Minister's response to call for care home plan 'inadequate'

1. The UK Covid-19 inquiry is in Cardiff to scrutinise the Welsh government's handling of the pandemic
2. The inquiry covers decision-making during the pandemic by the UK government and the devolved governments in Wales, Scotland and Northern Ireland
3. Today's session will focus on the impact coronavirus, and the responses to it, had on various sections of society
4. The bereaved families group said they wanted to know why Wales was nearly two weeks behind England in testing elderly patients for Covid, before they were discharged to care homes
5. The pandemic exposed existing racial inequalities, the inquiry hears
6. More than 12,000 people in Wales have died with Covid since the pandemic was declared in March 2020
7. We’ll bring you text coverage here, and you’ll also be able to watch by pressing play at the top of the page

Session ends for the day

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The issue of care homes during the pandemic was repeatedly raised on the second day of the Covid inquiry in Wales

Our live page coverage of the second day of the Covid inquiry in Wales is coming to an end shortly, but here are some of the main developments from today:

• Elizabeth Grant, from the Covid-19 Bereaved Families Cymru group, was the first to speak this morning, describing the experiences of her mother, Betty, who died after testing positive for Covid. Elizabeth said she was not aware of personal protective equipment (PPE) being used in the hospital, and said her mother was not tested for Covid when she was admitted

• Prof Emmanuel Ogbonna, from the first minister’s black, Asian and minority ethnic (BAME) advisory group, also spoke this morning saying the pandemic had exposed existing racial inequalities. He also said there were language barriers and cultural differences that made it difficult to get messaging to people from ethnic minority backgrounds
• Debbie Foster, from Cardiff University, spoke of the impact Covid had on disabled people in Wales, saying the specific challenges they faced “should have been understood” earlier than they were. She also said that there was a general feeling that disabled people were “seen throughout Covid as dispensable”
• The issue of care homes was also raised several times in today’s hearing, with Helena Herklots, older people’s commissioner for Wales, saying that older people were being discharged from hospitals into care homes without being tested for Covid. She also said that some of the messaging during the pandemic eroded older people’s trust in the NHS
• And the former children’s commissioner for Wales, Sally Holland, said she was not consulted about school closures in March 2020. She also pointed out that pubs were reopened before children were allowed into parks and play spaces, giving examples of where children’s needs were not taken into account

Impact on children continues to be felt

Bethan Lewis

BBC Wales family & education correspondent

When it comes to children and young people, the impact of the pandemic has perhaps become clearer with time.

The former children's commisioner Sally Holland told the inquiry that going to school, socialising and seeing family is not a "nice to have" for children but an important part of their development.

School attendance is still far lower than it was before the pandemic, and schools report a lasting impact on children's behaviour and mental health.

The inquiry will look at the extent to which decisions made by the Welsh government on school closures and other matters could have minimised those harms or made them worse.

Missing school had 'profound' effect on children

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Sally Holland said things like going to school are important parts of a child's development

Holland, who was children’s commissioner for Wales until April 2022, said the pandemic was an “extraordinary” period for children, who missed out on experiences such as going to school, socialising with friends and seeing grandparents.

“These are not just ‘nice to have’ for children but an important part of their development and ability to thrive,” she said.

She added that Covid had a profound effect on children, but sometimes their experiences were not always recognised separately from the general population.

Holland said Covid's impact has continued – and especially for specific groups.

“Inequalities children experience outside a pandemic became more evident during a pandemic,” she said.

These included poverty, disability, ethnicity and vulnerability for those where the home was not a safe place.

Pubs were reopened before parks and playgrounds - children's commissioner

UK Covid-19 Inquiry

Former children's commissioner Sally Holland said she could have helped the Welsh government if it had spoken to her about plans to shut schools

The former children’s commissioner for Wales has told the Covid inquiry she was not consulted about the closure of schools in March 2020.

While she would not have opposed the decision, Sally Holland said the government would have benefited from the commission’s knowledge and expertise.

She said the pandemic reminded people that schools were much more than just providers of academic learning.

“They feed our children, they sometimes wash their clothes and they are a very important source of wellbeing and support.”

She pointed out that pubs were reopened before children were allowed into parks and play spaces, giving examples of where children’s needs were not taken into account.

'Protect the NHS' - but was it at the expense of some?

India Pollock

BBC Wales social affairs correspondent

“Protect the NHS” was a clear message during the pandemic - but the older people's commissioner for Wales says that could have had a damaging effect on some older people who felt they shouldn't get help when they were ill.

The relationship between the health service and social services has often been under the spotlight, with hospitals being seen as the “cathedrals of care”.

A clear theme of what we've heard so far is whether that came at the cost of vulnerable people during the pandemic - such as disabled people and older people.

Government not focused on older people's vulnerability - commissioner

Helena Herklots has finished her evidence, where she suggested government ministers may not have been focused on older people when the threat of coronavirus was looming in early 2020.

