Meeting of the Parliament

Meeting date: Wednesday, April 1, 2020

Official Report 1417KB pdf

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Covid-19

The next item of business is a statement by the First Minister, Nicola Sturgeon, on Covid-19. The First Minister and members of the Cabinet will take questions at the end of her statement.

12:06  

Thank you for the opportunity to make a further statement about Scotland’s response to the Covid-19 epidemic.

We have now had the first full week of what I will refer to as lockdown measures, so I want to begin by thanking people across Scotland for complying with the rules. I know that the past 10 days have not been easy for anyone—that is a massive understatement. However, overwhelmingly, people across the country have been doing the right thing. That is not unexpected, but it is heartening, and it will continue to be crucial in the weeks to come. By staying at home except for essential purposes, all of us can play a part in stopping the spread of the virus, protecting the ability of the national health service to protect those who need it and, ultimately, saving lives.

In a few moments, I will talk about volunteering and support for businesses, but I want to start with an update on the spread of the virus, on what we might expect to see in the weeks ahead and on the steps that we are taking to increase capacity in the NHS and equip it to cope with the impact of this epidemic.

I confirm that, as of 9 o’clock this morning, there have been 2,310 positive cases of Covid-19 confirmed in Scotland. That is an increase of 317 on yesterday’s figures. As I have stressed every day, those numbers will be a significant underestimate of the true spread of the virus across the country. It is with sadness that I must also report that there have been 16 further deaths of patients who had tested positive for Covid-19. That takes the total number of deaths in Scotland to 76. I am sure that everyone in the chamber will join me in extending condolences to all those who have lost loved ones.

I know that everyone will also join me in thanking everyone working in our health and care sector. They are doing an extraordinary job, and everyone in Scotland is deeply grateful for their dedication and expertise.

The numbers that I have given demonstrate that, as expected, we are now at the stage of the epidemic at which the number of cases is rising rapidly. Unfortunately, that means that the numbers of people becoming seriously unwell and dying are also, sadly, rising. Of course, we hope that the lockdown measures that we are asking people to comply with will have a marked effect on the spread of the virus, and that we will see a slowdown in the next few weeks. However, given that these measures take some time to have an impact, it is too early to draw any firm conclusions yet. In any event, we must continue to plan for what will be a considerable impact on the national health service and on wider society.

First, I will address the impact on the NHS, which I must say is being felt already, and the steps that we are continuing to take to respond to that. We have already seen an increase in intensive care patients with confirmed or suspected Covid-19, from 51 in intensive care this time last week to 147 as of last night—that, in itself, is an increase from 135 yesterday.

Unfortunately, we expect that increase to continue for at least a further two or three weeks. However, I can advise Parliament that we have now achieved our initial target of doubling intensive care capacity in Scotland to 360 beds. Given that some of that capacity will still be required for other urgent care, that provides us with approximately 250 intensive care unit beds that can be used exclusively for Covid-19 patients.

I can also advise Parliament that we are now working to quadruple intensive care capacity to more than 700 beds for Covid-19 patients. To deliver that increase, we have ordered ventilators from a range of manufacturers and we expect those to arrive over the coming weeks. However, to bridge any gaps between now and the delivery of new ventilators, NHS boards have been working to repurpose operating theatre anaesthetic machines for use as ventilators. That is not a long-term solution, but it will allow us, over the next week or so, to rapidly increase capacity to more than 500 intensive care beds for Covid-19 patients. I pay tribute to all the NHS clinicians, medical physics colleagues and technicians who have worked non-stop in recent days to make that happen.

Our current modelling of the spread of the virus—I stress that it assumes continued high compliance with the lockdown measures—together with the steps that we are taking to increase ICU capacity, suggests that our intensive care units are now in a stronger position to cope with the expected peak of the epidemic. However, I again stress that we are in no way complacent about that and that we will continue to give all possible support to those who are working so hard on the front line. It is worth stressing again, because it is so important, that what I have just said assumes that people across the country will continue to do the right thing. Every single one of us who follows the public health advice is helping to reduce the number of people who will need hospital care in the weeks ahead and is therefore helping to reduce the risk of the NHS being overwhelmed.

The measures to increase intensive care capacity are part of a wider effort to ensure that the NHS has enough beds overall to cope with Covid-19 patients. I can report that, as of last night, including those in intensive care, there were 1,153 patients with confirmed or suspected Covid-19 in hospitals across the country. Clearly, expanding general hospital capacity is also important, and I can report to Parliament that we are on track with that. The target that we set at the start of the month of quickly reducing delayed discharge cases by 400 has already been met and we are now working to go further. That is of course good for patients, who should not be spending longer in hospital than they need to, but it also makes more hospital beds available for those who need clinical care. Overall, the NHS currently has around 13,000 beds, and through the reduction in delayed discharge and the postponement of non-urgent elective care, we estimate that at least 3,000 beds will be available to treat Covid-19 patients.

In addition to those 3,000 beds in our existing hospital network, this week we announced our intention to create a new temporary NHS hospital at the Scottish Event Campus in Glasgow. We expect the facility to be ready to care for patients within a fortnight. Initially, it will have 300 beds available, with the capacity ultimately to care for 1,000 patients if that proves to be necessary. Let me be clear that our current hope and expectation is that that hospital will not need to be used. However, we are—rightly, I think—preparing now so that we are ready if necessary.

In addition to hospital capacity, which is extremely important, we are all well aware of the vital role that NHS 24, general practitioners and primary care more generally are playing in the efforts to deal with the virus. The NHS 24 111 number is now the first port of call at any time of day or night for anyone who is concerned about Covid-19 symptoms. The service has been under tremendous pressure and I want to thank everyone there for an exceptional response. Patients calling 111 who need further advice or care are now being referred to new community hubs that are staffed by clinicians from across the healthcare system. If necessary, those patients will be given an appointment at one of our new Covid-19 assessment centres. That new network of hubs and assessment centres will allow GPs to focus more of their time on patients who have needs other than Covid-19 needs.

