Official Report 1247KB pdf
The next item of business is a debate on motion S6M-03492, in the name of Jackie Baillie, on Anne’s law—protecting the right of care home visiting. Any member who wishes to participate should press their request-to-speak button or put an R in the chat function.
16:10
Presiding Officer, 24 March will mark two years since Scotland entered its first day of lockdown. Those were some of the hardest days that many of us have had to face. Those of us who had family or friends to isolate with were the lucky ones and, even then, for many people, the weight of lockdown was huge. We did that because it was necessary, it saved lives and it was the right thing to do.
Since then, more than 4.4 million adults in Scotland have received at least one dose of the Covid-19 vaccine, and the number of patients in intensive care units with the virus has significantly decreased. Football and rugby stadiums are again packed with spectators, and nightclubs and hospitality venues can operate without restriction. We can meet friends to socialise and families can gather to celebrate milestones once again.
Lockdown appears to be a distant memory, yet care home residents continue to face some of the severest restrictions. People living in those homes continue to be the forgotten victims of the pandemic under the Scottish Government. For the past two years, adults living in care homes in Scotland have been isolated from their friends and families. For them, those hard days of separation are the reality, and the lack of urgency that the Government has shown in addressing the issue prolongs their suffering.
In November 2020, Natasha Hamilton brought a petition to the Parliament to ensure that family members could be granted access to relatives in care homes, regardless of lockdown levels. Natasha’s mum was Anne Duke, who was in a care home, and Anne’s family showed remarkable bravery in exposing the struggle that too many families experienced—the isolation, separation and loneliness, and the toll on mental and physical health. That story was echoed by people in my constituency. Let me share a quote from one of them, who said:
“Every day we are separated means that my mother’s wellbeing deteriorates. The restrictions in care homes are too severe, inhumane and have been in place too long.”
Let us look at the contrast. If any of us tested positive, we would be told to isolate for seven days. In care homes, it is 10 days. If someone is a close contact and triple vaccinated, they do not need to isolate but, in a care home, close contacts have to isolate for 10 days. For someone in a household with Covid, there are no restrictions, but a care home closes for 14 days. The reality is that that means rolling lockdowns and restricted visiting. Donald Macaskill of Scottish Care has said:
“such extended periods of isolation ... are unacceptable, disproportionate, unnecessary, and hugely damaging.”
I absolutely recognise the disparities between the isolation periods in care homes and those for the general public, but is Jackie Baillie asking us to reduce the isolation periods in care homes? If that is her point, what clinical advice has she received, and will she forward it to the Government so that we can look at it?
I will quote the First Minister in a minute, so the cabinet secretary might want to listen.
Almost one year on from the Scottish Parliament elections, when the Scottish National Party vowed to deliver Anne’s law for care home residents, the position is largely unchanged from what I have just described. As of 14 February, 92.3 per cent of care home residents in Scotland had received three doses of the Covid-19 vaccine, making the continuing restrictions hard to justify. There is no vaccine for loneliness and isolation.
Time and again, the Scottish Government has implemented restrictions and regulations but has not acted with the same speed when the restrictions are no longer required, despite knowing that being separated from loved ones causes harm to people in care homes.
The First Minister has correctly stated that lateral flow tests are 99 per cent accurate. We should trust and use the science. Staff undertake 12-hour shifts based on a negative lateral flow test, so why can relatives not visit on that basis? They do not interact with large numbers of residents, as staff do, and they do not work across the care home, so there is little risk of widespread transmission.
The change would be easy to deliver. Relatives need to be recognised as care givers. They are as important, if not more so, to the wellbeing of the person in the home. Let us make use of lateral flow tests to open up access. Let us trust the science that the First Minister referenced.
Scottish Labour has been forced to bring the debate to the chamber in order to demand answers and action. For those at the end of their lives, every day counts. [Interruption.] The cabinet secretary would do well to listen. The Scottish National Party and Green coalition cannot continue to drag its heels on strengthening residents’ rights. The Government has the power to make the change now. Its own records show that updated restrictions have left 21 per cent of care homes likely to be operating under severe restrictions, yet Anne’s law is discussed only when prompted by other MSPs.
This is a matter of basic human rights. There is an opportunity to do the right thing for care home residents, who have been let down so often over the past two years. It cannot be right that life goes on for the majority while others continue to suffer. All parties support early legislation, and I urge the Minister for Mental Wellbeing and Social Care to give a clear timetable for bringing such legislation to Parliament so that care home residents can enjoy the same freedoms as the rest of us enjoy.
The two-year anniversary of the start of the pandemic, as it approaches, will cause us all to reflect. We will be reminded to appreciate small freedoms, such as a cup of tea with family or lunch with friends. Let us not forget that, for some, those small freedoms are still out of reach. The Scottish Government must act, and it must act now.
I move,
That the Parliament understands that maintaining good social connections are crucial for the wellbeing and quality of life for residents in adult care homes; acknowledges that care homes have been unduly affected by the COVID-19 pandemic, and thousands of residents have been repeatedly separated from their loved ones due to restrictions; regrets that the Scottish Government has not yet brought forward legislation to strengthen the rights of residents and their families so that relatives are recognised as care givers and residents have the right to see and spend time with the people who are important to them, and calls on the Scottish Government to urgently introduce legislation to implement Anne’s Law so no one has to again experience what Anne Duke and her family, alongside many other families, had to go through.
We are very tight for time, so members will have to stick to their allotted times.
16:17
I welcome the opportunity to contribute to today’s debate. People who live in care homes and their loved ones are undoubtedly among those who have been hardest hit by the Covid-19 pandemic. Although action had to be taken to ensure that people in care homes were protected, I completely understand the distress that was caused by people being separated from those folks who are most important to them. I thank care home residents, their loved ones and care home staff for their continuing steadfast commitment during the pandemic to keep themselves and one another safe.