Nia Gowman, of the Covid-19 Bereaved Families Cymru group, asked Herklots if she agreed that people making decisions should have recognised in January and February 2020 that older people would be particularly vulnerable.

She said the issue was not raised with her by the Welsh government until March.

“I think that indicated that at that time, maybe they weren’t giving it that focus,” she said.

GP letter 'broke trust' some older people had with NHS

Herklots said a letter sent out by a GP surgery early in the pandemic “starkly set out how older people were being viewed at that time”.

“It really broke the trust that some older people had with the NHS,” she said.

She appeared to be referring to a letter Llynfi Surgery in Maesteg sent to older patients and patients living with frailties, which said it wanted them to complete “do not resuscitate” forms - to ensure emergency services would not be called if their condition worsened due to coronavirus.

“It also went on to say that scarce resources would be directed to those who were young and fit and more able to benefit," she said.

The surgery apologised after the commissioner raised the issue.

At the same time, the messaging about protecting the NHS was having a “damaging effect on some older people” who felt they shouldn’t approach health services even when they felt ill.

“I think particularly for people living on their own, it was frightening.”

Minister's response to call for care homes plan was 'inadequate'

UK Covid-19 Inquiry

Helena Herklots is the older people's commissioner for Wales

The older people’s commissioner for Wales said she first raised the issue of a lack of testing of Covid in care homes with Wales' deputy minister for health and social services minister Julie Morgan on 14 April 2020.

Helena Herklots said: “Older people were being discharged into care homes from hospital without testing, and people within care homes were not being tested."

She said the response from Morgan to her call for a care home action plan at the beginning of the pandemic was "inadequate".

Herklots said testing needed to be urgently improved during the pandemic in order to protect people.

Access to hospital treatment for care home residents was a worry, she said.

She said she was also concerned that GPs had stopped visiting care homes, and wanted assurances there was no blanket policy and that older people weren’t seen as less in need.

Inquiry evidence is selective and guarded, say bereaved families

BBC

Karen Rutter's mother died in May 2020 from Covid she had caught in hospital

Evidence being heard by the Covid-19 Inquiry has been described as “selective” and “guarded” by some of the people from the public gallery.

Karen Rutter from Oakdale, near Blackwood, lost her mother Christine Jones in May 2020 with Covid after catching it in hospital.

"I am here, hoping that the inquiry will bring to a close nearly four years of an awful time,” she said, adding that she had managed to speak to other people about their experiences around the pandemic.

“Some is very similar and some of it different,” she said.

Of this morning’s evidence, she said the responses were “quite guarded and quite measured”.

“They know how to phrase things, and how to respond,” she said.

This was a view shared by Ann Richards, who lost her husband Eirwyn to Covid in January 2021.

“I'd say from the professionals that have come in the room to give evidence that they've been selective in what they share - guarded in how they are putting things forward."

How can the public get involved?

Anyone can share their experience through the inquiry's Every Story Matters project.

The Covid-19 Bereaved Families for Justice campaign group - which criticised the UK government's handling of the pandemic - urged the inquiry to ensure these voices are heard.

Public hearings are streamed on the BBC News website and the inquiry's YouTube channel, and witness transcripts are published on the inquiry website.

Members of the public can also apply to attend in person.

Mandatory facemasks also a focus

Owain Clarke

BBC Wales health correspondent

The issue of a delay in testing patients on release from hospital to care homes is fast becoming one of the central themes of this inquiry.

Yesterday we heard that a thousand patients had been discharged in Wales without a test during March and April 2020, and we know some care homes became real hotspots for the spread of Covid resulting in many deaths.

But another issue raised in evidence this morning was why during the first summer of Covid, the Welsh government waited longer than its UK counterpart before making facemasks in Wales mandatory.

At the time Dr Frank Atherton, chief medical officer for Wales, gave three “harms” which he said could come about if he recommended face coverings for public use.

The first was regarding availability, and that stocks would be diverted from heathcare workers and caregivers. The second was about encouraging risky behaviour, perhaps encouraging people with symptoms to leave home.

The final harm he noted was about discrimination - not everyone can buy a mask or make one, he said.

But later masks did become mandatory.

Covid-19 deaths in care homes

We heard earlier about testing in care home for Covid-19, and the UK Covid inquiry will be looking at the number of care home deaths in Wales and whether more could have been done.

The below chart shows how more than one in five deaths in the first year of the pandemic – covering the first two waves – happened in care homes.

This totalled around 1,650 Covid deaths.

BBC

'Disabled people were seen as dispensable'

UK Covid-19 Inquiry

Debbie Foster said how Covid restrictions impacted disabled people should have been understood earlier

Debbie Foster, from Cardiff University, produced a report on the impact of Covid on disabled people in Wales.

