ASAP NHS is a Scottish campaign group which describes itself as “campaigning for the creation of an independent healthcare regulator. Public inquiry into patient safety. Protection for whistleblowers”. I have followed the activities of this group for some time because of my interest in patient safety issues.
There has been a rekindling of interest in the actions of Jason Leitch, Scotland’s National Clinical Director, given the recent announcement that he has chosen to step down from this role. Jason Leitch has previously attracted press attention because of deleted WhatsApp messages but this has not been the only concern regarding Jason Leitch’s actions. ASAP NHS has been raising concerns with the Scottish Government for some time.
On the 18 January 2024, ASAP NHS made a submission to the UK Covid Inquiry Team. The covering letter began:
“It was reported in the press, that former Scottish FM, Nicola Sturgeon and the group, on whom she depended for Covid-19 decision making, including National Clinical director, Jason Leitch, were code-named, ‘Gold Command’.
The covering letter concluded:
“Please find attached, ASAP NHS submission with detailed facts, which you may wish to take into consideration as part of the Scottish and UK Inquiries, in order to ensure, that essential ‘lessons are learned'”.
The following material is the submission made by ASAP-NHS [in html format]. To read the submission as sent please click here for the original pdf document.
EXPLANATORY DETAILED EVIDENCE:
A. LEADING SCOTLAND’S RESPONSE : ‘ACTUAL EXPERTISE’
Data, National Records of Scotland : ‘As of 19 February 2023, a total of 16 834 deaths registered in Scotland, where Covid-19 was mentioned on the death certificate.’ With so many grieving families and friends in Scotland, the handling of the pandemic, requires full, transparent disclosure and honest answers to all questions raised by them, in both Scottish and UK Inquiries.
Never in health and social care, has the need for transparency, accountability and honest answers been more crucial to so many; so vital in cause of learning lessons for the future. The Scottish Inquiry is only investigating policy areas under the control of the Scottish Government.
‘Who should be advising during a pandemic?:“It should be a no-brainer, your best bet is to follow those who have actual expertise.” June 2020, Ballantyne & Dunning
What qualifies. as having actual expertise when it comes to advising on Covid-19 ?According to Nathan Ballantyne: “Genuine experts have capabilities precisely tailored to the problems they tackle, allowing them to reach sound conclusions or at least reduce mistakes. They bring years of relevant training, historic knowledge and an appreciation of their limits.” Scientific America 2020
In March 2020, the former First Minister, appointed, Scottish National Clinical Director, Jason Leitch, as senior clinical advisor on Covid-19. By her side, throughout most daily televised Covid briefings, Jason Leitch became one of the most prominent figures and a household name during Scotland’s response to Covid-19. The former First Minister frequently turned to him for support and directed journalists’ questions to him for, “his expert clinical advice/view/opinion” and on whose advice she claimed in Parliament, “to take life & death decisions.”
In a ‘Policy Scotland’ publication, ‘Experts & Politics’ article, May 2020, the National
Clinical Director is wrongly described as one of the, “the medical advisors”.
Jason Leitch has no medical qualification, is not registered with the General Medical Council [GMC], has no licence to practise medicine or to give medical advice. Jason Leitch has no known scientific qualification in infectious diseases or pandemic management. All his UK qualifications lie within the field of dentistry/GDC registration : a dentist with post-grad qualification in oral surgery i.e. licence limited to perform oral cavity surgery: he is not registered to perform maxillofacial surgery, as wording in biographies or some of his own inferences might suggest.
Jason Leitch’s biography on the Scottish Government website, is a very brief summary of GDC qualifications achieved : with no defined details of his actual experience or information relating to any specialisation. undertaken, which would equip him with necessary skills to give advice on Covid-19 or to manage a pandemic at any level.