However, GPs are also dealing with significant pressure. Yesterday, we announced £15 million of extra funding to help with that. The money will support additional non-clinical staff and additional locum cover if GPs need to take sickness leave. The funding will also reduce the pressure that might otherwise have been placed on out-of-hours services by ensuring that many GPs will be able to remain open on Good Friday and Easter Monday this year.

The final health issue that I want to cover is the welfare of health and care workers. Testing is an important part of that. We are working at pace right now to significantly increase our testing capacity. We have already gone from the ability to do around 750 tests a day just a couple of weeks ago to being able to do around 1,900 tests a day now. Over the course of the next month, that will increase to around 3,500 tests a day. It is important to stress that that increase will be delivered within the NHS laboratory network. Commercial partnerships that are being developed at the United Kingdom level will increase capacity beyond that. As part of one of those partnerships, a new laboratory has already been established in Glasgow, which we expect to be operational within the next two weeks.

As testing capacity expands, we will progressively increase the number of health and care service workers who are tested. We have already published guidance to support that.

The other two immediate priorities for testing remain the treatment of serious illness and community surveillance, both of which are extremely important. However, we will also carefully consider the role of more extensive testing as part of our strategy—at the right time, of course—to bring the country out of the current lockdown measures.

What I have talked about so far is, of course, diagnostic testing, which tells people whether they have the virus. We remain hopeful that antibody testing, which confirms whether a person has had the virus, will also be available soon. We will keep Parliament updated on that.

I turn to the provision of personal protective equipment. The importance of ensuring that our health and care workers have adequate supplies of the right equipment simply cannot be overstated. Over the past four to six weeks, around 34 million items of personal protective equipment have been delivered to hospitals across Scotland to provide care for Covid-19 patients. Over this week, we are issuing almost 8 million items of personal protective equipment stock to staff across primary care and social care. That includes around eight weeks’ supply for primary care practitioners. We have reasonably good supplies of all key items at this stage, although it is important to say that we may face challenges in the future as global pressure on those supplies continues to intensify.

We have taken steps to improve not just the supply of PPE but its distribution. For example, NHS National Services Scotland is now operating a triage service so that it can respond more quickly to urgent requests for PPE from health and social care providers. There is a fundamental principle at stake, which I, the Cabinet Secretary for Health and Sport and the entire Government take extremely seriously: given everything that health and care workers are doing to protect us right now, we must do everything that we can to protect them.

In addition to the action that we are taking to improve the capacity of the health service, we, of course, continue to be acutely aware of the growing economic impact of the crisis. Many businesses perform an essential role. I thank those who are working to keep the country going at this time: people in the essential retail industry and our food and drink sector, our pharmacists, those in our energy sector, our road hauliers, and many more besides. I also thank all businesses that have done the right thing by prioritising the health of their workers, applying the precautionary principle, and deciding to close at this time. I know how hard that is, and I am hugely grateful.

As a further example of that, we heard confirmation earlier today that, for the first time in more than 70 years, the Edinburgh festivals will not take place this summer. That is a heartbreaking decision, but it is absolutely the right one, and it is another sign of how far reaching the impact of the epidemic will be. We have agreed that some Scottish Government support for the festivals can be used for different purposes, such as ensuring that freelancers and artists are still paid, and we will work with the festivals to ensure that they return even stronger next year.

More generally, the Scottish Government has welcomed the support that has been made available by the UK Government, including the measures that were announced on Thursday to help self-employed workers, although we will continue to press for improvements where necessary.

We have introduced a £2.2 billion package of support for businesses in Scotland. More than £1 billion of that package is for the business support fund, which will make grants of up to £10,000 available to small businesses and grants of up to £25,000 available to eligible properties in the retail, hospitality and leisure sectors. The business support fund is being administered by local authorities, and I understand that approximately 30,000 applications for grants totalling £350 million have already been received.

We want to get money to businesses as quickly as possible. I can therefore confirm that the Scottish Government is today transferring £950 million to local authorities so that payments can start going into the bank accounts of eligible businesses from Monday. I know how desperately hard the past few weeks have been for businesses, and I hope that those payments, together with the wider support that is available from the Scottish and UK Governments, will go some way in helping.

The final area that I want to cover is volunteering. On Monday, we launched the Scotland cares campaign, which encourages people to sign up to help their community. There are three different ways in which people can help. Medical students, or former NHS staff, can apply for positions working in health and care. In addition, anyone can sign up as a community reserve volunteer. That part of the programme will be co-ordinated by the Red Cross. People can also take up volunteering opportunities in existing organisations through Volunteering Scotland. It is still possible to sign up. Anybody who wants to volunteer but has not yet done so will find information on the readyscotland.org website.

The response to the campaign in the first few days has been brilliant. I can tell Parliament that, so far, a total of 41,000 people have registered an interest. They exemplify the sense of solidarity and community that has already characterised so much of the response to this epidemic.

That solidarity and sense of community must continue. I do not underestimate how difficult life is right now, but the fact is that staying at home remains the best way in which we can all show that we care about our families, friends, neighbours and communities. It is, in fact, the single most important contribution that any of us can make to tackling the epidemic.

We must, of course, continue to reach out to other people, even as we remain physically separated from each other. By staying closely in touch, we will all find it easier to stay physically distant. By doing the right things, and by remembering that what really matters in life is our health, love and solidarity, we will slow the spread of this virus, we will protect the NHS, we will save lives and we will get through this. I end by again giving my sincere thanks to everyone across Scotland who is playing their part.

