Q&A: Health secretary Jeane Freeman

The Cabinet Secretary for Health and Sport answers questions about the year in health

Apart from coronavirus, what is the most significant thing that has happened within your portfolio over the last year?

COVID-19 is the greatest public health challenge we have faced in our lifetimes and its impact is all encompassing in every respect, so there can be no question that it is the most significant thing. And it is not over. 

It has touched every single person’s lives. From the most tragic where lives are lost and there are people right now trying hard to come to terms with that loss, people who are dealing with the longer term health consequences of having had the virus and those whose health care has been delayed because of the need to focus on handling the virus itself.

People in Scotland have responded magnificently to work together to suppress the virus and now to keep its transmission as low as we possibly can. More than any, our NHS and social care staff have, day in and day out, worked tirelessly and with skill and compassion and neither I nor we can ever thank them enough.

There can be no question that the repercussions of COVID-19 will continue to touch all aspects of the health and sport portfolio, in ways we know now but also in ways that will only become clear in the months ahead.

This has been a relentless year for you between the Queen Elizabeth University Hospital problems and coronavirus outbreak. How have you coped with the pressure and did it make you consider quitting?

Of course I continuously reflect on whether or not we’re getting something right or if there is more we should be doing. It’s important to me that I do that because every single person who depends on our NHS, in whatever way, deserves whoever is the cabinet secretary to take the job that seriously. But that cannot be my sole focus.  So yes, I need to reflect and learn from experience but keep a clear focus on making the best decisions I can. That does mean listening to others, including opposition politicians, who have a responsibility to scrutinise and question what I do. But I hope nobody is questioning my intention to do my very best. People will judge whether that is good enough, but it really doesn’t serve the seriousness of the situation well if every area of disagreement or difference becomes deflected into resigning or not.

How personally responsible do you feel for coronavirus deaths in Scotland? Do they weigh on your mind?

Profoundly. Every single one of the lives that have been lost leaves a deep well of grief for their loved ones. Every single one is a person who was unique and is sorely missed. That’s a pain that I can never alleviate.

The decline in the daily numbers of COVID deaths to very low levels is a sign of real progress and of course I welcome that. But that doesn’t mean I forget about those who have died.

Do you think Scotland was prepared enough for the pandemic and for future waves?

Because of the hard decisions we took in the early stages, at no point during the first phase of the pandemic has the NHS in Scotland been overwhelmed. We also had the benefit of an experienced and effective national procurement service to scale up the provision of PPE and a single NHS which could act as one and rapidly redeploy staff and equipment and refocus care.

Aspects of that scale up alongside a determination to maintain levels of safe care are lessons to learn – creation of the safe COVID-19 community pathway, the increased role for community pharmacy, the huge increase in digitally-based care, the creation at speed of digital and crisis mental health support for both patients and staff – are just some examples. And we are restarting health services in a gradual way to ensure the safety of patients and to protect resilience within the system.

Now our job is to balance the need to retain provision and resilience against a rise in COVID-19 cases, plan for the winter period and safely restart services that have been paused. And in all of that remember to take care of our staff and to hold true to the determination that we provide safe, effective and person-centred care.

And all the time being flexible in our response, both strategically and in detail, as knowledge and understanding of this still young virus develops.

How can confidence be restored in the Queen Elizabeth University Hospital, the Royal Hospital for Children and the Royal Hospital for Sick Children?

I appreciate that there are families who still have questions about issues at the Queen Elizabeth University Hospital (QUEH) campus in Glasgow and I am determined that these questions will be answered. That is why I ordered a public inquiry into the matters which have caused concern at the QEUH and the Royal Hospital for Children and Young People and Department of Clinical Neurosciences in Edinburgh. The inquiry has statutory powers which is important and is judge-led. We need to let it do its job. But meantime we also need to recognise and not undermine the immense skill and expertise of those who work in these hospitals and the care and compassion they give to patients.

Looking ahead I am clear that in a country of this size we need a central resource for major infrastructure build – to provide central expertise right the way through the process and building in the best knowledge we have on infection prevention and control – from the production of the business case, through the construction of the facility, to the ongoing maintenance and lifecycle management and finally through to the disposal and/or decommissioning of the asset.

Coronavirus has led to delays in diagnostic and elective procedures, which in many cases already had long waiting lists. How will we catch up?

As the pandemic eases and the health service continues to gradually reopen, we will do all we can to tackle the backlog in outpatient and inpatient treatment that have been postponed, using clear national clinical prioritisation of need.

Urgent care, including cancer, has remained a top priority throughout the COVID-19 pandemic and the majority of treatments have continued. We will continue to ensure patients are seen and treated as quickly and as safely as possible and if necessary, changes will be made to treatment plans to minimise risk.

We’re also bringing in additional capacity to support diagnostic testing, including six mobile MRI scanners and three CT scanners, located across Scotland, which will become operational in the coming months and will support health boards and ensure patients have appropriate access to services.

Do you think the problems in care homes during the coronavirus outbreak show we need a nationalised social care service similar to the NHS, or at least reform of the way care for adults is provided?

I’m deeply sympathetic to the suggestion of a national care service, and I know that Angela Constance MSP has been doing a lot of work to champion that.

I have said previously that we’ll review the way in which social care as a whole is structured, delivered, regulated and funded and we will do that – building on the work we had begun on reform of adult social care before the pandemic.

During the pandemic I’ve been clear how important the safety, protection and wellbeing of residents and staff in care homes is to us. Already the sector is morphing  with actions in train to support residents and staff in care homes across Scotland, including enhanced arrangements in each NHS board area to ensure direct and frequent engagement with each care home in their area covering effective infection prevention and control practice, testing, PPE and staffing levels, providing direct NHS staff support where that is required.

Other than seeing friends and family, what did you miss most during lockdown OR what did you most look forward to doing after lockdown was lifted?

Actually missing seeing friends and family is what I have missed most. I’ve also missed the constituency visits to schools or the summer galas because both are genuinely really enjoyable. But I am a very fortunate MSP because I have a fantastic constituency team who have just got on and worked as hard as ever looking after constituents and each other.

If you had to spend lockdown with one other member of the cabinet, who would it be and why?

Well, I’ve basically spent this lockdown with the First Minister as we’ve worked to address the impact of COVID-19. Besides, each day since lockdown I’ve brought in soup Susan has made for me and the First Minister’s lunch. So, I’ll stick to lockdown with the FM to make sure we both keep getting fed.