“The Scottish Government does not hold any information about Jason Leitch’s qualifications or experience beyond that which is publicly available here. The Scottish Government does not have any business requirement to hold information beyond that which is already published.” FOI response received Dec. 2020
Before she appointed him, did the former F.M. look behind his brief Scottish Government biography, to check his actual credentials: experience, relevant expertise and the capability to be one of her closest, senior, Covid advisors who was providing advice on Covid, as she later said, “leads to decisions I take on matters of life and death,”: or did she check and appoint him regardless?
Notwithstanding, throughout the pandemic, Jason Leitch crossed the line from simply broadcasting information on Scottish Government public health measures, to regularly advising on a whole spectrum of specialist medical matters, from flu, epilepsy, cancer, autism etc etc.
A medically registered specialist would face GMC sanctions/charges for advising on areas beyond the limits of his/her competence, because it is dangerous and considered malpractice.
Why did Jason Leitch do nothing then or since to dispel the myth of medical training but rather encouraged it, through his own rhetoric, “I am a head and neck surgeon” with its medical connotation; also, accepting accolades and awards e.g. Saltoun Award presented to him, as “Chief Medical Officer” for “excellence in application of medical knowledge” ?
During the pandemic, he was also credited with expertise in public health, in the field of epidemiology, which he, himself, alluded to, speaking scathingly of, “armchair epidemiologists”: notably in a TV spat with Piers Morgan, March 21, 2020.
Asked by Mr. Morgan to justify the continuing of large pubic events, Jason Leitch pulled
rank, “You train for it.”, he said. “I’m not sure where your Master in Public Health came from Piers?”
From his own account, [Personal Reflection – Dental Mirror 2007] his US, MPH was awarded
after attendance at a fast track programme, for a duration of 7 weeks over the 2 summers of 2005 and 2006 [15 credits each ] at Chan School in Boston. With no previous or subsequent public health experience, any claims of his MPH expertise in the area, after just fourteen weeks are totally illusionary, disingenuous and a dangerous misapprehension to keep up during a pandemic.
His professorships are honorary and not academic awards: as such, according to university awarding rules, the honorific title should not be used pre-nominally and the honorary status always made clear.
In view of revelations by Jason Leitch during the past year, it is patently clear that from the very start he was fully aware of what is known as epistemic trespassing.
Did Jason Leitch reveal to the FM in March 2020, that he had none of the ‘actual medical/scientific expertise’ required to advise on killer disease Covid-19 or manage a pandemic?
Did he reveal to the FM facts about his [puzzling] fast-track, US. MPH award? If not, why not: why did he decide to blag it out ?
It is instructive to note that all UK leaders, with the exception of Scotland’s First Minister, were flanked up front by highly qualified, experienced medical/scientific experts in the relevant field of infectious diseases and management of epidemics: viz UK’s highly qualified & experienced Professor Chris Whitty
Mostly, from Eire to New Zealand, as recommended by the WHO, those appointed to the forefront of the Covid-19 response had the highest of credentials for the responsibility handed to them.
Whether or not the advice they gave was sound, as Nathan Ballantyne says, “genuine experts in any field have the knowledge and experience, to reach sound conclusions or at least reduce mistakes,”
Interestingly, another exception was Brazil: the medical/scientific experts sacked: their advice not welcome to the President, who replaced them with a non-medical/scientific army general: the catastrophic results for the people of Brazil speak for themselves.
B. ACCOUNTABILITY: EPISTEMIC TRESPASSING ACTUAL EXPERTISE
The phrase ‘epistemic trespassing’ was coined by philosopher Nathan Ballantyne and was defined as: “Experts from one field, drifting over highly visible boundary line and into a domain where they lack the relevant evidence or the skills to interpret the evidence well. However, they keep talking.”
Whilst regret for loss of life to Covid-19, expressed by Scottish decision makers, is undoubtedly heartfelt, their apologies for mistakes are qualified with defensive claims, “of doing the best they could with what they knew at the time”: clearly the best is not good enough, if the necessary skills to make sound judgments are wanting.