The First Minister and the Cabinet will now take questions.

In weeks that we will long remember, all of us have witnessed the very best in our public services and in so many others—doctors, nurses, all other staff, shop workers, volunteers and, indeed, the country at large. With the peak still yet to arrive, we know that difficult days lie ahead, and we really are in this together.

I thank the First Minister for her comprehensive statement. Again, I offer our support to ministers as they tackle the many challenges that we face. I add the condolences of all my colleagues to those who have lost loved ones in the days since we last met.

I will focus my questions on four major issues on which public information could be clearer. The first is testing, and I appreciate the extended part of the First Minister’s statement that was given over to the issue. We know that some doctors and nurses are staying at home with flu-like symptoms, but they do not know whether they have the virus.

The Scottish Government has started testing key workers. Yesterday, the First Minister said that that was a priority and that she wants to achieve an increase to 3,000 tests a day. Today, she said in her statement that she wants an increase to 3,500 tests a day. Can she confirm that she expects those 3,500 key worker tests a day to be achieved by the end of April, as she suggested in her statement? Can she confirm whether the commitment includes all healthcare workers, including dentists and others?

I thank Jackson Carlaw for his comments and expressions of support.

Let me turn to the issue that Jackson Carlaw raised. Within the current NHS laboratory network, we expect to be able to carry out a total of 3,500 tests per day by the end of April. That will cover the three priority areas that we have set out for testing, the first of which is treatment for those with the most serious illness. The second is the testing of key workers. We have started to prioritise key workers on the basis of those who are more critical to maintaining rotas, and we will extend that as our testing capacity increases.

The third priority is, of course, ensuring that we have a robust system of surveillance across the country, which HPS, through our new community hubs, has been working to put in place. That will allow us to assess, monitor and report on the spread of the virus across the country, in a way that is similar to what we do for flu every year.

After the end of April, we intend to continue to try to increase the number to above 3,500 tests per day, but that is the target that we have set out to achieve over the next month. As I have said, as of today, we have capacity for 1,900 tests per day. That relates to tests is within the NHS laboratory system, but there are a number of initiatives over and above that, which I hope will give us significant additional capacity that will enable us to accelerate that progress, particularly with key workers, even further. One of those initiatives is a United Kingdom-wide commercial partnership, and Scotland will play its full part in that through the opening of an additional lab in Glasgow, which has already been established and which we expect to become operational in a couple of weeks.

There is a real focus on making sure that we are using testing as extensively as possible and focusing testing on the right areas. I have noticed that the centre for disease—I think that that is the name of the organisation that I am about to quote—has talked about the “rational basis for prioritising” in that kind of way while capacity is being built up and extended. Sorry—the European Centre for Disease Prevention and Control is the organisation that I am referring to.

Finally, one thing that occupies more of my mind, and which the cabinet secretary and I are talking about and will increasingly be discussing intensively with our expert advisers, is how we use more extensive testing as part of the strategy to take the country out of lockdown. It is too early to assess this now—I am summarising and using shorthand here—but we are discussing how, if we are as successful as we want to be in suppressing the virus at this stage, we can use testing to go back to a strategy that is more like the contain strategy as opposed to the delay strategy that we are using now. That is the other reason why it is important that we accelerate and expand the testing capacity as quickly as possible. We will keep Parliament up to date as those plans progress.

I thank the First Minister, especially for that final point and for being encouraging as we try to normalise—at least relatively—our lives again. I am also sure that she will undertake to ensure that there is complete transparency as to which groups of front-line NHS staff can expect to receive testing as a priority.

The second issue is contact with vulnerable people. All MSPs will have constituents who fall within one of the vulnerable groups and who were probably expecting a letter last week but were then confused when nothing arrived. When letters started to arrive this week, there was concern that the information in them was quite long and complex, and that a mobile phone or internet access is required to register for help. There was some doubt among GPs about whether they still had to call patients individually, and councils have told us that they do not know how many people in their areas might have received letters.

None of us doubts the good intent underpinning all of that—that is understood. However, the situation is slightly confused, and vulnerable people are therefore understandably worried. Has every vulnerable person now received the letter? Is the Scottish Government certain that, between its letters and the efforts of GPs and councils, every vulnerable person will be contacted and no one will be inadvertently overlooked?

I will take a bit of time to give as much detail as possible. When we talk about “vulnerable people”, first and foremost we are talking about the group that we refer to as “shielded”. That is a group of up to 200,000 people in Scotland who have certain conditions, such as people with specific forms of cancer; people with severe respiratory conditions; people with rare diseases that leave them vulnerable to infection; people who have received solid organ transplants or are on immunosuppressive therapies; and women who are pregnant and have congenital heart disease.

The first point that I would make is that it has been very important to get that list of people as accurate as possible. We do not want to mistakenly send letters to people who really do not need to be in that group, because what we are asking them to do is so incredibly restrictive for a long period of time. Therefore we have taken time to make sure that those records have been checked and are as accurate as possible.

I took part in a meeting yesterday to get an update on the issue. The figure will have increased by now, but as of yesterday, 94,000 of the letters had been issued, and the others are going out over the next day or so. The people in that group will also have a contact text number, but we are making sure that they are able to phone as well.

The letter is complicated, but the advice that we are giving to those people is serious and complicated. Their being able to contact us—central Government and local government—will enable us to contact them back to ask what they need in terms of food and medicine delivery. Arrangements are in place to ensure that those services are delivered.