Restricting care home visits early on was one of the hardest decisions that the Government had to take. Throughout the pandemic, we have sought the views and experiences of families with loved ones in care homes in relation to the impact of visiting restrictions. I am very close to the issue, and rightly so. I ensure that I see all correspondence on visiting, and I always respond personally. I have huge empathy with people who have experienced separation and loss. Many of the stories of separation are, to be quite frank, heartbreaking.
The minister has recognised the anxiety and stress felt by families and staff in our care homes, but does he recognise that that despair exists to this day? A care home manager in my constituency wrote to me to ask the Government to stop testing so that it would stop bringing back restrictions. What does he say to staff and families who believe that, while the rest of society is being released from lockdown, care homes are not?
I do not quite get Mr Cole-Hamilton’s point—I might have picked it up wrong. Jackie Baillie is right to say that we should be testing, but he is saying that we should stop testing. I do not quite get that.
On Jackie Baillie’s points, people can visit care homes even during outbreaks. We have made that clear, and we will go further. Visitors are tested already. I would welcome any clinical advice that Jackie Baillie has on those issues, because that might help us counter some of the advice that we are getting.
Will the minister give way?
I have a lot to go through.
Our named visitor guidance was introduced last year as a first step towards implementing the changes that we all believe are necessary. It emphasises that care homes should always support visiting, even in an outbreak, unless there are truly exceptional circumstances. The Scottish Government expects care homes and local health protection teams to embed our guidance.
As the strategic framework outlines, people who live in care homes should be supported to enjoy fulfilled, meaningful lives that are free from restrictions as far as possible. My officials, in collaboration with the Care Inspectorate, are focused on working with the sector to ensure that care homes support visiting and to work constructively with those that do not.
Will the minister give way?
I really do not have time—I have a lot to say. Maybe I will give way later.
I thank care home staff and health protection teams who have tirelessly worked to facilitate regular indoor visiting in more than 90 per cent of care homes. Those efforts to maximise visiting and adopt the aims of Anne’s law ahead of any new measures show a welcome consensus across the sector.
The development of Anne's law follows a Care Home Relatives Scotland petition on rights for residents to see their loved ones, which was lodged by Natasha Hamilton, who was unable to see her mother for prolonged periods during the height of the pandemic. Her mother was of course Anne Duke, who has now sadly passed away. We fully supported that petition and I am pleased to say that there was cross-party support. In September last year, we made the commitment in our programme for government to strengthen residents’ rights and bring in Anne’s law.
Given the need to move quickly and effectively to ensure that legal rights can be instituted and, importantly, enforced, we have chosen to deliver that work by strengthening the health and social care standards using legal powers under the Public Sector Reform (Scotland) Act 2010, and by strengthening rights further through primary legislation.
As members will be aware, any change to legislative powers requires us to consult, so later in September we launched two linked public consultations to seek views on the preferred options for implementation. We have now received the analysis of those consultations. Responses came in from individuals, including families, and from a wide range of organisations, including care home providers.
The independent analysis showed that there was considerable support for the approach of introducing Anne’s law by strengthening the health and social care standards and then introducing primary legislation. We published that analysis only last week, on 2 March. I thank everyone who took the time to submit their responses.
Given the support for those proposals, there is no need to undertake further time-consuming legislative processes, such as Scottish statutory instruments, to make change happen.
I can announce today that, using legal powers under the Public Sector Reform (Scotland) Act 2010, we will introduce by the end of this month those two new strengthened statutory care standards, which will ensure that visitors can be involved in the care and support of their loved ones and provide a strong emphasis on helping residents and their families remain connected.
You need to conclude now, minister.
Finally, that also means that the Care Inspectorate, under its existing legal powers, will now have a strengthened role to ensure that the new standards are implemented and, more importantly, upheld. The Care Inspectorate is committed to that work and, to augment it, we will provide further support and dedicated resource to enhance the Care Inspectorate’s role in supporting visiting rights.
You do now need to conclude, minister. You are well over time.
I will say more about primary legislation in summing up, Presiding Officer.
I move amendment S6M-03492.2, to leave out from “understands” to end and insert:
“recognises that the COVID-19 pandemic uniquely necessitated difficult restrictions in care homes to minimise the risk of transmission of the virus that has proven deadly to the most vulnerable in society; further recognises that these restrictions have other impacts on the wellbeing of residents and that maintaining familial and social connections for care home residents can be vital to their wellbeing; welcomes that later this month the Scottish Government is bringing forward new statutory standards under the Public Services Reform (Scotland) Act 2010 to help ensure visitors can be involved in the care and support of their loved ones as the first step of introducing Anne’s Law, and notes that this will be further underpinned by Anne’s Law being part of the foundations of the new National Care Service, and that the legislation to deliver this is being introduced in the coming months.”
16:24
I thank Jackie Baillie for securing this important debate before Parliament today.
It is just over two years since Covid arrived on Scotland’s shores—two years since fears ran through our communities, schools were shuttered and businesses were forced to close; and nearly two years since elderly and vulnerable care home residents were isolated from their families, losing their lifelines and often access to someone who addressed their core care needs, and losing the cup of tea and the bit of chit-chat that brought to life the family photos by their bedside. They were shut out from that vital support for months on end, and the purpose of Anne’s law is to ensure that that never happens again. Closing off residents in care in their home was, in the words of Natasha Hamilton, “a human tragedy”.
As we have heard, Natasha’s mum, Anne Duke, was one of those who could not secure the comfort of their loved ones during the pandemic. Anne, a former care home therapist, who passed away at the age of just 63 last November, was cut off from her devoted family while battling early-onset dementia. That prompted Natasha to launch a petition for Anne’s law that made its way to this Parliament.
Sadly, many people did not live long enough to see their loved ones one last time, or they saw them only through a window or at a distance; sometimes, they did so from behind screens and hazard tape. Our care homes bore the brunt of the pandemic, and it has been heartbreaking for families.
Over the past two years, many lessons have been learned and the path ahead looks far less bleak, thanks to vaccination and accurate and widespread testing. However, there are still lessons to be learned, restrictions to be lifted and questions to be answered. Fundamentally, there are also practical steps, such as Anne’s law, to be implemented. Although we fully accept Labour’s motion, which we warmly support, we have lodged an amendment, in which we seek a commitment from the Scottish Government to explore—no more than that—the possible extension of Anne’s law to include other settings, such as community and cottage hospitals, where care is given.