The handling of the pandemic raises basic questions: could different decisions have limited the death toll: who is accountable for decisions taken?
Throughout the pandemic, Jason Leitch omitted to correct those who described him as “Scotland’s Covid Chief”, “Coronavirus Expert”, “Chief Covid Aide” or to inform the public that he did not have the key breath of knowledge or any specialisation in infectious diseases, public health or pandemic management.
It has become clear that Jason Leitch is fully aware and in some trepidation, that he is facing the prospect of a number of inquiries: “I think the rest of my career might be public inquiries, I fear.”
He is hoping, with all fingers crossed it seems, that inquiries, “will be truth and reconciliation rather than blame and looking for folk to charge with manslaughter” . . . “and there’s a long story to come out about whether we did that right, wrong or a mix”.
Indeed, during the past eighteen months or so, Jason Leitch has, at every opportunity, been back-pedalling on his previous assertions, that the First Minister was listening following what she termed, “his expert clinical advice”. Attributing Jason Leitch with “expert clinical analysis skills” with regard to Covid-19, is, to use words of Robin McAlpine, “pushing the boundaries of language a long way”.
Somewhat late in the day, Jason Leitch has confirmed. what many either knew or suspected that in he holds neither infectious diseases nor MPH expertise: claiming now, in the face of inquiries, that he was simply a messenger; which strikes as blame shifting away from himself to nameless others behind the scenes.
During a 2O22, ‘International Forum Europe’ , Jason Leitch revealed exactly how out of his depth he knew he was. Reflecting on his leadership role when Covid-19 struck, saying he felt like: “Homer Simpson and his size of brain” . . . ” I didn’t feel equipped. I didn’t know what to do.”
His comments, expose self-awareness of his lack of competence for the advisory Covid role he had been appointed to but, “he kept talking”
There was no mention of whether or not he confided in the First Minister, that she had appointed him in over his head but surprising if neither she or others didn’t notice. During a BBC Radio Scotland broadcast, Off The Ball, December 2022, Jason Leitch made extraordinary, shock disclosures, relating to his MPH, which was in direct contradiction to his previous allusions to expertise, “Yes, so I mean, he told listeners: “I am not a public health expert. I can just talk out-loud in a straight line occasionally. I am not an actual public health doctor.”
There were earlier admissions by Jason Leitch, along the very same lines His admissions on that occasion are astonishing to read, “I’m a dentist who then became a surgeon who then did public health as a hobby so I genuinely do feel a bit of a fraud in that environment.” It’s-not-my-job-to-understand-the-politics-of-the-pandemic’ – Holyrood Magazine 25.08.2021 “The real public health professionals know I’m pretending to be a public health guy. I’m a surgeon” he told an interviewer. Glas. Uni. Ave. Mag. Summer, 2022
When asked on a number of occasions, about wishing that he had done anything differently, Jason Leitch points to the discharge of patients into care homes but deflects responsibility with the defence of hindsight, “we didn’t have the knowledge then” . . . “in hindsight, if I’d known”. Discharging untested patients into care homes, was judged illegal by High Court in England in 2022.
Jason Leitch swings, between swagger about his key role in decision making, “I was in the room when lock-down decision was made. I gave the advice with which to make the decision.” Leadership in time of Crisis’ presentation, Harvard Chan Sch. 03.05.2022 “Those of us in the front of decision making, knew that we had to triple our intensive care capacity. We had to empty our hospitals as quick as we could” a defensive position, absolving himself from any responsibility for decisions.
That Scottish Government policy decision, which Jason Leitch at one time, took some responsibility for, was shockingly irresponsible, defying all lay common sense. In cause of freeing up hospital beds, the discharge of hospital patients into care homes, 1300 we are told, was an early, Covid policy priority: in some cases Covid positive patients were transferred into Covid free care homes; in other cases, healthy patients abandoned to care homes, already full of Covid.
