COVID-19: Questions to the Minister for Health and Social Services

Janet Finch-Saunders MS, Member for Aberconwy: Diolch, Dirprwy Lywydd. Thank you for your statement, Minister. You'll be aware that the tragic situation in Welsh care homes has triggered the older people's commissioner to refer the Welsh Government to the Equality and Human Rights Commission. She has highlighted delays to testing as a key concern.

On 16 May, you announced the expansion of testing to everybody in care homes. However, according to one local authority, there's a hope that their care homes, within the Betsi Cadwaladr University Health Board area, will be tested by 8 June. However, it has been described as an ambitious target. Why has it taken over three weeks since your announcement to test all care homes, to include our residents and care workers there? Do you also agree that this is made even more scandalous by the fact that patients were initially discharged from hospitals to care homes without any tests, putting many at risk?

And finally, Minister, will you explain why there is no COVID-19 monitoring or data being collected on those receiving social care in their own homes? This appears to me to be a forgotten part of our society, placing them and our own social care workers and domiciliary care workers at risk.

Vaughan Gething MS, Minister for Health and Social Services: I thank the Member for the three questions, I think, but I'll start with the first point. It's really clear that we're not loose and misleading with our language: the older person's commissioner did not refer the Welsh Government to the human rights commission—she's had a conversation and she's clarified that she wants there to be a UK-wide look-back at the position in care homes across the UK, and, as the First Minister has indicated, and indeed as have I, we expect that there will be look-back inquiries and we'll be happy to co-operate with each of those official inquiries. And this Parliament, I would expect, will want its own exercise in looking back on lessons learned and decisions taken at the time.

So, on domiciliary care, on your final question, it's of particular concern to me and to the Deputy Minister. It's an area where we've already had access in terms of testing of key workers. And it's an area that is, I know, a regular concern to the Welsh Local Government Association as well, because we do recognise that there's an issue about transmission and how we protect people and that's often from people coming into that person's home. So, the staff themselves want the assurance that they're not, effectively, acting to provide coronavirus to the vulnerable people who they are helping to care for, and that's why they were always one of the key workers within our system, and, of course, there's now expanded access in terms of online bookings for the system of testing that we have available in Wales.

All care homes will be tested within the next two weeks. Some health boards think they may have that test within the next week to 10 days. Others will be slightly later, but, within the next two weeks, I expect all care homes, residents and staff to have been tested. That's a deliberate policy choice we made, and I actually think that the time that it will have taken to do so compares well with every other UK nation, including, of course, England just over the border, where I understand that about six in 10 care homes are yet to be tested. But, as I say, our expectation is that, within two weeks, all care homes in Wales will have been tested.

Another thing, on the final point that you made, that I need to respond to, is that symptomatic people should always have been tested before discharge from a hospital. There should always have been a current test for people to have left hospital. We moved to a position—which we acknowledged at the time was beyond the scientific advice and the advice of our chief medical officer about whether there was a scientific basis to do so—to test every person discharged into a care home, symptomatic or not, but that was specifically about making sure that there was confidence within the system, because we recognised that more harm could be caused if the whole system clogged up. In regular times, we discuss the harm that is caused to people who are not discharged effectively and quickly, and so this, I think, was a pragmatic measure and the right one to take. And I'm sure I'll have more time to re-discuss the past on other occasions, but I'm content that we are doing the right thing on the right evidence base in the here and now for the people of Wales. 

Janet Finch-Saunders MS, Member for Aberconwy: Thank you, Minister. I have to say, whilst you say this testing will take place within two weeks, you know the high figures that have been recorded here in north Wales, it's my opinion that if you were to suddenly test all homes, say within two or three days, we wouldn't just see our figures spike, we would see them skyrocket here.

Now, the testing centre here in Llandudno was opened on 29 April. According to an FOI that I submitted to the Betsi Cadwaladr board, only 258 nursing home and local authority workers were tested at the Llandudno site by 28 May. This actually works out, on average, as eight workers a day. There are criticisms about the testing centre not having much traffic going through it when there is mass testing still required here in the north. So, I would like your opinion on that. Why were so few critical workers seen in this centre last month? And what steps are you taking to monitor testing levels at all drive-through centres across Wales? I would like to see those figures reported.

Testing does remain troublesome here. As of 27 May, testing capacity was over 9,000 a day. On Monday, only 2,492 tests were undertaken. Why is all the testing capacity not being used, when we know out in our communities we have these people—vulnerable people—who need these tests? How can we therefore have confidence in test, trace and protect if the number of daily tests are only around 10 per cent of the 20,000 tests a day the Welsh Government has previously stated that contact tracing could require?

Vaughan Gething MS, Minister for Health and Social Services: I will deal with the final point first. Contact tracing could require up to 20,000 tests depending on where we are in terms of coming out of lockdown and the rate of the transmission spread. Trying to compare where we are now with what might happen months in the future is a pretty foolish place to get yourself into and it's not at all an honest way of describing where we are. And I just think, at a time when people are worried, to try to put out ideas and figures that are openly and undeniably misleading is incredibly irresponsible. 

On your figures on north Wales and care home testing, we're actually going through and seeing that north Wales has the highest per head testing ratio of any of the health board areas in the country. So, it's already got a higher testing level than anywhere else. But the good news about that is that whilst there are more people who are identified as having COVID-19, we're actually recognising that when it comes to the harm that's caused, in terms of hospital admissions and, indeed, then in terms of mortality rates, in mortality rates its the second lowest of the seven health boards in Wales, and that's good news for people in north Wales. 

On the Llandudno testing centre, I regularly have feedback from local resilience fora and other partners, including people representing staff and employers in the social care sector, and they've indicated for some time a significant improvement in access to testing and making use of the referral arrangements. They have been improved now further, with greater ease of access for the public as well as critical workers, who can all now book online to book their own test at at drive-through centre. So, we've made not just improvements in the lab capacity to undertake more tests, but access to those has improved. 


I was on my final point. The two to three thousand tests a day that we're undertaking now is a measure of the current need and demand that exists within our system, but we anticipate that that will increase as we move further out of lockdown, and, as there is more contact between people and greater need, we can actually follow up and test more people. It goes back to what I've said consistently—our test, trace and protect system requires a bigger infrastructure, and we're in a place now where we've got a much more significant capacity to be able to do so.

Thank you, Deputy Presiding Officer.