious'

Robin Allen KC, for the Welsh Local Government Association (WLGA), told the Inquiry: “Despite the evidence to the contrary from the former Minister for Health and Social Services, Vaughan Gething, any assumption that social care settings are safer than hospitals must be rejected as a fallacious generalisation. No future policy should be built on this assumption. Policy must be built on the recognition of the many and varied constraints on delivering residential care.

“ … The WLGA emphasises the importance of investing in the workforce. It is not enough for the Chief Social Care Officer for Wales, Albert Heaney, to have noted how the system is very fragile, with problems of high turnover of staff, and a very low-paid workforce.

“It is obvious that such fragility, if continued, will cost lives in a future pandemic. So the WLGA emphasise, this is the time for urgent meaningful action to improve the resilience and quality of the social care sector, and to rebuild public confidence.”

'Poignant'

In one of the final pieces of evidence given to Module 6, Cate Griffiths, whose father Group Captain Harold Griffiths died after being one of 45 residents of a care home in north Wales who tested positive for Covid-19 during a cluster outbreak, said: “I appreciate this chance to have my voice heard. I'm speaking on behalf of the many thousands who no longer have a voice, as well as the bereaved families in Wales.

“In the summer, during a lucid moment on the phone before my dad died, he asked me if I felt that the Welsh Government was looking after us, if it was making good decisions for us. Poignant and prescient, in retrospect.

“Care home residents were and remain, as we know, a singularly vulnerable group. These precious people, people who have contributed both societally and fiscally to our country throughout their lives, needed to be protected.

“From what I've heard over these last weeks, none of the institutions responsible for the protection of Welsh care home residents did that. It is heartbreaking and it compounds our grief.

“If we're lucky, we will grow old. But age does not diminish the value of our one wild and precious life, to quote the American poet, Mary Oliver. My father was old. My father deserved better. We all deserve better.”