According to ‘Public Health Scotland’, 3599 discharges took place in March 2020 of patients who had never been tested. Of the 650 who were tested, 78 were positive but the discharges still went ahead. According to officials, the policy continued, even after a ‘two negative tests’ requirement. More died in care homes than in hospitals, we are told.
Not only were care home residents denied treatment in hospitals, but blanket ‘Do Not Resuscitate’ [DNRs] were imposed without the consent of either patients or families, adding to the grief of those
bereaved.
Jason Leitch claimed to have been in the front line of Scottish Government decision making, ‘delayed discharge policy’. On 2 April 2020, he described the strategy in terms of a successful achievement, to an International Society Quality Health, webinar audience: “We have completely transformed health and social care services in 3 weeks: quadrupled intensive care beds [6 weeks] . . . “it’s been like nothing I’ve ever learned or even read about”: he described how in just 3 weeks, bed blocking had been reduced by a third, with 600/700 “moved out safely” and “will not be going back – unless they deteriorate”: his words have somewhat an ominous ring now.
By way of that defence, claims to have only been the messenger, relaying Government policy : pointing to those behind the scenes, whom he calls, “the real experts”; those who spoon-fed him information when he, “didn’t know what to do”, strike as blame-shifting, couched in terms of, ‘the big boy done it …..’
No one would dream of pointing the finger and blaming Jason Leitch, or anyone else, for what was not known in the early, uncharted days of Covid-19; nevertheless there are a number of problems with the validity of Jason Leitch’s ‘hindsight’ and other lines of defence. Regardless of what the First Minister actually knew when appointing him, Mr. Leitch, himself, was fully aware, that he was trespassing outside his own area of dental speciality and limited level of public health training but nevertheless, he continued to talk and make pronouncements in a most authoritative manner, with no hint of his claim, that he was relaying second-hand advice : from, “a proper boffin” whom he “called daily,” on “speed dial” and, “who gave us the advice to then give advice to the First Minister. I mean, I
would phone him before I did the media, before I did a Press Conference“.
Apart from Chinese Whispers, being an ineffective and risky way to communicate such critical information, Jason Leitch has admitted that he does not have the breadth of background knowledge to weigh up and translate the advice he was given: “It’s not that I understand the hard stuff, it’s the opposite – I have to have it explained to me and then I can translate it.”
Unlike Jason Leitch, the patently qualified, England’s Chris Whitty understands the ‘hard stuff’. It is difficult to understand the logic behind the former First Minister’s proxy style of Covid information governance.
As the leading public face, in communicating Scottish Government Covid management measures, giving advice or answering questions, Jason Leitch gained ‘expert’ celebrity status and a unique platform on broadcasting, print, internet and social media from which he addressed the public; often going way beyond Government messaging, straying into and assertively passing judgements on questions relating to medical specialities, for which he does not have registered competence.[malpractice for GMC registered professionals]. It is a fundamental truth, that apart from basic common sense and lay, gut instinct, there was evidence and warnings to be seen as early as February 2020, about the deadly spread of the disease, which he clearly didn’t pick up on. [Asymptomatic spread was identified, Feb. 2020, Diamond Princess]
People, even within the medical profession were led astray about his credentials: assuming from his Senior Clinical Advisor title and alphabet of post-nominals, that Jason Leitch was a highly qualified, medical surgeon with specialist knowledge and experience in public health; ‘an exceptional expert’ : misconceptions which Jason Leitch, himself, continues to encourage, “I am a head and neck surgeon” [Q/A David Hume Institute, 2022]
From early days, in February/March 2020, some of Jason Leitch’s misinformation was heard with disbelief and challenged on broadcasting and social media, by both the general public and a alarmed GMC registered medical and other scientific professionals: a proponent of herd immunity: “we have no choice but to follow a herd immunity strategy”, “if asymptomatic can’t spread the virus so safe to hug your granny”; “masks don’t work for the public”; “tests are rubbish”; ”can’t catch it twice”.