Local authorities, through local resilience partnerships, are working to ensure that they also have local arrangements in place to capture all those vulnerable people. We are working closely with local authorities, which have good information and intelligence of their own, to make sure of those people’s identities. A huge amount of work is going on to ensure that all those people are captured—Jackson Carlaw knows in what sense—and provided with the care and support that they need.

We also now seek to focus on a wider group of vulnerable people. For example, I am getting a lot of contact from a lot of elderly people who are at home and find it difficult to get online shopping because of the understandable waiting times that supermarkets are dealing with. We are now looking at how to extend some of the arrangements that I have described in order to look at a broader range of vulnerable groups. That is work in progress, but we will continue to keep the Parliament updated.

I accept that we do not want to include individuals who do not need to be included, but we all have constituents who expect that they will be included, and they are obviously anxious and need that confirmation and clarity as soon as possible.

In the rush of the past few weeks, we have seen a pulling together of companies, workers and Government. I hope that that kind of co-operation will long outlive the present crisis. The efforts of manufacturers, both large and small, and universities to develop ventilators have been pioneering and exceptional. I congratulate those that have repurposed theatre anaesthetic machines, as the First Minister detailed.

We now need to understand how those efforts will translate into front-line equipment. Jeane Freeman told the media a few weeks ago that “around 700” ventilators would be in place; more recently the Scottish Government used the higher figure of 1,000. It was then suggested that those might not be available until midsummer. Meanwhile, some of the procurement is UK-wide: Professor Jason Leitch confirmed that Scotland would have a share of the 8,000 ventilators that are being bought at a UK level.

No one doubts the intent here, but those varied messages are potentially confusing. Can the First Minister clarify how many ventilators in total the NHS in Scotland expects to have, from where those are being sourced and by when it hopes to have them?

I will first complete a point on the previous question. It is important for people to know that they are in a shielded group. Many of those people will know that already, as they are in close contact with their health professionals and the list of conditions is available. However, that does not in any way undermine the importance of getting the letters to people as quickly as possible.

On the issue of ventilators, I hope that we are not giving mixed messages; I appreciate that different strands of this work, when they are articulated in different ways, might sound as if they are saying different things. I will try to set out our position step by step. The Scottish Government has a number of orders in for ventilators with existing ventilator manufacturers, mainly from overseas. Assuming that those orders stay on track, they will be delivered over the next number of weeks or—and I can provide the information in more detail—by the summer. That will take us to slightly more than 1,000 ventilators. That is the first strand, and I stress that those are orders with existing ventilator manufacturers and that they are not dependent on companies repurposing what they do.

Secondly, Scotland will seek to participate in the UK-wide procurement. Thirdly, efforts are on-going on a UK basis to see whether companies can repurpose to produce ventilators as well—we have been looking at that as part of the UK efforts but also through the work that Ivan McKee has been leading. Our current estimate of the ventilators that will come into use over the next number of weeks is not dependent on companies doing different things and changing or repurposing their capacity.

My final point is to stress that, given the modelling and the numbers it suggests we will face in terms of intensive care requirements over the next two to three weeks, the work that we have done to repurpose the theatre anaesthetic machines and the number of ventilators that we currently have in stock and operational in our hospitals give us greater confidence that we will be able to meet that peak demand. It is nevertheless important that we continue to see orders for the medium and longer term being delivered.

I thank the First Minister—that was extremely helpful.

My final point relates to personal protective equipment, which the First Minister referred to, and full face masks in particular. In mid-March, Jeane Freeman reassured us that we had adequate supplies of PPE. Some supply issues then emerged, as they have across the whole UK, and the Scottish Government made a number of changes to distribution. As a result, the chief medical officer, Catherine Calderwood, said last week that “Distribution should not” now “be a problem” in Scotland, and Jeane Freeman has said that hospitals, GPs and social care now have appropriate supply.

Of course, the need for PPE is on-going, as the First Minister said; it is not a one-off, and it is an issue for the entire public sector. This week, the Justice Committee was contacted by officers at three separate prisons saying that they do not have the kit that they need to stay safe. Yesterday, the Royal College of General Practitioners, the Royal College of Nursing and Scottish Care all wrote to the Scottish Government saying that their members lack the protection that they need. They said:

“Every minute we wait is a minute too long. All staff, no matter where they work, must feel safe. We will continue to raise this issue until it is resolved.”

If she can, will the First Minister tell us whether she is confident that every public servant who needs protective equipment will get it, and is she now able to say when they will get it?

Every public sector worker who needs protective equipment—and I will come back to that point—should absolutely have it. We are working on an on-going basis to make sure that that is the case, again on an on-going basis. There are three issues that, for understandable reasons, are very often conflated: supply and stocks; distribution; and advice as to what items of PPE are required by different groups of workers in different circumstances.

On supply, right now, we have fairly healthy stocks of all the key items, but I do not want to labour that point because there is huge demand for them and global supplies are under pressure, so we cannot be complacent about that.

On distribution, to be candid, I do not think that we have done as well as we would have wanted to in the past couple of weeks. Significant steps have now been put in place by NHS National Services Scotland to streamline and improve that. For example, the exercise that is under way this week to proactively get eight weeks’ worth of supply to GP practices is an important part of that work, and there is a triage system to deal with urgent requests more quickly. I am much more confident that the distribution issues have been resolved, although with an operation of such scale, I cannot guarantee that issues will not arise. However, we will absolutely work as hard as possible to resolve any issues that do arise.

On the final issue, Health Protection Scotland advice is available on which groups of health workers need which items of PPE in which circumstances. Not every health worker will need the FFP3 masks that are talked about; for many, it will be appropriate to use other types of mask. That advice is under on-going review, and the four nations across the UK have been looking at whether there is a need to update it. If there is, I hope that that will be done in the next day or two, and we will make sure that that advice is there.