Will the member take an intervention?
I will not, I am afraid, because I am short on time.
We are sceptical of the SNP’s amendment, which offers yet more dither and delay. Notwithstanding what the minister has announced, we must recognise that, when it comes to Anne’s law, the ball is at the minister’s foot, he is in the penalty box and the goal of delivering Anne’s law is right there, so why is he—as the SNP too often does—kicking it into the long grass?
Will Mr Hoy give way?
I must carry on.
Today’s debate is not about the reasons as to why so many died in our care homes—that will be for Lady Poole’s public inquiry to determine—but we know that Common Weal described the situation in our care homes as
“possibly ... the single greatest failure of devolved government ... since the creation of the Scottish Parliament.”
Families need closure so that they can properly mourn those who passed away. Anne’s law could help them to move on and to remember those who died.
We should also remember the heroic efforts of the staff who work in the social care sector, who were often there when residents passed away. In the early days of the pandemic, Covid ripped through care homes indiscriminately, killing our friends and family members, so it is understandable that steps were taken to protect staff and residents from infection. Many staff struggled to access personal protective equipment. Staff went to work not knowing whether they would return home infected with Covid. They formed small armies of infection control. However, the decision to prevent all access to care homes created what has been described as potentially “dangerous closed institutions”, where families could not act as the eyes and ears of homes and residents.
Leading public health experts back Anne’s law and recognise the care that it will provide. In its own consultation, the Government was clear in its objectives. It recognised that families and friends play an essential role in the health and wellbeing of people who live in such homes, and it admitted that prolonged isolation from family and friends is likely to be detrimental to the welfare of the resident.
All that campaigners are seeking is to ensure that people who live in adult care homes have rights to see and spend time with the people who are important to them and who often care for them. As Natasha Hamilton said,
“There are no silver bullets for Covid, we need to learn to live with it. That can’t mean separating families. That’s just cruel and barbaric.”
Anne’s husband, Campbell Duke, is a retired social worker. Before Covid, he previously spent 40 hours per week by his wife’s side at her care home in East Kilbride. Speaking before Anne died, he said:
“Families need each other more than ever but they’re being let down ... What we need is for the human rights of care home residents to be guaranteed in emergency legislation. I believe there would be a majority in Parliament for this.”
I believe that there is a majority in the Parliament for Anne’s law, and it is clear that now is the time to act.
I move amendment S6M-03492.1, to insert after “Anne’s Law”:
“and to explore extending its scope to include those receiving care in other health and care settings such as hospitals and residential care facilities,”.
16:29
I am grateful to Jackie Baillie for bringing the debate to Parliament. I offer her our unconditional support: we stand full square behind Labour in its quest to see the proposed law being taken through Parliament.
The late American author Professor Leo Buscaglia once reminded us that
“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”
Perhaps we often underestimate the power of simply being able to hold someone’s hand and give them a hug, and, in some cases, at the end of their lives, to kiss them goodbye. During the pandemic, the absence of that simple and carefree human contact with loved ones was felt acutely by thousands of care home residents in Scotland; sadly, it continues as we speak.
The Government website states:
“Visiting is an integral part of care home life”
and has a vital role to play in maintaining the mental and physical health
“and quality of life of residents.”
It goes on to say that it
“is also crucial for family and friends to maintain contact ... with their loved ones, and to contribute”
in their own way to their care.
An Age UK survey attempted to record the toll that the pandemic has taken on people living in care homes and their families. The responses were heartbreaking. One respondent said:
“I feel as though I have locked my parents away and thrown the key away”.
Another mentioned
“time that can never be retrieved”
and said,
“I don’t want mum to die”
without
“family, a thing she has always dreaded and I promised would not happen.”
I have spoken to many of my constituents whose loved ones have been in care homes during the pandemic. People want to be safe and they want desperately to protect their loved ones, but many have felt, and still feel, that a balance was not struck between protecting loved ones from the virus and maintaining regular and vital contact.
Several times in his speech, the minister talked about “visitors”. He did not talk about family care givers. Alex Cole-Hamilton has recognised the important contribution of people such as Campbell Duke and Natasha Hamilton, who are in the building today, listening to every word. They are not visitors—they are family care givers. Does Alex Cole-Hamilton agree?
I absolutely agree. To clarify my intervention to the minister, I say that we are shutting such people out of our care homes. The care home manager who got in touch asked that we end testing not because she was cavalier about the virus but because she could not abide the restrictions coming in again and again and blocking people from offering the care that they give.
How we have dealt with care homes over the pandemic has been staggering. As coronavirus started to take hold in Scotland, in the foothills of the pandemic people with it were moved from hospitals into homes, which caused the deaths of many. We can contrast that with the latter stages of the pandemic when, as we have heard countless times, many people who had been triple vaccinated were still prevented from visiting their loved ones—in some cases, during the last weeks and days of their lives, when they needed them most. That is demonstrably, starkly and tragically the case as we have heard many times, such as in the case of Anne, in honour of whom the law would be named.
My party whole-heartedly supports the motion in the name of Jackie Baillie. It is vital that either the Scottish Government introduces a bill or that we do it through the private member’s bill process, instead.
If I may, I will finish with the words of Anne’s husband. In a letter that he penned following her death, he said:
“For seven months they literally kept us from being with you. You endured the humiliation of being viewed outside from two metres when you needed and required close touching and hugging. And someone close enough to whisper, ‘I love you.’”
It is my sincere hope that the Government listens to Anne’s story and to countless others’ heartbreaking stories, and that it makes the changes that are necessary to ensure that no one is ever again denied the right to be with a person whom they love—to simply hold their hand, kiss their cheek and give them a hug.
We move to the open debate. Paul O’Kane joins us remotely.
