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Spending cuts to the Health and Social Care budget will reduce expenditure on vaccines, test and protect and PPE for health workers – our last remaining, albeit futile defences against Covid-19

Dear (MSP),

I am deeply concerned to see that the Scottish Government  is cutting £116 million from the Health and Social Care Covid budget as part of the Emergency Budget Review (Annex A). These “savings” are to come from ” a range of actions relating to Covid expenditure on vaccinations, test and protect, PPE and additional capacity to drive down additional costs”. No further details have been published as yet, however, “test and protect” and PPE are now only provided in healthcare settings, and additional capacity presumably refers to the ability to separate patients with Covid from those without. In short, the Scottish Government is seeking to further cut Covid mitigations in healthcare settings, including hospitals, despite the facts that:

a) hospital in-patients are on average much more vulnerable to the impacts of Covid and indeed other infections (including influenza) than the average population. 

b) As a 2022 briefing by Public Health Wales states, “nosocomial [originating in hospital] COVID-19 outbreaks have been associated with major disruption to hospital services, as well as with patient morbidity and mortality”.  Clearly, this finding is not limited to Wales. Failure to prevent in-hospital Covid outbreaks leads to many patients having to spend longer being treated in hospital, and some of them to die.

c) In England, where there are no Covid mitigations in many clinical settings, not even masks, many clinically vulnerable people report having cancelled appointments and avoided seeking routine healthcare for fear of infection (from 24 mins). 

d) Healthcare workers have the highest rate of Long Covid of all occupations. Long Covid results from repeat as well as first Covid infections, and vaccination provides only very limited protection against it (as opposed to the much higher level of protection against severe acute Covid). 

According to the “summary of evidence on equality and fairness of the Emergency Budget Review,”the only potential impact considered regarding those cuts is equal access to vaccines. Impacts on vulnerable people and on healthcare workers appears to not have been considered at all. 

I appreciate that the Scottish Government is facing a difficult financial situation due to expected cuts in the Scottish block grant. However, it seems unconscionable to me that savings should be sought by making hospitals more dangerous for patients and staff. NHS Scotland is in deep crisis, with large numbers of healthcare workers considering leaving their jobs, with record waiting times for emergency treatment this year, and very significant excess deaths throughout most of 2022. These cuts will inevitably cause much higher rates of staff absence due to acute Covid, more staff developing Long Covid, more patients having to be treated for longer, and more patients dying. 

Please can you raise these concerns with the Scottish Government, urge them to reverse the decision to reduce Covid mitigation measures in healthcare settings, and ask why the “equality and fairness” impacts of exposing clinically vulnerable patients to greater risk of infection appear to not have been considered. 

Many thanks.

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