2. Framework for Decision Making
Listen to an audio version on Soundcloud.
The First Minister has set out our intention to be open and transparent about the options for Scotland in tackling this outbreak – that is why we published COVID-19: A Framework for Decision Making and supporting documentation. This sets out the approach and the principles that will guide us, the different factors that we will need to take into account, the assessment framework in which we will take decisions, and the preparations we need to make now.
COVID-19 is first and foremost a public health crisis, and the measures to combat it have been necessary to save lives. But those measures also cause harm, and can have the most negative impacts on some people in our society least able to withstand them. We are learning that the harms caused by the pandemic are not felt equally.
Our response to this pandemic must recognise these unequal impacts. Just as we have sought to shield those most at risk, we must continue to provide additional support for those who need it and seek to advance equality and protect human rights, including children's rights, in everything we do.
The effects of increased isolation can be particularly severe for older people, people living alone and people who require support, whether at home or in a homely setting such as a care home. Harmful effects on the economy can also impact hardest on families with low incomes and people who were already experiencing the effects of inequality. For example, the impact for women who take the disproportionate share of caring responsibilities (paid and unpaid), means they are likely to experience particular disadvantage. This will also be a significant issue for other groups already disadvantaged in employment terms, particularly disabled people, minority ethnic groups and some other groups with protected characteristics. Reductions in community support can disproportionately affect many of these groups, and the impacts will intensify the longer the lockdown continues.
We have asked those at the highest clinical risk to shield for at least 12 weeks. We do not want people to shield for any longer than necessary, as it has a clear impact on people's quality of life. We will be guided by the evidence in assessing the continued risks from the virus, as well as people's lived experience of shielding and what matters to them. We will clearly set out the way forward on shielding in the coming weeks.
Our Framework for Decision Making makes clear that the way we approach the COVID-19 crisis aims to protect those most at risk and to protect human rights. The measures currently in place are legally required to be lifted as soon as it is considered that they are no longer necessary to prevent, protect against, control or provide a public health response to the incidence or spread of the virus in Scotland. These considerations, aligning with our overarching commitments to human rights, equality and social justice, will be at the centre of our thinking as we consider options to relax restrictions. As the First Minister said in the Scottish Parliament on 13 May, they will "run right through every decision that we take".
This document shows how we will consider and decide on changing restrictions. We will look at the cumulative and overall impact of those measures, and of ongoing restrictions. We will not consider changes in isolation, but in all areas, assessing the impacts, positive and negative, across the aggregate of decisions and across all four harms. We will consider:
the scale of impact, in terms of the numbers of people and businesses likely to benefit;
whether the approaches will protect and support the groups and individuals in society most in need of support, their impact on protected characteristics, and the extent to which they would help to reduce inequalities in outcomes; and
evidence about the impacts of the current measures and any relevant wider evidence from other countries and scientific research.
This document sets out some of the ways we are already making those decisions:
- We know that school closures are having a negative effect on many aspects of children's progress and development, including their wellbeing. This will be particularly so for some of our most disadvantaged young people. That is why we are prioritising measures such as provision of school based education, early learning and childcare, youth work and adult learning.
- We also recognise that in transitioning through and out of the crisis we need to take a holistic approach to support those families who will be more affected than others by the impact of Covid 19 and the mitigation measures. This means asking professionals across health, early learning, schools and social work to work together to support families who are struggling, and working with the third sector to provide holistic, practical, well-being support for families.
- During the pandemic, the provision of support within people's homes may have changed to reduce the risk of disease or as a result of distancing measures. So we are supporting the operation of support services for at-risk adults.
- Necessary changes to the care home sector such as restricted visiting and a pause on normal activities and routines in order to protect residents, staff and visitors is having a significant impact on the wellbeing of residents and their loved ones. Care homes are first and foremost people's homes and it is important that we find safe ways for people to reconnect with their families and friends.
- Many households are concerned that the COVID-19 crisis will have a financial impact on them or their family. We are investing £2.3 billion into support for businesses and employers, including hardship funds for self-employed people and the creative and tourism sectors, and support for the SMEs who create so much of Scotland's employment.
- We know that the essential public health measures we have had to take, are in themselves creating an economic emergency which has had a significant impact on people's jobs, living standards and inequalities in our society. We have real sympathy for those who have had to close their businesses or who have lost their jobs and we understand the need to carefully get our economy moving again as quickly as we are able to do that safely and to help people back into work.
- We are making plans to restart housebuilding - essential if we are to meet our aspirations around reducing homelessness - and energy efficiency schemes to tackle fuel poverty.
- Necessary changes to the criminal justice system have unfortunately led to backlogs and delays which have impacts, particularly on the health of victims of crime. So we are supporting the operation of the justice system and have increased support for victims. Decisions about the operation of courts and tribunals are ultimately a matter for the senior judiciary.
We will draw on a wide range of data and expertise to understand the impacts of the pandemic and the measures to combat it. Scottish Ministers have access to a range of professional advisers and expert groups, both within and beyond the Scottish Government, including the Poverty and Inequalities Commission and Equality and Human Rights Commission. We will also listen carefully to the voices of those affected to understand the lived experience on which our policies must build.
A wide range of research and analysis on COVID-19 is underway across Scotland. This includes a programme of work funded by the Chief Scientist's Office (CSO) that enables Scottish Academic Institutions to research issues arising from the COVID-19 pandemic.
There is a balance of harms to weigh up in easing or re-tightening any restrictions. Public Health Scotland and collaborators have recently published a paper on the risks of distancing measures negatively impacting on people's health, and how to mitigate these wider harms. It finds that the interventions in place to lower transmission of the virus can themselves cause a wide range of harms and that building a more sustainable and inclusive economy for the future will be crucial to mitigating these wider harms
In Scotland there are approximately 170,000 people shielding. Around half are over 65 years (14% over 80 years). A quarter of those shielding live in the most deprived areas of Scotland.
Structural inequality causes damage to our society, as the impacts of Covid-19 have highlighted. But the way we have responded to it as a society has shown there are ways to do things differently:
- our homelessness response focused on ensuring everyone experiencing homelessness had a home in which they could safely self-isolate and practise physical distancing;
- local services have developed new and innovative approaches to reach children in their own homes, including regular telephone and online contact, as well as practical and emotional support; and
- our approach to free school meals, working with local authorities, has shown that very large numbers of children and young people from low income families can be supported in a range of ways, including via a 'cash-first' (direct financial payments) approach.
We will take the chance, as we emerge from this period, to chart a better way forward in support of all of Scotland. As we move forward we want not simply to return to where we were, but to build on the innovative responses seen throughout the crisis to build a Fairer Scotland. We will use the lessons learned during the pandemic to help us make progress towards our long term outcomes of lower, poverty levels, greater equality, inclusive communities and respected and enhanced realisation of human rights. Our decisions in coming weeks and months will aim to do that.