She said problems included things like "the wearing of face masks which disadvantaged people with hearing impairments, the social distancing regulations which were problematic for people with visual impairments, and the locking up of a lot of people with learning disabilities” due to lockdowns.

She added that many of these issues “should have been understood” early on.

The inquiry heard that seven in 10 deaths between March to July 2020 were of disabled people.

Asked if that was seen as inevitable, she said there was a culture of “inevitability” coming down from the UK government when it came to people who were vulnerable because they had pre-existing health conditions.

She said there had been a feeling among the group involved with the report that “disabled people were generally seen throughout Covid as dispensable."

Cultural differences not taken into account

Jenny Rees

BBC Wales health correspondent

The inquiry has been hearing about the higher risks faced by people from black and minority ethnic communities. Data told us at the time that they were disproportionately affected.

But Prof Ogbonna also highlighted the huge ethnicity data gaps in health statistics, meaning a full appreciation of just how much they were affected still isn’t clear. Those ethnicity gaps persist today.

He also flagged that the language used in communicating risks was in English and Welsh – and not the language used by those at very high risk.

Prof Ogbonna also said that cultural differences that could impact the meaning of messages were not taken into account.

Ogbonna says pandemic exposed existing racial inequalities

The risk of Covid-related death was 1.9 times higher in black, Asian and minority ethnic people compared to white people, and 1.8 times higher in men from Bangladeshi and Pakistani backgrounds than for white men.

Prof Ogbonna said there were some language barriers to reach people from ethnic minority backgrounds who were at greatest risk, and there were also some cultural differences to overcome in getting messages across.

He also said that the pandemic had further exposed existing racial inequalities.

“Mental health issues are more likely to be found in ethnic minority communities and consequences are more likely to be profound in those groups. So it was a particular concern that during a pandemic like Covid that would be exacerbated," he said.

Poor ethnicity data across health and social care services

UK Covid-19 Inquiry

Prof Emmanuel Ogbonna said ethnicity data across all health and social care services is poor

Prof Emmanuel Ogbonna has been giving evidence – he is from the first minister’s black, Asian and minority ethnic (BAME) Covid advisory group.

He is also vice-chair of Race Council Cymru, which wrote to the chief medical officer to complain about the disproportionate impact the pandemic was having on people from ethnic minorities.

The BAME group was set up after the letter was sent.

Prof Ogbonna said ethnicity data across all health and social care services and many other public services is poor.

One area of concern is that it is not recorded on death certificates, although he acknowledged “not everyone feels comfortable” in recording the information.

He said the Welsh government was very engaged with the group.

Pain and grief on display at hearing

India Pollock

BBC Wales social affairs correspondent

Why did the Welsh government wait until two weeks after the UK government to introduce testing for patients being discharged from hospital into care homes?

This question, asked at the inquiry again today, was raised with the Welsh government in late 2021 by grieving families.

Elizabeth Grant, from Covid-19 Bereaved Families for Justice Cymru, says she's still waiting for an answer two-and-a-half years later.

The continued pain and grief is evident at the inquiry this morning and the question remains - was the care of people outside of hospital an afterthought for decision makers?

Wife of hospital porter died after he was sent home with Covid symptoms

UK Covid-19 Inquiry

Amanda Provis said her mother died just days after her hospital porter husband - who wasn't given PPE at work - began showing symptoms of Covid

Amanda Provis, also of the Covid-19 Bereaved Families Cymru group, said she lost two relatives from Covid, including her mother.

Her father was a hospital porter who was not provided with PPE, she said, and he started showing symptoms of Covid at the end of March 2020.

She said her mother then began to show Covid symptoms a day or so after he was sent home from work.

She said her mother was “too afraid” to go to hospital. On 7 April 2020, she received a telephone call from her father to say her mother had died.

Government ‘caught with their trousers down’ over care home testing

Elizabeth Grant, representing the bereaved families group, said they wanted to know why Wales was nearly two weeks behind England in mandatorily testing elderly patients for Covid before they were discharged into care homes.

The inquiry has heard how testing was introduced in England on 16 April 2020, but only started in Wales on 29 April.

Grant said: "It sounds like they [the Welsh government] were caught with their trousers down. And when they realised the impact of the virus on Welsh shores, they sat on their hands.”

Bereaved daughter says mum not tested for Covid before leaving hospital

UK Covid-19 Inquiry

Elizabeth Grant said she was not aware of the use of personal protective equipment (PPE) at the hospital her mother was discharged from

The second day of the inquiry has opened with evidence from Elizabeth Grant, whose mother, Betty, died after testing positive for Covid.

Betty had only been discharged days earlier from a community hospital in April 2020.

Her daughter said she was not aware of the use of personal protective equipment (PPE) at the hospital, and her mother was not tested for Covid on admission to it or when she was discharged from the previous hospital she was in.

Grant is a member of the Covid-19 Bereaved Families Cymru group, which is participating in the inquiry.