More generally, we are looking at providing bespoke guidance and advice to different groups of public sector workers about how to best protect themselves. Some of that advice will be about PPE and some will be about safe social distancing and other working practices. I give an assurance that we take the issue extremely seriously. There are complexities in it, given the logistics, but we have made improvements and will continue to do so, so that every public sector worker who needs such protection has the assurance of knowing that they will get it.

I extend our condolences to all those who have lost loved ones to the coronavirus.

I thank the First Minister for an advance copy of her statement. In these challenging and anxious times, I offer the support of my party to the Government in the fight, for all of us, against this virus. Those working on the front line in our NHS and social care services also have our full support. It is because of that that I need to raise testing with the First Minister again.

The commitments to roll out testing to key workers are welcome—it is something that we have been calling for since the very beginning. However, the NHS and care staff that I speak to still have real frustrations and anxiety about the lack of testing. They are worried for themselves, but also for their patients, co-workers and families. Will the First Minister confirm how many front-line health and care staff have been tested, and will the Government start reporting daily the number of key workers who have been tested, as well as the number who have tested positive?

We are hoping to get to a position in which we can report daily, not just on the total number of tests that are being carried out, but on the breakdown of that number between the three priority areas that I have spoken about. I cannot give that number today. I can say that—forgive me, I think that I am reading this table correctly; I will correct what I say later if I am not—around 1,700 tests were carried out yesterday. We have the capacity right now to grow that to 1,900, and we are doing that.

There will always be a difference between the number of tests that are carried out and the number of people tested, because some people require more than one test. We are trying to get, on a daily basis, much more granular information around that.

On testing for key workers, we have been working very hard in the Scottish Government to accelerate the expansion of testing so that more key workers can be tested. It is important to say—healthcare workers, more than any of us, will know and understand what I am about to say—that testing is not a complete panacea. If a healthcare worker is isolating because somebody in their family has symptoms, but that worker does not have symptoms, testing will not be appropriate. However, testing will help, to a great extent, to make sure that we do not have healthcare workers with symptoms isolating unnecessarily if they do not have the virus.

For that and other reasons, we are focused on trying to expand testing as much as possible, and health boards across the country are very focused on doing that. As I said a moment ago, guidance is already available that helps with the prioritisation of testing.

We will continue to provide as much information as possible to Parliament as the situation progresses, including some of the more detailed information that Richard Leonard has asked for.

I thank the First Minister for her answer. We raise questions of testing simply because it is clear, from international experience, that comprehensive testing has been critical to successfully limiting the spread of the virus.

Two weeks ago in Parliament, the First Minister reassured us that her aim was to increase testing capacity in Scotland to 3,000 tests every day. Today, the First Minister mentioned the figure of 3,500 tests a day. However, it is clear from the daily updates that we are still far below that figure. In fact, the average daily number of tests over the past two weeks is just 754—a quarter of the target—and not the 1,900 daily capacity that the First Minister just referred to. NHS and care workers are asking me, so I am asking the First Minister, why that testing has not happened.

The answer to that is reasonably straightforward, although I understand the frustration and the desire to see us increase testing capacity more quickly.

The provision of equipment and having the staff trained and able to do testing is, unfortunately, not something that can simply be increased overnight. It takes time to do that. We have gone from the position, just a couple of weeks ago, in which we had the capacity to do around 750 tests a day—which had, in itself, been increased since the start of the epidemic—to the position that we are in now, in which we are able to do 1,900 tests a day, and that will increase again in the next few days. I am now reading the table accurately. In the 24 hours that ended at 9 o’clock this morning, 1,710 tests were carried out. We are increasing the capacity and we will continue to do so.

As I said earlier, we have firm priorities for testing—the three priorities that I have spoken about. The World Health Organization is talked about a lot, understandably. Some of what it is saying is, I think, about countries that are still in a containment phase. We are in a delay phase, but as we come out of that and come out of these lockdown measures and go back to something that is more about trying to contain the virus, the importance of testing will become even greater. That is why we are working so hard to increase the capacity and we will continue to do so.

Testing is an essential part of our response, but on its own it is not enough. I have previously raised the importance of PPE with the First Minister and I know that she agrees with me, as we have just heard. However, workers, trade unions and professional associations continue to voice serious concerns about the availability and quality of PPE that they and their members are receiving.

In the past 24 hours, the British Medical Association Scotland said:

“BMA Scotland’s members have raised with us concerns about the quantity, quality and speed of roll out of PPE.”

Yesterday, the RCN said that it had heard from district nurses who had run out of PPE but were still required to make home visits.

The Government’s new PPE distribution measures, which were put in place on Monday, are welcome. We cannot have supplies stuck in warehouses while staff are put at risk in our communities. The last thing that staff should have to worry about during this time of immense pressure, when we are relying on them so much, is whether they have supplies of the right equipment.

Can the First Minister therefore confirm that, when the updated guidance that she spoke of earlier on when and what PPE to use in Scotland’s NHS and care services is issued, it will match the guidance from the World Health Organization, and can she give a guarantee that we will have adequate supplies of the right PPE to see us through this pandemic?

I will say a number of things on that. The Government, and the health secretary in particular, is talking to groups of workers in the health service, trade unions and professional organisations on an on-going basis. The health secretary spoke to the BMA yesterday about the issue, and we are actively listening and responding to concerns. That is why the changes to distribution have been made and why eight weeks of supply is being issued proactively up front to general practices this week.

We will continue to listen. The health secretary is establishing an email hotline so that any group of workers, or worker, who has concerns can very quickly make sure that the Government, not just those who are distributing the supplies, is aware of the concerns and so that we can respond.