16:33
The importance of today’s debate cannot be overstated. Our care homes have been at the centre of the pandemic over the past 2 years. Let me put on record my thanks to the amazing staff of our care homes, who are often underpaid and feel undervalued, and who have done all that they can to protect people and to support their families. We know that people who live in care homes and their families all across our country have suffered immensely.
The reality is stark. From 2020 to 2021, there were more than 2,500 excess deaths in Scottish care homes—each person the loved one of someone. We know that there are still many questions to be answered about how that was allowed to happen, so answers must come in the inquiry.
What made the pain even worse for families was that not only did they lose loved ones, but they could not even be there to hold their hands or stay by their sides in their final hours. That was not the case only in 2020, when we were all under tight restrictions; it continued to happen over the following year. As restrictions for the rest of the country eased, care homes had to remain under repeated lockdowns, which caused untold harm and trauma to residents and their families.
I am sure that all members agree that such a situation is terribly tragic. As restrictions are lifted and we understand our new Covid reality, we must ensure that such a tragedy never happens again. That is why I support the motion in Jackie Baillie’s name.
The story of Anne Duke has touched the hearts of thousands of people across our country. The continued efforts of her husband Campbell and her daughter Natasha Hamilton have helped to bring the issue to the fore in public debate.
We should not hesitate: the Government should not wait but should act with the sense of urgency that the situation deserves. The SNP’s amendment to the Scottish Labour motion shows that the SNP still does not get it. I find the amendment to be quite insulting in its failure to acknowledge Anne Duke and her family, and the contribution that they and other campaigners have made.
The Government wants to defer implementation of Anne’s law until the introduction of the national care service—a process that will take many years—despite the fact that, in the recent consultation, there was virtually unanimous support for Anne’s law and the right of people who live in adult care homes to see friends and family. Respondents also thought that the right should be enshrined in law in order to ensure parity across our country, rather than relying on the discretion of individual care homes. That shows the importance of introducing Anne’s law.
The Scottish Government’s actions in the care home sector led the Scottish Human Rights Commission to express concern about social care users’ experiences during the pandemic. The commission said that the situation in care homes raised concerns under article 2 of the European convention on human rights, on the right to life.
Even now, after a consultation has told the SNP that there is support and the commission has pointed to failings and concerns, there are still challenges for families who want to see their loved ones regularly. Indeed, care homes have been receiving confusing messages from public health teams about when they should and should not restrict access. I raised the matter with the First Minister in early January, but there are still issues.
Never again should we have such a situation in care homes in Scotland. As we have heard from other members, it is vital that our loved ones have the right, when they are in someone else’s care, to see and have important contact with their families and friends.
It is time for the cabinet secretary and ministers to listen to relatives and care users. It is time to implement Anne’s law and to end the pain of loved ones being parted when they need one another most.
16:37
I thank Jackie Baillie for bringing this important debate to Parliament, and I thank Natasha Hamilton for her petition in honour of her mother, Anne Duke, which highlighted the social isolation that Covid restrictions caused in Scotland’s care homes.
As we have heard, the proposed Anne’s law would recognise that families and friends play an essential role in the health and wellbeing of people in care homes. One of the saddest parts of the pandemic has been the enormous sacrifices that many people have made to keep others safe. Restrictions in care homes were particularly difficult, and cut residents off from family and friends.
To tackle such isolation, the Scottish Government invested £1.5 million in an initiative to connect residents in Scotland’s care homes. The initiative was launched in November 2020 and aimed to equip all care homes in Scotland with digital devices, connectivity, training and support in order to tackle social isolation and to help residents to enjoy the benefits of online access.
However, for many people, the transition to digital communication was difficult, even when the technology worked well. Some respondents to the consultation noted that their loved ones became more withdrawn and despondent, despite daily video calls. Therefore, I welcome the evaluation of the initiative that the University of Stirling is undertaking in collaboration with the Scottish Government’s technology-enabled care programme and the Digital Health and Care Innovation Centre. Dr Grant Gibson, who is the project’s leader and an expert in dementia care said:
“it is likely that at least some elements of the switch to greater use of digital platforms to support social interaction among care home residents will become permanent. Therefore, there is a clear need to evaluate whether the programme was successful, and to learn the wider lessons ... to inform wider initiatives supporting digital connectedness and inclusion of care home residents in the future.”
I am sure that all members in the chamber look forward to delivery of the SNP’s manifesto commitment to
“strengthen residents’ rights in adult residential settings.”
The Scottish Government will introduce Anne’s law in Parliament as soon as possible, but it is also taking immediate action to ensure that care home residents and their families can benefit from the proposed law’s aims and principles now. That includes working with the Care Inspectorate to update and strengthen its health and care standards, with a strong emphasis on helping residents and their families to remain connected.
The Scottish Government is also introducing new statutory standards under the Public Services Reform (Scotland) Act 2010 to help to ensure that visitors can be involved in the care and support of their loved ones. I thank the Minister for Mental Wellbeing and Social Care for his understanding and on-going hard work to ensure that Anne’s law is brought to Parliament, while considering the sensitivities of more than 400 consultation respondents.
The overwhelming heartache that was felt by Natasha Hamilton and by many other families across Scotland during lockdown is something that we will remember for many years, with heavy hearts.
16:42
The Covid-19 pandemic has been difficult for everyone. Up and down the country, isolation and loss have been felt by so many. However, as a result of the strength of families who have been affected, we know in particular about the impact that has been felt by those in our adult care homes. Isolated for so long, disconnected from their families and unable to have the human connection they need, those in our adult care homes have been disproportionately impacted by the pandemic.
Despite what the previous speaker said in her contribution, the reality is that families feel that this Government has not been providing them with enough support. Families in my region of South Scotland, like others across the country, have had to go to their loved ones’ windows for a chat; some have watched their condition deteriorate without being able to sit next to them; and others have lost loved ones without even being able to say a final goodbye. Those are serious matters. It is one of the most heartbreaking stories of the pandemic; we must address it now and never allow it to happen again.
