A new investigation into the Covid outbreaks that ravaged Scotland’s care homes is required, the Tories said after it emerged the agency that conducted the last inquiry is required to protect the reputation of SNP ministers.
Annie Wells, the shadow health secretary, said there was a "blatant conflict of interest" between Public Health Scotland’s (PHS) ability to independently investigate the scandal and a "communications framework" that requires it to shield the government.
She said "a new, truly independent report" was needed to provide the families of more than 3,000 care home residents who died with a "comprehensive analysis" they can trust.
Jackie Baillie, the Scottish Labour leader, said the disclosure of the framework was "just another example of the micromanagement and control freakery which defines the SNP".
Almost 5,000 patients were sent to care homes between March 1 and May 31 last year, most of whom were not tested. More than 100 were transferred despite having tested positive for the virus, without later testing negative.
In its original investigation, published in October, PHS stated: "There is no statistical evidence that hospital discharges of any kind were associated with care home outbreaks."
Nicola Sturgeon seized on that passage but the Office for Statistics Regulation later criticised the presentation of the report, saying the discharges were "consistent with a causal relationship" between transfers and outbreaks.
In its revised analysis, published in April, PHS admitted that care homes were 21 per cent more likely to have an outbreak in the period within 30 days of a hospital discharge.
Although its new report said "no statistically significant association" was found between the two, it concluded: "We cannot rule out a small effect, particularly for those patients who were discharged untested or discharged positive."
On Friday, PHS insisted the reports were robust and produced independently of government, and its communications strategy "does not change the substance, content or independence of those publications".
Humza Yousaf, the health secretary, said: "These claims are not true. Public Health Scotland functions entirely independently of ministers – as of course is right and proper – and any suggestion to the contrary is absolutely wrong."
But it emerged on Friday that the framework commits the agency to "reducing the potential impact of the risk on the reputation and credibility" of the Scottish government and local authorities.
The document, obtained by The Times under the Freedom of Information Act, also sets out a system for scoring PHS communications according to the political risk they present to SNP ministers.
Those deemed high risk include communications that could cause "sustained or widespread criticism of the Scottish government", force ministers to make statements to Holyrood or lead to front-page headlines. Among the questions used to assess the risk are: "Does it challenge – or could it be interpreted as a critique of – Scottish government position or policy?"
Ms Wells said: "This news calls into question if the findings of that report were compromised. The revelation that Public Health Scotland must protect SNP ministers may well explain why key information was omitted."
Ms Baillie said: "Public agencies don’t exist to protect the reputation of ministers, and a competent government has nothing to fear from honest accountability. On vital matters of public health, Scotland deserve answers, not nationalist spin."
But PHS said the care home reports were produced in partnership with the universities of Edinburgh and Glasgow in line with standards set by the Office for Statistics Regulation.
A spokesman said: "PHS discharges its duties with integrity and is committed to work that is both open and transparent. A risk assessment for all publications is undertaken only to inform the supporting communications approach, and for the awareness of sponsors. It does not change the substance, content or independence of those publications."