Former health secretary Jeane Freeman has told the UK Covid inquiry that she will regret "for the rest of my life" the Covid deaths which occurred in Scotland's care homes, but that there was "no risk-free choice".

Giving evidence to the inquiry in Edinburgh, Ms Freeman said the government had to weigh up the danger of frail elderly people being exposed to the virus in hospital versus discharging them untested into care homes because there was so little capacity available for testing in the early days of the pandemic.

Half of all Scotland's Covid deaths during the first wave occurred among care home residents.

Ms Freeman said she was "very concerned" about the situation facing both the residential and care-at-home sectors in March 2020, with the Scottish Government issuing its first formal guidance to providers on March 13 telling them to end non-essential visiting and to introduce social distancing.

She said: "I regret very much, and will do for the rest of my life, any deaths that occurred there because of action the Scottish Government didn't take or did take, but could have done better."


Ms Freeman said the Scottish Government was hampered in its response to the care sector due to the "very limited" data available, including basic information like the number of care homes operating in Scotland.

She said that there was a pressure to move frail elderly patients ready for discharge out of hospital as quickly as possible because it was feared that their risk of exposure to Covid was greater in acute settings.

"Against this was the risk of transferring people to care homes who had not been tested," said Ms Freeman, who served as health secretary until May 2021 - covering the first two waves.

"What we attempted to do was to put in place additional mitigation measures to the national manual on infection prevention and control which all care homes were required to follow."

These precautions "increased significantly over a relatively short timescale", said Ms Freeman.

She added that the decision not to Covid test all patients being transferred from hospitals into care homes in March 2020 also "goes back to our earlier conversation about the lack of testing capacity."

The inquiry heard that Scotland was capable of processing just 350 Covid tests per day in mid-February, rising to 780 by mid-March.

This expanded to 4,350 by the end of April and rapidly thereafter as additional premises, staff, and kits became available - including with the rollout of a UK Government 'Lighthouse' lab in Glasgow.

The Herald: Jeane Freeman was health secretary during the first phase of the pandemic, until May 2021Jeane Freeman was health secretary during the first phase of the pandemic, until May 2021 (Image: PA)

Ms Freeman said she expected there to be "flexibility" around the care home rules in relation to residents with dementia who would find them distressing, but added: "In all of this, there was no risk-free choice."

Speaking of care home visiting, activities, and communal dining, Ms Freeman said: "To allow that to continue was to increase the risk of transmission of the virus into the care home, and transmission of the virus within the care home."

Ms Freeman also told the inquiry that she had been given "pretty categoric" advice in the earlier stages of the pandemic that only infected people with symptoms could spread Covid.

Minutes from a Cabinet meeting dated March 3 showed that the advice at the time was to "delay the spread of the disease into the summer months" through a strategy of containment.

Ms Freeman said the virus appeared to be occurring in "clusters" at the time and contact tracing was being used to try to prevent its spread, but that it quickly became apparent that widespread community transmission was underway.

Asked why the Scottish Government did not act sooner to implement non-pharmaceutical interventions (NPIs), Ms Freeman said there was a fear that people would not comply if measures were implemented "prematurely".

She said: "If you act too quickly - prematurely - then you don't have enough evidence and rationale to convince the public that they should comply with what you're asking...People need to believe there's a basis for what you're asking them to do that is about protecting themselves and others."

Earlier in the day, Ms Freeman was asked whether the experience of the H1N1 swine flu pandemic in 2009 - which resulted in a total of 392 deaths in the UK - had provided a false reassurance.

"I did not find it reassuring," said Ms Freeman.

"My primary position was 'that was then, this is now'. We don't know it's going to be the same."

She said that she felt a "growing feeling of trepidation" during January, with preparations underway from the end of January to ramp up bed capacity in the NHS with modelling forecasting that nearly 80,000 people could be hospitalised with the virus.

However, a lack of testing capacity "was significant in my mind from the outset", said Ms Freeman.

Baroness Hallett asked whether she ever questioned why this was the case.

"I probably asked in fairly robust terms," said Ms Freeman, but added that that it had "had not necessarily featured highly" in NHS priorities over the prior two decades. She added that it was "disappointing" not to see the UK-run Glasgow Lighthouse lab retained.

Earlier Ms Freeman told the inquiry that she exchanged a "very small number of text messages" with the former First Minister Nicola Sturgeon during the pandemic because most of their discussions took place verbally.

However, Ms Freeman said it was not her policy to delete WhatsApp messages "because it didn't occur to me to do so".

She added that she was "not aware" of a specific Government policy advising officials to erase informal messaging.

The inquiry has heard that a number of other officials, including Ms Sturgeon, routinely deleted messages with only the "relevant and salient" points being transferred into the corporate record.