Care homes have been repeatedly closed to visitors during the pandemic; they have often been the first premises to close and the last to reopen. Of course we know how important it is to protect the most vulnerable in a care home setting, but we also know how important it is to strengthen their rights while they are in that setting.
It is therefore crucial that Anne’s law is introduced to Parliament, as Scottish Labour has called for. As we have heard, Anne’s law would ensure that relatives of residents are recognised as care givers—that is a key point—thus giving residents of care homes the right to be visited by those who matter most to them. That would ensure that they have the contact of which far too many in Scotland’s care homes have been deprived. The situation has simply gone on for far too long. Measures could be introduced to ensure that relevant infection control guidance is followed and that residents’ physical safety is protected. Although the Scottish Government has committed to introducing Anne’s law, that must be done with purpose, and promptly, because care home residents and their families are still being failed.
Even now, a positive test in a care home for a resident leads to a 10-day self-isolation period while the rules for everyone else have been relaxed. We know only too well the negative impacts that prolonged isolation can have on an individual’s mental wellbeing.
Families such as Anne Duke’s are calling for urgent action, and it is crucial that the First Minister and the health secretary listen and deliver it. To not act now is to keep families waiting, inflict more difficulty on residents and their loved ones and exacerbate an issue that has already impacted thousands of Scots. Families will not stand for it, and neither will Scottish Labour.
In conclusion, I once again pay tribute to those who work in our care homes, the residents and their families. The challenges placed in front of them throughout the pandemic have been significant and hard to overcome, but they persist, and they fight for change that will benefit the lives of residents in our adult care homes across the country.
Our fight for Anne’s law will continue because we know the impact that interaction with loved ones has on each and every one of us, and we will not stop until the Scottish Government acts. My message to the Scottish Government and all members is that we must act now in the interests of some of the most vulnerable members of our society. I therefore urge all members—I am looking to members on the Government’s back benches—to act now. Step up and support those families. Support Labour’s motion at decision time.
16:46
The Scottish Conservatives recognise the impact that Covid restrictions have had on care home residents and their families, and we gladly support the principles that underpin Anne’s law.
During the height of the pandemic, care home residents were unable to see their loved ones. Steps were taken to protect staff and residents from infection but, with hindsight, they undoubtedly caused much anguish for many residents and their families. Anne’s law is the product of a petition to the Scottish Parliament that was lodged by Natasha Hamilton, who was unable to see her mother for prolonged periods during the height of the pandemic. The petition called on the Scottish Parliament to urge the Scottish Government to allow a designated visitor into care homes to support loved ones.
We agree that residents’ rights must be strengthened to give nominated relatives or friends the same access rights to care homes as staff, while following stringent infection control measures. It is unacceptable that residents and families have been subject to a postcode lottery. We must ensure that contact between residents and their close family and friends is not subject to haphazard and fluid policies. Family and friends provide critical support to residents’ mental and physical health and wellbeing, and there is no doubt that prolonged isolation from friends and family has a detrimental effect on care home residents.
With that in mind, we are disappointed that the SNP Government has taken so long to make good on its commitments and now appears to be dragging its feet on introducing the legislation to the Scottish Parliament, despite cross-party support. The commitment to deliver Anne’s law is nearly a year old, but the Scottish Government has not set out a timetable to deliver it. It has merely said that
“Anne’s Law will be introduced to Parliament as soon as is practically possible”.
The SNP allowed more than 100 Covid-positive hospital patients to be sent to care homes at the beginning of the pandemic. A report from Public Health Scotland found that from 1 March to 31 May, 113 hospital patients were discharged to care homes despite testing positive for the virus in hospital. A further 3,061 were not tested at all prior to discharge.
Former health secretary Jeane Freeman admitted that the SNP Government failed to take the right precautions when moving elderly patients from hospitals into care homes during the pandemic. Despite all that, the SNP has refused to order a public inquiry into deaths from coronavirus in Scotland’s care homes. The Scottish Parliament voted for
“the Scottish Government to hold an immediate public inquiry to find out what happened in Scotland’s care homes during the course of the pandemic”,
but Nicola Sturgeon merely said that
“we take note of the Parliament’s view”
and that the SNP Government was seeking
“early discussions on whether and how such an inquiry could be established”.—[Official Report, 5 November 2020; c 22.]
Of course, it is not only our elderly who are in residential care or nursing homes. Many young adults with physical and learning disabilities are also in care. They, too, deserve the right to see their families. Just as isolation from friends and family has a detrimental effect on care home residents, it has a negative impact on young people in similar care settings. There are stark differences between how the public and how care home residents are restricted, as Carol Mochan has rightly pointed out.
Anne’s law has cross-party support. The SNP must stop dithering and bring forward the legislation so that residents and families can have confidence that we are moving beyond what has been a failed and broken approach.
16:50
I am fully supportive of the principles of Anne’s law, and I was moved by the testimony of Anne’s daughter, Natasha Hamilton, and the many others who could not be with their loved ones in care homes at the height of the pandemic.
The Covid pandemic threw challenges at us that are unprecedented in living memory. We all remember the fear of not knowing what Covid-19 was, how it could be spread, who would be most vulnerable and how infectious it could be. In February and March 2020 we had no vaccine, and we looked on with fear at how the virus ripped through Italian towns killing thousands of people, wondering what it would do to us and how we would cope when it arrived.
It was right to be cautious. We did not know what we did not know. Care home residents were particularly vulnerable. We now know what it is to live through a pandemic, we know a lot more about infection control and we recognise how important emotional support and family care are, alongside infection control.
I do not often do personal speeches, but I will do now. I last saw my gran, Anna Taylor, in February 2020. She was living in the Oakbridge care home in Knightswood in my friend Bill Kidd’s constituency. When my sister and I visited with my parents, we were joined by her excellent key worker, Bismay, a wonderful woman who went above and beyond for my gran. Bismay gently prompted my gran to say who her visitors were. “Relatives,” she said, with firm commitment. She did not really recognise her granddaughters, but she still enjoyed seeing us. There was a bit of determination in her answer to Bismay: she was determined to get that question right. She always recognised my dad.