Let me be very clear on the guidance: there is Health Protection Scotland guidance right now, which is robust and quality guidance that complies with relevant standards. As people will understand, and as I have previously said in the chamber, I do not decide what the guidance is in terms of who needs to and who does not need to wear different types of PPE. I am not qualified to do that; I rely on expert advice, which comes from Health Protection Scotland.

If there is a need to update the guidance—the four countries of the UK have been looking at that in recent days—it will be updated and any explanations will be given. Healthcare workers can rely on the guidance that is in place right now. It tells people what kind of PPE is required in different circumstances, and it allows those distributing it to make sure that we have the supplies and that they get to the front line as quickly as possible.

I, too, extend my sincere sympathies to all who have lost a loved one, at a time when they may have been unable to visit or even to pay their respects. I also thank all those working to care for, protect, feed, deliver stuff to and transport us. We are truly grateful.

I would like to understand what liaison is being undertaken with the Scottish Fire Brigades Union and the Scottish Police Federation with regard to the sustainability of their services as more and more of their officers are forced to self-isolate in line with the Government’s advice. Testing those front-line emergency personnel must be a priority so that we can ensure that every able emergency worker can assist during this unprecedented emergency. Will the First Minister confirm when a testing regime will be in place for all our emergency services?

First of all, on the point about liaison, the Government, in particular the Cabinet Secretary for Justice, will liaise closely with the Scottish Police Federation and the Fire Brigades Union, and indeed with the Scottish Police Authority and the Scottish Fire and Rescue Service, to make sure that those who work in those services get the right advice and proper protection when it is needed.

On the issue of testing, my answer is the same as the one that I have given several times already: we are building up testing capacity. We must prioritise the use of that testing capacity in line with the three objectives that we set out. Among key workers, we have been prioritising health and social care workers—for reasons that people will understand. As we build up the testing capacity, we will be able to do more of that. That is the general position on testing, which applies to the particular groups that Alison Johnstone asked about.

Testing helps us to better understand where the coronavirus is, but as testing increases, how will the Government use the information that the results provide to better protect the most vulnerable, including homeless people and those without a fixed address, who may not receive the shielding advice that they desperately need? How will the information from the test results help to ensure that the services that those people require can reach them when they most need them?

We are working hard with local authorities to ensure that people in vulnerable groups—I am not talking specifically about the shielded group but about the kinds of groups that Alison Johnstone mentioned, such as those who are homeless, or rough sleeping—are being contacted and are being given accommodation and access to the services that they need. That work is on-going and is important notwithstanding the wider question about testing.

One of the objectives of testing is to provide surveillance to enable us to know how the virus is operating, whether particular parts of the country are affected more than others and whether different groups are more affected than others. That is why surveillance is such an important part of the strategy for testing. As I said before, unless there is a particularly bad flu outbreak, most people do not pay much attention to such things, but it is the same kind of system that is used every year during the flu season. That reporting will be important in this context and will allow us to take informed decisions about different groups and where we have to target particular action. As we start to come out of the lockdown measures, the system will give us better intelligence about how to do that in a way that will not simply reactivate the spread of the virus.

There is another important development that I have not yet mentioned today, but which has been reported by the Government over the past week or so. The chief medical officer has established a new scientific advisory group, chaired by Professor Andrew Morris, to ensure that the UK-wide modelling that the scientific advisory group for emergencies—SAGE—is using to inform its advice to the Government can be provided and considered at a more granular level for Scotland.

All those things are important in ensuring that we understand exactly what the virus is doing and how we can modify our response.

I offer my condolences to all those who have lost loved ones and my appreciation to those public servants, including those working in care homes, who are doing an exceptional job just now. It is incredibly stressful for them and I am sure that everyone here appreciates their work.

My questions are designed to be helpful and to bring clarity rather than to criticise. I am not convinced that there is clarity about which businesses and organisations should continue to operate and which should close. Some seem to believe that all non-essential businesses should close, but health guidance does not say that. With some exceptions, it says that if businesses can operate safely, they can continue whether they are essential or not.

The whole situation is causing great anxiety among workers and employers. Can the First Minister bring some clarity to this important issue?

I have tried very hard to be clear on that in a way that accepts up front that we cannot give bespoke guidance that covers every situation, although we try to offer advice wherever possible.

We have a group of businesses that have been told categorically that they should close. Such businesses include non-essential shops, pubs, restaurants and theatres. At the other end of the spectrum we have businesses that are essential to the on-going operation of the country, such as the businesses that keep the lights on and food flowing through the supply chain. Those essential businesses should keep operating, while following health advice.

We recognise that in the middle of that spectrum there are different circumstances. We have set out principles for businesses to consider, such as whether the activities that the business is engaged in are material to the wellbeing of the country and if so, whether the business can allow staff to work at home and if not, whether it can ensure safe social distancing. I have said clearly that if a business’s answer to those questions is no, it should be closed.

I make no apology for that, although—trust me—I do not underestimate the impact of the situation on the economy or the challenge and task for us all in rebuilding the economy afterwards. As I said—deliberately starkly—yesterday, we can rebuild and repair the economy, but we cannot bring back to life people who have died.

That is why the absolute priority is for any business that is in any doubt to err on the side of protecting the health of its workers and protecting life. That is my clear advice to such businesses.

That helps to bring clarity. I have spoken to many businesses, employers and workers, and I know that it is possible to work through those issues. However, that takes a bit of time, so clarity is important.

Should those who share homes with people who are on the shielded list go to work, or should they remain at home? What is the advice to employers on that?

Some people in self-isolation or who are shielding are beginning to run out of cash and do not have access to online shopping. They can get support from a mutual aid group, but has the Government considered other ways of ensuring that people can pay for goods if they do not have cash or access to online shopping?

