Freeman will regret Covid care home deaths 'for rest of my life'

1. Jeane Freeman, former Scottish health secretary, has given evidence to the UK Covid inquiry in Edinburgh
2. She said she would regret "for the rest of my life" any deaths which occurred because her government did not take action or could have done better
3. Freeman said she felt there "wasn't sufficient urgency from the UK government” at a Cobra meeting in March 2020
4. She said she did not delete any of her WhatsApp messages during the pandemic - primarily because "it never occurred to me to do so"
5. Earlier, Michael Gove said there was "irritation" within No 10 when then First Minister Nicola Sturgeon announced a ban on mass gatherings in Scotland shortly after a Cobra meeting in March 2020
6. The UK levelling up secretary said Sturgeon's move was "unwise" and led to concerns about the Scottish government being trusted - although he felt it was better to "err on the side of forgiveness"

Bringing today's coverage to a close

Thanks for joining today's coverage of the UK Covid Inquiry during its latest hearing in Scotland.

We'll return tomorrow for the questioning of former Scottish Finance Secretary Kate Forbes and former Deputy First Minister John Swinney.

You can read our report on today's events here, and head here to remind yourself of why the UK Covid Inquiry is currently in Scotland.

Monday's coverage was brought to you by Gabriela Pomeroy, Ashleigh Keenan-Bryce, Craig Hutchison, Graeme Esson, Paul McLaren and James FitzGerald.

What we did we learn this afternoon?

• Jeane Freeman, the former Scottish health secretary, says she will regret "for the rest of my life" any deaths in care homes caused by the government’s action or inaction.
• She was grilled about infection prevention in care homes, and the failure to test hospital patients before they were moved to care homes.
• Basic infection control systems were not consistent in all care homes, she said, but officials worked with care providers and local authorities to improve the system. She denied Jamie Dawson KC's suggestion that the system was "completely inadequate".
• In March 2020, social distancing and visiting restrictions were introduced to care homes, but there was a severe shortage of testing and personal protective equipment (PPE). Freeman told the inquiry "we could not magic kit and skills it out of thin air"
• She told the inquiry she "knew the virus was serious" early on and started preparations in January 2020. But she admitted was no public messaging of the threat until the first case was announced on 1 March.Earlier in the day, the UK Levelling Up secretary, Michael Gove, told the inquiry that UK ministers were irritated when Nicola Sturgeon announced a ban on mass gatherings before they did, and that led to mistrust.

Scotland struggling to implement vision of a national care service

Susie Forrest

Health producer, BBC Scotland

Jeane Freeman has today expressed regret for any mistakes she made that contributed to the thousands of Covid deaths in Scotland's care homes. She previously admitted that the Scottish government failed to understand the needs of the sector.

Today she reiterated a point made last week by NHS Scotland chief executive, Caroline Lamb, about a lack of data on the social care sector at the outset, because it is run by local authorities rather than central government. The former health secretary says this hampered efforts to put measures in place to protect the residents of care homes from the virus.

Before she stood down from her job in 2021, Freeman announced that Scotland would work towards establishing a national care service, saying that "long standing issues in adult social care [had been] thrown into sharp relief during the pandemic, and they demand our attention."

But since then, the Scottish government has struggled to bring the vision of a national care service to life as its estimated costs have spiralled to over £2 billion.

In December, it was announced that the plans would be delayed by three years and scaled back, as "more work" was needed to agree on plans with local councils.

Watch: Freeman voices regret over Covid care home deaths

I will regret Covid care home deaths for 'rest of my life' - Freeman

Discussing Covid infections in care homes, Jeane Freeman said she would regret "for the rest of my life" any deaths which occurred because her government did not take action or could have done better.

Why didn't officials directly refute misinformation?

UK Covid inquiry

Just before the end, Claire Mitchell KC asked on behalf of Scottish Covid Bereaved why the Scottish government decided not to refute misinformation on social media.

The principal reason was to avoid a "he said, she said" situation, Freeman responded.

Rather than get drawn into "tit-for-tat" social media rows, officials set up forums in which staff could ask questions about their concerns, the ex-minister said.

She said webinars were used a great deal by Scottish Care and the Scottish government, along with open meetings that happened by video call.

Freeman: Care sector was not as adequate as I would have liked

Before the proceedings came to a close today, Freeman admitted that the Scottish government's knowledge of the adult care sector was not as adequate as it needed to be at the start of the pandemic.

She said officials worked with care providers and local authorities to increase understanding and identify "deficiencies" in how the system was operating.

She denied Jamie Dawson KC's suggestion that the system was "completely inadequate".

She said "it was not as adequate as I would have liked it to be", but added that everything that could be done with the resources available was done at that point, and that things improved with time.

Some care homes had better controls than others - Freeman

A "deep-dive" meeting into care homes took place on 15 April 2020. Was this a sign that "insufficient efforts" had so far been made to protect residents in care homes, Dawson asked.

Freeman said it was becoming clear that basic infection control systems were not the same in all care homes.

"That is not a criticism of any member of staff," she said, but some care homes were responding more fully than others.

Monday's hearing comes to a close

The questioning of Jeane Freeman has just ended. There are one or two more remaining lines from the closing stages for us to update you - so make sure to stay with us.

UK Covid inquiry

Freeman: Hospital discharges just one factor in care home outbreaks

The former health secretary points out that some care homes did not have outbreaks, despite receiving patients who'd been discharged from hospitals.

Freeman says the issue is a complex one. She says the size of care homes as well as the availability of PPE also played a role along with the testing - or lack of.