During the pandemic there were short periods when Anna’s sons and daughter could not visit but, overall, Covid infection was limited and quickly contained. Oakbridge’s infection control was outstanding. When the staff could do so, they facilitated visits from my uncle, aunt and father so that they could come in and see their mother, sometimes clad in full PPE from top to toe at the height of the pandemic, and always rigorously tested, up until Anna passed last year—not from Covid, I must add, but from old age. She was 97—and she would be absolutely horrified that I am divulging her age.
I spoke to my uncle and my dad this morning about Oakbridge, and they could not praise the staff there highly enough—with the regular telephone updates from Bismay, the facilitation of safe visiting whenever possible, the rigorous protection of vulnerable residents from infection and, always, attention to and understanding of the emotional needs of the residents and their families. Oakbridge is a model of what care should look like.
We have learned a lot these past two years and, if that learning can make the rights and the emotional wellbeing of care home residents firmer and if it can support our excellent care homes to safely facilitate them, I am all for it. I am grateful for the opportunity that our debate on Anne’s law has given me to mention the great care that Oakbridge gave Anna, what its staff did to ensure that her children could always see her and how much that meant, and still means, to my family.
16:53
I thank Jackie Baillie for securing the debate, and I pay tribute to Anne Duke’s family for their campaigning on this issue.
Social care has experienced some of the worst impacts of the pandemic. Covid-19 infections have devastated many care homes, and residents and their loved ones were cruelly separated by restrictions on visiting that were introduced for their safety. The pain of being separated from a loved one when residents may be feeling scared, isolated and lonely is terrible. Having loved ones in hospital over the pandemic who sadly passed away and who we could not get in to see was devastating. We do not know what we missed—what we might have picked up from their behaviour or what comfort we could have offered them. I am sure that many people listening to the debate know all too well the feeling of helplessness at not being able to get to their loved ones.
When I met some Anne’s law campaigners outside Parliament, they spoke very movingly about the impact that such separation has had on them and their family.
I thank them for their incredible campaigning efforts, which have resulted in the Government committing to make those changes, as we heard earlier from the minister.
As we have heard, visiting restrictions can affect care home residents’ physical and mental health. Many people in care homes have dementia and it might be difficult for them to understand why they cannot see their family members. Interruption to routine and lack of social contact may also cause their health to deteriorate.
A survey of 128 care homes published by the Alzheimer’s Society in June 2020 showed that nearly 80 per cent had seen a deterioration in the health of their residents with dementia due to lack of social contact. The Alzheimer Scotland report, “Covid-19: the hidden impact”, revealed that
“The disruption to daily routines, social interactions, and health and social care support has had a negative impact on the physical and mental health of people with dementia and carers”.
Restrictions can also cause particular distress to people who may be in the last years or months of their lives. For those people, the past two years may have robbed them of their last opportunities to spend time with the people they love; our thoughts and condolences go out to all of them.
When visiting was stopped, many people had to turn to remote communication methods just to stay in touch with residents. However, as we have all learned over the past two years, that is a poor substitute for being able to talk to our family and friends face to face, to hug them, and to see their body language and their facial expressions.
As a minimum, we must ensure that people in care homes have the right to receive visits from their loved ones. That recognises that friends and family play a vital role in supporting the health and wellbeing of residents and that a care home is a person’s home and their right to family and private life should be respected.
Social contact must be prioritised in any social care recovery plans. As I and others have said, visiting restrictions were introduced to keep people safe from Covid, but we must also consider the wider risk to wellbeing posed by limited social contact. It is a delicate balance, which we must get right in any forthcoming legislation.
Although the focus should be on upholding the rights of the resident, it is vital that we consult staff and the sector as we move forward, so that any changes are implemented safely. Legislation alone will not be enough. We need to ensure that it is accompanied by robust safety and infection control procedures, as well as access to PPE and training for staff.
Organisations such as the Coalition of Care and Support Providers in Scotland and Scottish Care have raised concerns about the wording used in the programme for government and the Anne’s law consultation document—specifically,
“giving nominated relatives or friends the same access rights to care homes as staff”.
They have pointed out that that is a greater level of access than is proposed in the consultation questions and that staff have legal duties of care to all residents, which visitors do not have. I would be grateful if the minister could comment on that in his closing speech.
I again pay tribute to Anne Duke’s family by welcoming the action announced by the minister to help visitors be involved in the care of their loved ones, and by reaffirming the Scottish Green Party’s full support for Anne’s law.
Before Mr Mason’s speech, I remind members that any colleague who has participated in the debate needs to be back in the chamber for the closing speeches, in around four minutes’ time.
16:58
I fully agree with the main theme of the motion in that continuing contact with family and friends when someone has moved into a care home is incredibly important for all concerned.
Our own family was in that position, as my mother went into an Abbeyfield care home in Rutherglen in January 2019 and stayed there for over two years until she died at the age of 93, just a year ago, in March 2021. Therefore, we were restricted in seeing her for the last year of her life.
In the warmer weather, it was easier, as we could all sit outside, but, as we got to the end of 2020 and into 2021, it became quite a struggle to arrange visits, with one of the family sitting outside for half an hour while she was all wrapped up and sitting just inside the door, so we were not enthusiastic about the restrictions that were in place, but we followed them. However, I have to say that this care home is tremendous. It is a smaller home in the third sector, and it has a friendly, homely atmosphere while still being professional. Up to the point of my mother’s death, there had been no Covid in the home whatsoever.
I should say that I used to work for a care home company in the 1990s, as an accountant, and I know that some families are reluctant to see an elderly relative going into a care home, as they feel that it is somehow second best. However, as far as we, as a family, were concerned, the care home was the best option for her. Originally, it was my mother’s suggestion when she was younger. It became her home and she belonged there. It was the best place for her, and the care that she received was better than the family could have provided. Absolutely, in normal times, a resident in a care home must have the right to receive visitors, and families should have the right to visit. In fact, sometimes it is the family who need the visit more than the person who is in the home. I suggest that there is a balance to be struck, and to achieve that is not easy. The right to visit and be visited goes along with the duty of the care home to promote the wellbeing of all its residents and to protect them from harm—be that physical, mental or emotional.