There are concerns about how parents and carers of disabled children who are supported can maintain that support when they are at home and are shielding or self-isolating. They are under incredible stress right now and need such support. What can the First Minister advise?

I am happy to make more detail available on my answers to those questions, because they are all important.

As quickly as I can, on the question of people sharing a household with somebody who is in the shielded group, the advice to the shielded group is to isolate themselves in their households as far as possible. That is hard advice. They are advised to sleep in a separate room and to use separate utensils, towels and such like. It is about them isolating themselves. That said, if the nature and circumstances of the household make that more difficult, I ask the employers of people who are in the same household as a shielded person to take that into account if their business is still running. It is really important that they do so.

On access to cash, we have given local authorities money to increase the Scottish welfare fund as a source of emergency support for people. We are also providing additional resources to local authorities to deal with food poverty and to give more resources to organisations that are working on the front line of the issues. Detail about that is available, but we can make it available again, because it is important that people are aware of it. For understandable reasons, the waiting times for universal credit are long at the moment, but we encourage people to apply for such support.

We continue to work with councils and front-line organisations to ensure that, as far as feasibly possible, we get as much direct support to people as we can. I have already mentioned the issue—experienced particularly but not exclusively by older people—of the difficulty of getting home deliveries of food from supermarkets, and we are very much focused on seeing whether we can do anything to address that, in addition to what we are already doing for shielded people.

As well as the First Minister’s statement, we have had helpful, detailed and lengthy questioning from the party leaders on behalf of their parties. As we turn to the 24 members who want to ask questions, I ask that they restrict themselves to one question, if they can. I ask them to identify the Cabinet minister to whom the question is addressed and I urge each Cabinet minister to respond as succinctly as possible.

My question relates to business. What is the Scottish Government’s view on private nurseries that continue to charge for places while they are closed and are in receipt of funding introduced by the Government to help businesses cope with the impact of Covid-19?

That question also covers education aspects; I am happy for my education colleagues to give more information on it.

In terms of keeping businesses productive and maintaining capacity, some of the announcements that have been made on support for three and four-year-olds have been important. Local government colleagues have ensured that private nurseries that were in receipt of funding for three and four-year-olds could continue to receive that funding to enable places to be maintained. From discussions, my understanding is that people can speak to their local nurseries and negotiate with them.

Members should remember that those private nurseries have staff, who should be supported and paid.

If people are in receipt of income—there are many people who are working from home and are being paid—even though their child cannot attend the nursery, they will want to make sure that they have a nursery to go back to, when it is fully open, not just for themselves, but for others who are not in work. People need to take a commonsense approach, because we want to keep capacity. Workers will want that capacity. However, if they are not using the nursery, and they are not being paid, that is a different issue. There needs to be flexibility both from parents and from the private nurseries.

We need to make sure that we all get through this together and that when we return to a containment—or different—phase, such capacity is there.

Following the announcement that the national cancer screening programme will be paused, what consequential impact is that likely to have on early diagnosis and mortality rates for cancer outcomes in Scotland? Will ministers agree to publish information on that, if it is available? If patients who are currently in the screening programme need further screening, have they been informed about plans to support them during this time?

I will take the last part of that question first.

For patients who are currently in the screening programme, it will be completed. If they need any further treatment as a consequence of a diagnosis, or any further tests, that work will be completed, too. In getting to this point, we consulted the Scottish Cancer Coalition, and we remain in regular contact with it, so that it can ensure that those with whom it is in touch with are also kept informed.

The decision was taken on the basis of clinical advice. That will also advise us about the best way to pick up the programme again when the pause is ended, and to ensure that everyone who would have been called is called as soon as we are able to restart the screening programmes.

Across all social care sectors and settings, carers are frightened, either because they do not have any PPE or because they do not have the right PPE. I have raised that issue in Parliament previously.

Yesterday, the First Minister was made aware of a survey of GMB Scotland members, which revealed that a majority of care workers have lost confidence—due in part to a lack of PPE, but also because they do not believe that safe systems of work are in place for them or for the people who rely on their care. I am told that absence levels are soaring—in some parts of the country, more than a third of people are off sick already—and that care packages have been withdrawn or downgraded.

Not valuing carers is going to cost lives. I ask the Cabinet Secretary for Health and Sport: who is advising the First Minister that there are reasonably good supplies in place? Is the cabinet secretary convinced by that advice? Have we got the guidance right? That is not the real-world experience of carers, their families and the trade union representatives who stand up for them.

I take seriously all issues around PPE. I assure Ms Lennon that I now monitor on a daily basis the supplies, the outgoing stock and the supply line.

Over lunchtime, a letter will be issued to the Health and Sport Committee—I have taken steps to ensure that it is circulated to all MSPs—which will provide two things in addition to what the First Minister has said. It will provide members with the new dedicated email address for MSPs, unions, members of the public and individual members of staff to raise particular issues relating to individuals not having the PPE that they think that they require. That will be monitored continuously, and immediate action will be taken to ensure that, when such issues are raised, they are acted on and resolved within the same day, if at all possible, and that the individual who raised them is informed of the steps that we have taken.

Tomorrow afternoon, I will again speak to Scottish Care to ensure that the direct distribution line that we have created for the supply of PPE, and for the ordering of PPE by care homes and care-at-home providers, is operating satisfactorily in its first week. Where it is not, we will take the necessary steps to ensure that it does.

I know from emails that I have received that there are carers who are receiving supplies of PPE—that is as it should be, given the volume that we have released—but we will continue to work our way through any glitches. The four direct ordering and distribution lines will make a significant difference, along with a dedicated capacity to monitor constantly any specific issues that are raised.