It is a damning indictment of his patient safety and care remit, that when his attention was drawn to it, early March 2020, by concerned registered medical professionals, Jason Leitch, argued strongly on social media with a Scottish doctor against evidence of international research re. aerosol spread: “The virus is not air borne.” “Doctor, there is no such thing as aerosol spread.” 04.04.20 twitter
His attention was also drawn to key messages from Trisha Greenhalgh, Oxford University
Professor Primary Care and Sciences: “Because Covid-19 is such a serious threat, wearing masks in public should be advised.” BMJ April 20208.04.20. Ben Shukman, Science editor, BBC News, reported on Finnish research re.transmission by aerosol spread with same message about face masking to minimise transmission.
Eyebrows were raised, when Jason Leitch was seen to struggle for rational answers during
an interview, 16 March 2020, with Ciaran Jenkins: reminiscent of ‘Yes Minister’ but no
one was laughing [Channel4 news, 16 March 2020] Of all the online sessions, which raise concerns about his misinformation that risked harm, the April 2020, Alliance Live one stands out:
Q/A interview on 15.04.2020 for Alliance Scotland:
Jason Leitch was invited to give up-to-date clinical advice and answer questions from members and from their carers, who were anxious to do the right thing for those they looked after : disabled people with long term conditions, some immunosuppressed, many shielding : in essence the most vulnerable group in Scotland, those at greatest risk from covid19, who it was recognised in the earliest days of the pandemic, require enhanced help and protection, compared to the rest of the general public. In the wake of emerging evidence available by 15.04.2020, is impossible not to be aghast at the advice, at times nonsensical, which Mr. Leitch handed out that afternoon to the very concerned, highly vulnerable group :
“The virus is not spread asymptomatically – if no symptoms you won’t be facing droplet spread”; “mask wearing is to protect others – hard to spread if you don’t have the virus”:;”if care worker wants to wear a mask going into a house can do so”;”if I chat to someone in a social situation, I don’t need a mask”; “if symptomatic, rules change – mask for close-up care” : “wash your hands” : “masks are not without risk – you have to put them on & off”; “masks give a false sense of security”;“blow your nose into your elbow “; “the virus isn’t in the air so you won’t be breathing it in – you have breathe it in or you require to ingest it”
Jason Leitch has accepted praise for his ability to translate complex scientific information, providing clear calm advice. His above advice on 15.04.2020 was veritably dangerous. There is no of knowing, what harms may have resulted.
IN SUMMARY: ACCOUNTABILITY
In full knowledge that he was epistemic trespassing, Jason Leitch made assertions and fielded questions about Covid-19, exuding the confidence and authority of a genuine, relevantly qualified expert.
He brushed aside all previous warnings from GMC registered doctors about his misinformation; in doing so, he betrayed the trust of a very scared public, including those most at risk, by failing to listen and to adopt precautionary principle, when there was noting to lose versus a potential to save lives.
One day soon, a Covid inquiry must judge from all the evidence, who should be held accountable for decisions taken in Scotland, during the pandemic.
As one blogger put it: “I, much more dubious about Jason Leitch who seems to me has been blagging his way through this crisis and just lustily regurgitating whatever happens to be the London line from Whitty or Vallance on any given day. I’ve been spontaneously contacted in recent days by a couple of people with strong scientific backgrounds and they were both scathing in their verdict on Leitch. There’s no doubt Leitch has the gift of the gab and that some people are tremendously impressed by that.”
END of SUBMISSION.
Explanatory note about title and image:
The following social media exchange, 8 June 2019, may give an indication of how Jason Leitch has enjoyed his position of power and explains the choice of title for this post:
Jason Leitch: “Thanks all. It’s a genuine honour and still sinking in. Thanks to all who have helped along the way #BirthdayHonours #CBE”
Pennie Taylor: “Jings! Do we have to call you ‘sir’ now?”
Jason Leitch: “Only you….the rest can call me Commander…..”