Once again, we are in the area of competing rights: the rights of the individual resident, the residents as a whole and the families involved, not to mention the rights of the staff. If there had been unrestricted or even less restricted visiting in my mother’s home, I suspect that she might well have caught Covid and died earlier. I accept that that would not have been a tragedy, as she was 93 and had lived a good and full life. However, I am happier that she avoided Covid and lived that bit longer. Personally, I am pleased that visiting was restricted; however, to be frank, other members of our wider family would have leaned more towards the view that it would have been better for her mental and emotional wellbeing if she had had more visits, even if that had shortened her life a little. I do not believe that there is any absolute right and wrong here. No two families are the same, no two of us in one family are the same, and no two care homes are the same.
The proposed legislation will need to be carefully worded in order to get the balance right. Inevitably, some people will feel that it goes too far in one direction and others will feel that it goes too far in another. Although most of us in the chamber agree that visiting rights should be placed in statute, we also need to agree that, in very exceptional circumstances, those rights may have to be temporarily suspended. I am grateful for the opportunity to discuss the issues. Covid has been an incredibly hard experience for many families, including mine, and we all want to learn from those experiences.
17:03
I draw members’ attention to my entry in the register of members’ interests. I am a practising NHS doctor.
The Scottish Conservatives support the principles underpinning Jackie Baillie’s motion. We seek to extend them to include those who receive care in other health and care settings, such as hospitals and residential care facilities, and we would like to see a review of that.
As Craig Hoy reminded us, Anne’s law is the product of a petition to the Scottish Parliament by Natasha Hamilton, who was unable to see her mother, Anne Duke, for prolonged periods during the height of the Covid-19 pandemic. She urged the Scottish Government to allow a designated visitor into care homes to support loved ones.
Every one of us recognises the impact that Covid restrictions have had on care home residents and their families. During the height of the pandemic, care home residents were unable to see their loved ones. Those steps were taken to protect staff and residents from infection, but they undoubtedly caused anguish for many residents and their families. An elderly patient told me:
“For almost two years, you have all saved my life, but I haven’t lived.”
Friends and families play a vital role in the health and wellbeing of care home residents, and they also support their care, often complementing the support that is provided by care home staff. Prolonged isolation from family and friends has been detrimental to the welfare of adult care home residents. We agree that residents’ rights must be strengthened to give nominated relatives or friends the same access rights to care homes as staff have while stringent infection control measures are followed.
I cautiously welcome Kevin Stewart’s announcement in his opening speech, but, as he ran out of time and could not give us further information, I will be listening intently to his closing remarks. We should be clear that getting Anne’s law in place as soon as possible will help to stop the suffering of loneliness.
Craig Hoy reminded us of the importance of family, and Alex Cole-Hamilton spoke correctly about the vital nature of human contact. I often speak to relatives who are agonising over the decision to put their loved ones, including partners and parents, into a care home. They feel that they are not doing enough for their loved ones and that they are abandoning them. That is in normal times, but the idea of not being able to hold their hands or give them a kiss or a hug is unimaginable.
I had a heartbreaking case in East Kilbride. The family contacted me and described visiting their mother in a care home just up the road as being like a prison visit. Does Dr Gulhane agree that we need to move on from a situation like that?
I do agree. We cannot be in a situation in which families feel that way, because our care home residents need that loving touch and caring nature.
Paul O’Kane was correct in talking about how the SNP amendment does not get the point. The design of the national care service will take too long, and we need to ensure that not a single person suffers as Anne Duke and her family had to suffer.
Evelyn Tweed was correct in speaking of how the use of technology caused patients to withdraw and decline. Let us think about that in relation to ourselves. If we speak to people only over technology such as a phone or video, that does not give us the same feelings of warmth as meeting those same people does, be they friends or family. I believe that technology can help, but it cannot be the only method of interaction, because touch is vital to the wellbeing of people, especially those in care homes.
Sue Webber spoke of how we have all been in agreement over Anne’s law for more than a year. That is cross-party support for a law that is simply right.
Gillian Martin’s moving story showed us how important Anne’s law is in ensuring that everyone can receive the excellent care that her grandmother and her family received.
If the Scottish Government is serious about Anne’s law, it should expedite the law and not kick it down the road for inclusion in the Government’s proposed national care service bill.
The SNP’s record on matters relating to the vulnerable people in our care homes is a difficult read. The impact of coronavirus on Scotland’s care homes, as a result of the SNP’s decisions, has been described as having been the single biggest failing of devolution, and there have been many.
The Government appears to be dragging its feet on Anne’s law. We call on the SNP-Green Government to stop dithering and bring forward legislation, so that residents and families can have confidence that we are moving beyond that failed and broken approach.
17:07
I thank all members for the contributions that they have made today. As we all know, this is an extremely important debate.
I also thank Natasha Hamilton, Campbell Duke and other members of Care Home Relatives Scotland, who have been at the heart of discussions. As we have heard today, it is tough to hear some of the stories of what folk have gone through.
I agree with what many members, including Graham Simpson, have said. There is nothing better in this life than a bosie, which, in the north-east vernacular, is a cuddle. It is extremely important that we do our level best for that family connection, because a lack of that connection with loved ones, especially earlier in the pandemic, has had a devastating impact on some people.
I thank members for the heartfelt accounts that they have shared. I am sure that everyone in the chamber has heard from constituents and families who have loved ones in care homes, and we have heard many stories of those people today.
We know that the recommended measures that were put in place have been necessary to safeguard people for whom the on-going risks of the virus are significant. We have acted on the best possible advice from our public health teams and clinical advisers. With some of those clinical advisers, I am meeting Care Home Relatives Scotland tomorrow, so that there can be a broader discussion about the reasoning for some of the things that are currently in play. I am more than willing to talk to any member about that and give them access to the clinical advice that we have. If folk have differing clinical advice, I am more than happy to look at that, as is the Government.