She says: "I am not saying the discharge from hospital without a test had no impact. What I am saying is that it was one of the factors."

Freeman indignant at any implication she was careless

Kirsten Campbell

BBC Scotland political correspondent

Jeane Freeman is known in Scottish politics as a bright and capable woman.

She's in a unique position as someone who has been a minister in an SNP government as well as an adviser to a previous Labour-Lib Dem coalition government.

She's being put under pressure by this line of questioning about whether the Scottish government had "frankly unrealistic" expectations about infection prevention and control measures in care homes, and the lack of testing of hospital patients before they were moved to care homes.

She expressed regret for any care home deaths because of actions the Scottish government did or did not take.

She has also seemed to voice indignation at the way the questions have been framed, arguing it implied a careless attitude that she did not have.

'You cannot magic equipment and skills out of thin air'

"You cannot magic out of thin air" appropriate kit, buildings and the people with the right skills needed for testing, says Freeman.

But the Scottish government moved as quickly as it could to increase capacity and eventually managed to do that, she says.

"I understood the vulnerabilities" she says, and she also understood the risk some carers might pose to those they cared for.

There were concerns about guidance, Freeman accepts

Jeane Freeman says no alternative to the Scottish government's mitigating measures was being offered by Dr Macaskill at Scottish Care - or by anyone else.

The former health secretary agrees there was concerns about the guidance issued on 13 February 2020 about whether or not a patient with Covid could be transferred to hospital.

She explains it was not always appropriate for an elderly person who was terminally ill to be transferred to hospital, but says the manner in which the guidance was written caused concern. She says she asked the chief medical officer to clarify the guidance.

'I did not write PPE guidance'

Dawson questions Freeman on the "completely unrealistic expectations" of the Scottish government regarding PPE in care homes.

Freeman says that there were serious issues being raised that needed to be taken seriously.

She says: "I did not write PPE guidance.

"PPE guidance came through our chief nursing officer directorate, based on their clinical understanding of infection prevention and control informed by all the emerging - and constantly emerging - information on the nature of the virus. So PPE guidance changed over time."

UK Covid inquiry

Jamie Dawson KC asks Jeane Freeman a question

The challenges for care homes in getting PPE

Freeman is talking about the problems for care homes sourcing personal protective equipment, or PPE. Demand was high and the price was soaring.

So in March 2020, the Scottish government announced that the NHS national procurement service would get more PPE for the social care sector. This was "as soon as possible", she says.

'In none of this was there a risk-free choice'

Jeane Freeman tells the inquiry about her discussions with Dr Donald Macaskill, the head of Scottish Care, about whether it was possible to introduce social distancing.

There needed to be flexibility around people who had dementia, she stresses, but accepts that "in none of this was there a risk-free choice".

She says understood very well the difficulty and distress caused to care home residents due to restrictions by ending communal dining and visits. But, she says, to have allowed such activities to continue would have been to increase the risk of transmission in care homes.

The risks of moving patients from hospital to care homes

UK Covid inquiry

Freeman explains that there was a twofold concern for patients being moved into care homes.

1. She says it was felt that patients who were ready to be discharged should not stay in hospital any longer than required - especially if they were elderly or frail - because a longer stay in hospital could bring other health risks like diminished muscle capabilities or cause confusion
2. There was also the additional risk of contracting Covid in hospital

She continues: "Against that was the risk of transferring people to care homes who had not been tested."

For that reasons, she says, "additional mitigation measures" were put in place, which all care homes were required to follow.

Freeman: 'I will regret for the rest of my life' care home deaths

Freeman says she wants it on record that she was personally very concerned for people receiving care at home and care home residents.

She says she will regret "for the rest of my life" any deaths that occurred in care because of action or inaction by the Scottish government.

Care home discussion began in February 2020, Freeman insists

The questioning turns to social care - and the first recognition in the Scottish cabinet that people in care homes could be particularly vulnerable to the virus.

Jamie Dawson KC asks if there was a lack of urgency or prioritisation of the issues that were likely to be faced by those in care.

The former Scottish health secretary refutes this - saying guidance was issued to care homes on 13 March 2020 which advised social distancing, visiting restrictions and that patients should be screened clinically to ensure that they weren't being transferred inappropriately to care homes.

Freeman denies that the cabinet meeting under discussion was the first time that consideration was given to this situation.

She goes on to say Scotland's chief nursing officer had been leading discussions with Scottish Care (which represents care providers) and the Convention of Scottish Local Authorities (Cosla) in February that year.

Questions for Freeman about adequacy of preparation

Lisa Summers

BBC Scotland health correspondent

Jeane Freeman told the inquiry a bit earlier that she began to take steps to prepare for a pandemic in January 2020.

But there are questions about how adequate efforts were to contain the virus in those early weeks of the year.

At the start of February, the NHS in Scotland only had the capacity to carry out 350 tests a day, which increased to 780 by the middle of March. That wasn’t nearly enough capacity to identify all the cases in the community and trace contacts to limit the spread.

Freeman admits there was too much faith in the ability to contain the virus - to flatten the curve of infections. She says it was "a mistake" for officials to think they could delay the worse of the wave of infection into the summer.

Freeman: Virus spread 'far too quickly' for containment

UK Covid inquiry

Freeman says it was a "mistake" to believe that early efforts at containing the virus would see Scotland through the next few months of 2020 and delay the peak in caseload until the summer months.

She elaborates: "The virus was transmitting far too quickly for that."