Institutional Failure

I want to start by saying something that might surprise you. The number of deaths in Scottish care homes is a scandal and Nicola Sturgeon's attempts to excuse it by inventing her own facts about English care homes is a disgrace but.............I have considerable sympathy for Jeane Freeman.

Both the UK and Scottish Government's were too slow to react to the Coronavirus. By early March however it was clear a crisis was coming. Quite what its scale would be was the great unknown. How many would catch it? How many would become seriously ill? How many would need hospitalisation? How many would die? 

What was known, even then, was that at the European epicentre of the outbreak at that time, in Lombardy, the hospitals were being overrun. There were more patients than beds. And the fear was that his might happen here.

So it made perfect sense to try and free up hospital beds. And perfect sense to try and free up beds by relocating those who were in hospital but did not require to be there for the purpose of treatment but simply because they were unfit to go directly home.

Suppose that hadn't been done? Suppose the disease had proved even more life threatening than it has? Suppose that people, who might have survived, started dying as they could not get a hospital bed? Because beds were occupied by those who didn't need to be there? 

That would have been a scandal even beyond that which has actually happened. 

So clearing beds was an absolutely justified priority. Deciding that where their occupants should best go (the practice in normal times) needed to take second place to their simply going somewhere.

So when Ms Freeman signed off on buying care home places in bulk? Absolutely right.

And while I do not have sight of the executive advice that followed, I am reasonably certain that it was to the effect that "Any patient who can be safely discharged should be discharged". 

But it wasn't for the health minister to take a crash course on the medical qualification that would have qualified her to define the word "safely". That was then delegated to officials. It was surely for them to decide if discharging patients without them having first had a coronavirus test still met the requirements of that word? 

Now, perhaps, but I very much doubt it, officials advised the Minister that, to comply with her imperative, patients would need discharged without tests,whatever the consequence, and she replied "go ahead anyway".If that happened, Hell mend her. But I suspect that's not what happened. She was never asked that question, at least until much of the damage was done. The policy was correct. Its execution was not. That's not a failure of Government at a political level. It is institutional failure.

And that is going to be my theme here. That, in this crisis, the Scottish Government might well mainly have performed quite well at a political level but it has fundamentally failed at an institutional level.

And before I move on to other examples, I want to defend (up to a point) Ms Freeman once again. On tracing. 

If I had been the Scottish Health Minister,I'd have happily signed up to tracing being a UK responsibility. But Ms Freeman (at least in current incarnation) is a Nationalist. So she wanted a Scottish scheme. And, indeed, when the UK Government announced they were recruiting 15,000 tracers, we announced we'd be recruiting 2,000 of our own. Petty, but fair enough in their own terms. 

Except that when it was announced the UK had 13,500 tracers in post, the press then revealed that we had none at all!

Now again, do I think Ms Freeman did not want tracers recruited? That she made a public statement on the subject and then forgot to do anything else about it? I don't think that for the moment. She told her officials to get on with it and, not unreasonably, assumed that they were getting on with it. Nobody expected her to conduct individual job interviews. I suspect that she was surprised as the rest of us to learn from the newspapers that actual recruitment hadn't even started. Again, that wasn't political failure, it was institutional failure.  

But enough of health. Let's look at some other areas. Let's start with volunteering.

Shortly after the lockdown, the UK Government set up a volunteering scheme to help the NHS and other public services. Within 24 hours, hundreds of thousands of people had signed up.Including tens of thousands in Scotland. Except that the UK Government hadn't made it clear that they could only operate this scheme in England. Now, yet again, a non nationalist administration here would just have said, "Pass their names on". They were, after all,  people volunteering to help during a national emergency. You'd have thought even the SNP wouldn't prioritise making a xenophobic point over endangering people's lives. But if you did, you'd be misunderstanding the nationalist mindset. 

Nonetheless, I have no doubt the nationalists wanted there to be a Scottish scheme. Indeed they eventually had one. The key word is "eventually". 

When they knocked back the "English" scheme, the instructions to officials wasn't difficult. "This is "their" scheme. Revisit it. Insert "Scottish" and "Scotland" as appropriate wherever possible.. Set up a website. Get on the phone to NHS Scotland and tell them to get back to you by 5pm tomorrow as to how these people might best be utilised".

If had set that task to my trainee, I would have been disappointed if he had not accomplished it within 36 hours. 

In fact,it took the best part of three weeks. I'm not going to waste time checking the exact chronology but my feeling is that from lockdown to the UK scheme being announced took less time than from the UK scheme being announced until the Scottish one followed. During which time a huge amount of momentum was lost. I had a journalist pal trying to get figures on comparative numbers of volunteers but, such was the obfuscation of the Scottish Government on comparable numbers, he eventually gave up.

Now, the decision not simply to go with the UK scheme? That was a political decision with which I disagree. But the delay on there being a Scottish scheme? That, again, was institutional failure.

I need to speed up. 

Schools. At an early stage it was just accepted that our schools would be closed for five months. That is not happening anywhere else in the UK. Or indeed the world. Closing schools ruin lives. But whatever. Teachers need their holidays. If there were still to be six weeks Summer holiday, why haven't they started now and be planned to end in mid July? Sure,a lack of political will, but was any other option except continuous closure ever put to Ministers? I sense, again, institutional failure. 

Justice. (Declaring an interest, don't even get me started). I could choose any number of examples but, I ask non lawyers doing this daily, is there anywhere, except our sheriff courts, where you still can't do video conferencing? Or, I ask lawyers, is there anywhere else in the mainland UK where there are still no jury trials? And the time it took to devise an early release scheme for low risk prisoners? Again the, particularly useless, Minister doesn't help, but still, even he wasn't even given options! Institutional failure.

Local Government support. I get, I really do, that precise figures need properly calculated but no payments to account? And, anyway, how long does it take to work out precise figures? Institutional failure.

Business support. Again, we could have gone with the UK Scheme, but didn't. Because,in truth, our current administration hates UK schemes. However, even in their stated reservations, it was because the English scheme missed out fish farms. So how long did it take to sort this out? And then after it was announced, so inadequate that it required to be substantially revised  via a press statement issued in the middle of the night. Demonstrating a level of incompetence which I am sure was not the intended objective of the political administration. In this case you certainly can't say the Minister is either stupid or lazy or insouciant. But it would be unrealistic to expect her alone to produce the details of the scheme. Again this was an institutional failure..

Our democracy. The absurdities of Rees-Mogg insisting on personal attendance at Westminster to vote? A given. So obviously MSPs can vote remotely? Well, actually, no. Because that's not quite yet been organised. Since March 23rd (March 23rd!), it has not been organised, Despite us having the initial advantage over Westminster in terms of electronic voting in the chamber. Do I think even the SNP want that? No I don't. Institutional failure in spades.  Just as was the fact that, within two months of passing the Coronavirus (Scotland) Act, we required a Coronavirus No.2 (Scotland) Act to do lots of things that had been overlooked the first time.

Before closing I'd also make the point that not all levels of government in Scotland have failed.  With a few minor hiccups, local government has performed competently and on occasions heroically throughout. HMRC have also played a blinder in delivering the furlough and self employed support schemes.

When this is over, all of this needs to be calmly analysed. Not least to advance their own principal project, the SNP would benefit from a better functioning permanent administration. The last thing they need is for "Scottish" to become synonymous with "worse".  Politicians can't do this themselves. But they can ensure that people and structures are in place which can. Let that be one of the lasting lessons of this crisis.