Will the minister take an intervention on that point?
I will take a very brief intervention.
Is the clinical advice telling the Government to delay Anne’s law? If not, why is it not happening?
The clinical advice is very complex. I will come on to exactly what we are about to do as I move through my speech.
I assure Monica Lennon that the cabinet secretary, the Government and I feel the pain of the folk who have had to go through periods of isolation. None of that has been lost on me or on the Government. It is hard to believe that we cannot simply pop in and see those who are most important to us on a daily basis, but we have had to deal with the pandemic.
As many members, including John Mason, pointed out, at the beginning, any visits that took place were often outside for short periods and with distancing in place. As Gillian Martin said, there have been inside visits, which have involved adherence to infection protection measures. That is not what any of us is used to, and I recognise that it has been a particularly hard situation.
The experiences and views that have been expressed illustrate that families and carers are essential partners in supporting the wellbeing of family members who are in care homes. Today, we have heard that they often play an essential role in a person’s care, whether by providing support with eating and drinking, communicating wishes or emotional care, or by providing a connection with the outside world.
Mr Hoy accused us of kicking the issue into the long grass, and Ms Webber said that we were “dithering”. Let me be clear: the legal standards that we are putting in place will provide an immediate route to the implementation of Anne’s law, because the Care Inspectorate is required to take account of the standards in its inspection and enforcement regime. It is important that the families out there know that that is the case.
Minister, you need to conclude. You are well over time.
We need to underpin that in legislation and take account of the likes of Mr Hoy’s amendment. I will not pre-empt the vote, but if Mr Hoy’s amendment is pre-empted, I am willing to talk to him further about the issue. We have to get it right not only in care home settings but in hospitals and other care settings. I am willing to talk to any member about how we move forward and get it right.
Thank you, minister. We are pressed for time.
17:12
In closing this short but hugely important debate on behalf of Scottish Labour, I thank everyone who has taken part and those who are listening, including Campbell Duke and Natasha Hamilton, who are in the Parliament building with other members of the Care Home Relatives Scotland group. Natasha’s petition is 97 signatures short of 100,000, so I ask those who have plugged it but have not signed it yet to please do so and to share it on social media.
I will be clear: the debate is not about the principles of Anne’s law, nor is it about the case for Anne’s law. It is about the when of Anne’s law, and what we have not heard from the minister is a date. Evelyn Tweed thanked the minister for all his hard work, but we have been here before. I will come on to speak about the debate that we had back in 2020, when we all agreed the principle of Anne’s law.
Today is about delivering on a promise to give effect to Anne’s law. We heard about the SNP manifesto, but this is not about one manifesto. Sue Webber and others are correct that Anne’s law has cross-party support—we are all on the same page.
I thank the former health secretary, Jeane Freeman, who was very accessible and approachable and who had regular meetings with colleagues from across the parties. In the debate in 2020, she recognised the unintended consequences of the lockdowns and she talked about the importance of touch. On the same day, she also gave evidence to the COVID-19 Committee. That gave people hope that things would change and that we were going to use the tools that Jackie Baillie and others have talked about, such as the use of PPE, vaccines and testing. We have all those tools, but if the minister were to look at his own figures on the Scottish Government website, he would see that we are going backwards. More care homes have put in place restrictions. This week, a higher number of care homes than last week are allowing only essential and outdoor visits. Has the minister seen the Scottish weather? We need to look at that issue.
We cannot be complacent. We are hearing loud and clear from our constituents and from the Care Home Relatives Scotland group that people living in care homes are being treated differently from the rest of society.
Jennifer Dick’s mum lives in a care home in Edinburgh. The care home put in additional restrictions from 21 February, which have been extended to 15 March. When Jennifer asked if she could take her mum, who had tested negative for Covid, on a short drive, or even back to her house for a visit, the manager said no. I believe that the restrictions will now be in place until 22 March.
When the minister meets the group tomorrow, I hope that he will discuss those matters. I hope that he will also apologise to Campbell Duke and Natasha Hamilton, and to the others who are listening today. It is great to hear tributes from Gillian Mackay and others about the importance of the motion and the principles, but anyone who votes for the Government amendment today will erase Anne Duke from the motion.
The motion amplifies the voices of the people who are asking us to get it right. That is not my opinion, or that of Jackie Baillie, Alex Cole-Hamilton or anyone in the chamber; it is what the group, which does not feel listened to, has been saying.
For new members, I point out that, in October 2020, a motion was lodged in my name that recognised the importance of family caregivers—I say to the minister that we did not talk about visitors; we talked about caregivers. At that point, 200 days had passed, and Jackie Baillie is right to say that we are now two years down the line.
In that debate, we all agreed the principles, yet we do not have Anne’s law. We even paid tribute to politicians in Ontario for legislation that they were progressing—the More Than a Visitor Act (Caregiving in Congregate Care Settings), 2020.
I think that the Tory amendment today is correct, and we will be able to support it.
I want to talk about two women: Hollie, who is 37; and Alice Hall, who is 97. Holly has a learning disability and lives in a care home. She wrote to the minister at the end of January, I believe, saying:
“It feels like I’m back to square one again. It feels like I’m a prisoner again.”
She feels forgotten. Alice knows that her time on this earth is limited. Her daughter, Sheila, said:
“after 2 long years, 3 vaccines, surviving Covid ... surviving isolation ... my mum needs to have the same freedoms as everyone else in Scotland.”
The situation is urgent, as my colleague Paul O’Kane conveyed. We need to stop the dithering and discrimination. On behalf of care home relatives Scotland, I say to the minister: please bring back to our care homes the love, hope and joy that are missing. People want joy; they want hope. People living in care homes—they are living in their own homes, as has been rightly said—do not deserve to be treated differently.
Yes, we should protect people in care homes using all the infection prevention and control tools that we have, but the Government must stop making excuses. I beg ministers just to get on and take this action on behalf of Anne’s family and all the other families who are living through the situation today.
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