THE Health Secretary has warned that restarting NHS services suspended during the coronavirus lockdown will be a “long-term” effort, not a “flick of the switch”.

Jeane Freeman said the health service would remain on an emergency footing for at least another 100 days as it tried to “remobilise” while coping with the continued threat of Covid-19.

The scale of the backlog facing medical staff was underlined by official figures showing a collapse in planned operations in April.

NHS Scotland’s statistics division reported just 3,406 elective operations were carried out compared to 20,192 in March. drop of 83.1 per cent.

Compared to April 2019, the number of operations was down even more, by 87.5%.

Ms Freeman also faced fresh criticism over the number of elderly people transferred from hospitals into care homes at the start of the pandemic and the continued shortfall in Covid tests conducted in Scotland, compared to the’s testing capacity.

Official data showed a huge transfer of delayed discharge patients over 75, with the number in hospital falling from 1,108 in late February to 331 in late April.

The Scottish Tories claimed the elderly had been “rushed out of hospital” as part of the drive to clear NHS beds in readiness for Covid cases before testing was mandatory.

The Scottish Greens claimed the testing figures “didn’t add up” as they were far too low to cover the 53,000 care home staff offered routine tests.

In a statement to MSPs on restoring non-urgent services over the summer, Ms Freeman said it had to be “carefully and cautiously” done, and would not be a return to pre-lockdown “normal”.

She said: “We will start to remobilise the NHS, but I have to make it clear that that will be no ‘flick of the switch’ moment. Remobilising in circumstances in which the virus is still with us, and the impact of changes in restrictions, need to be carefully and continuously monitored.

“That is a complex undertaking in which many factors, some of which will change over time, must be balanced.

“That makes the exercise long-term, as well as complex.

“The immediate priorities cover cancer, elective procedures, mental health, primary care and important quality of life and preventative care services including pain clinics, dental care and optometry, and they cover planning for the return of screening services.”

She said the restart would also require “replenishing stockpiles and readying services” for winter, when there could be a Covid second wave.

She acknowledged that, while emergency services had continued in lockdown, pausing other treatments “was not without cost” to patients.

She said: “We all increasingly understand the cost of dealing with this pandemic to health and to our well being; it has brought worry, continuing pain and anxiety for many.

“Stopping large and important areas of healthcare was never a decision I would have taken if I felt I had any other choice and I deeply regret the pain and the anguish that caused.

“But there was no other choice, lives were - and still do remain - at stake.”

Labour MSP Monica Lennon said the slump in planned operations meant Scotland was “storing up a backlog of health problems.

BMA Scotland chairman Dr Lewis Morrison said the Scottish public had been “really patient” during the outbreak, but many now had medical issues which required attention.

He said: “We’ve done things very differently for the last 10 weeks and we’re going to have to keep doing that. We’re not going to be able to go back to seeing people one after the other after the other in the way the NHS used to.”

Theresa Fyffe, Director of the Royal College of Nursing Scotland said: "Recovery will be a complex and lengthy process and will need to take account of the demands that have been placed on health and care staff in recent months. There will undoubtedly be challenges in finding new ways of working to ensure infection prevention and control and maintain social distancing.”

Official data showed 510 delayed discharge patients were moved out of hospitals into Scotland’s care homes in April, taking the total transferred during the outbreak to 1,431.

Last week it emerged that 921 delayed discharge patients - those clinically well enough to leave hospital but with nowhere to go - were moved into homes in March without testing.

Scottish Tory leader Jackson Carlaw said: “The over 75s were rushed out of hospital, either to care homes or back to the community. And as we now know, they weren’t routinely tested for coronavirus.

“These were the most vulnerable people in our society, and they were sent out of hospital to places where they would mingle with equally vulnerable individuals.

“It’s no wonder Covid-19 has spread like wild fire in our care homes.

“The SNP government needs to explain why so many over 75s were chased out of hospital during a global health pandemic without proper testing or protection. The situation has become a national disgrace for the SNP.”

Holyrood’s health committee is to grill Ms Freeman on the “shocking impact” of coronavirus on care homes - the location of almost half of Scotland’s Covid deaths - tomorrow.

She admitted yesterday she didn’t know how many care home residents had died in hospital after being admitted for Covid, saying the information was “not held centrally”.

Other daily Covid data showed the number of tests conducted in Scotland on Monday was 4,406, a marked increase on Sunday’s low of 2,779.

The capacity is 15,500.

Green MSP Alison Johnstone queried the low number, saying it should take 7000-plus tests a day just to test care home staff.

Ms Freeman said health boards had plans for testing staff, but there had been “glitches” to overcome, such as staff worried about losing pay if they tested positive and had to isolate.

“The Government has now acted to resolve that impossible dilemma for them,” she said, but added: “We cannot expect 100 per cent of people to give consent [for a test].”

Ms Johnstone said: “These figures simply don’t add up. Scotland is testing an average of 4,600 people a day, and that is across all sectors.

“If regular testing of care home staff had begun, then that alone would use up to 7,570 tests per day, and that’s before any residents, patients or NHS workers are tested.”

Labour MSP Jackie Baillie added: “The SNP government has proudly announced the expansion of Scotland’s testing capacity but with the number of tests falling their testing strategy remains ineffective.

“Without a rapid expansion in testing we cannot move to the ‘test, trace and isolate’ stage and so cannot safely continue to ease the lockdown.

“It is time for the SNP government to swallow its pride and get to work to expand testing.”