As I have said to all our union colleagues so far, we will proceed by resolving specific issues in the way that the GMB did with the ambulance service. That matter was successfully resolved in the course of a discussion that lasted an hour and a half. If people come directly to me, I will meet them, we will resolve the matter and we will move on.

I have been made aware this morning that Police Scotland has some, but not all, of the PPE that is required but that PPE has not yet been issued to Police Scotland front-line staff. Will the Cabinet Secretary for Justice look into that?

I spoke to the chief constable about that matter just this week. Additional PPE has come into Police Scotland. It is limited stock, because it will be given to officers who have a reasonable chance of coming into contact with someone with coronavirus. Police Scotland is monitoring that situation regularly. The advice that was given to me by the chief constable is that Police Scotland has the appropriate PPE and the appropriate stocks. If Stuart McMillan has concerns in relation to his constituency, I will discuss them offline with him and raise them directly with the chief constable.

The First Minister mentioned progress that was made on delayed discharge, but evidence suggests that many people who are ready to leave hospital are still stuck in hospital settings because local authorities are struggling to provide suitable care. I am sure that we all agree that the safest place for someone who is fit and able is at home. I therefore ask the First Minister, how many people are currently in a hospital setting who should not be there? What specific and direct support will be given to local authorities, which claim that funding and resource are the two main reasons for cancelling discharge?

In March, the health and social care partnerships, in co-operation with the Scottish Government and local authorities, reduced the numbers of delayed discharges in our hospitals by 500. We will continue to work towards a further reduction of 500 over the month of April. There are about 1,100 people in hospital who are clinically able to leave that setting but are not yet able to do so. For some of those individuals, there are adult with incapacity or power of attorney issues. We are working hard to progress those as quickly as possible. However, for the majority, who should either be at home, with the support that they need, or, if it is more appropriate and is their wish, in a care home, work is under way with our local authority partners. I have given our local authority partners a commitment that the Government will meet any additional costs that are incurred in ensuring that that happens, and in meeting the additional demand for social care. This is not an issue about funding; it is an issue about the resilience of the workforce.

Along with my colleague in the Convention of Scottish Local Authorities, Councillor Stuart Currie, I am working with each health and social care partnership, and individual local authorities, to help them to work out what their rotas should be, how they can use appropriately redeployed council staff—for example those who are no longer working in other areas—to free up staff who could work in social care, and how they can make the best use not just of the returners to health and social care who we have talked about before but the social work, nursing and medical students who are entering our workforce to help us with this challenge.

My question is for the Cabinet Secretary for Economy, Fair Work and Culture, who, on 18 March, announced £25,000 grants for hospitality, leisure and retail properties with a rateable value of between £18,000 and £51,000. However, by 24 March, the upper limit had mysteriously fallen from £51,000 to £50,999—surely just a wee admin error. A restaurant and bar in my constituency that employs 31 people was refused a grant because its rateable value is £51,000. I have been advised that, for the sake of £1 of rateable value, that business could now close. I would therefore be grateful if the limit could be restored to £51,000. If it is, cabinet secretary, that will save those 31 jobs.

Kate Forbes, the finance secretary, is dealing with the operation and delivery of the scheme. Some 80,000 businesses will benefit from it, and we have heard that 30,000 businesses have already applied for grants.

On the rate relief scheme, the member’s analysis is correct. Clearly, the rate relief and the grant schemes were developed with two principles: speed and simplicity. That means that they can also be quite blunt, and the finance secretary is looking at those businesses that might fall through the gaps and the areas where we might need to provide additional support.

The member raises a specific case. However, it is not the first time that I have heard such matters being raised, and I will bring it to the finance secretary’s attention and ask what can be done, particularly in that area, to make sure that the measure is not as blunt as it might be for some businesses, especially when there are concerns about jobs.

I hope that people will be able to bear with us. The plans—not just those of the Scottish Government, which are worth £2.2 billion, but those of the UK Government—have been developed at speed. Making improvements as we go along will be one of the things that Kate Forbes and I will be looking at.

I appreciate the earlier remarks about online deliveries for our elderly and vulnerable people. When can we be confident that those people are receiving the food and sustenance that they need, either through the supermarkets or a volunteer network? What is the timescale for that?

I will not give a definite timescale right now, because I am not confident about what that would be.

We are, with local authority partners, first and foremost focused right now on making sure that the shielded group have the deliveries and the support that they need. As soon as possible—I think that I said earlier that, yesterday, I took part in a session that looked at that issue in particular, among others—we want, either through extending the arrangements for the shielded group or through other ways, to capture other particularly vulnerable groups. Over the Easter recess and beyond, I will undertake to keep Parliament updated on what additional mechanisms we are able to put in place.

This question is directed to the Cabinet Secretary for Economy, Fair Work and Culture. She will be aware that the Scottish Trades Union Congress has highlighted that food and drink sector companies are playing fast and loose with the concept of essential work. That is true in other sectors, too, including in some Government agencies. What redress do workers have who do not believe their work to be essential and whose health is being put at risk because they are being forced to come to work? They have been told that if they do not come to work their job will be at risk.

When speaking about how we are dealing with Covid-19, the First Minister referred to all of us having to be part of the national mission to tackle it. That means employers, too. Clearly, some categories of employers are essential, but they must work in a way that is safe and embraces social distancing and health and safety measures.

Some businesses are closed. There are businesses that might be considered as part of an essential sector, but not all businesses in a sector are essential. There are questions about whether, for example, it is essential, at this time, for distilleries to supply our supermarkets with whisky that will not be used for three years. We are asking employers to think very carefully about what they do. Staff should report to their unions, and to their managers, if they feel any discomfort.

We have asked the construction sector to close non-essential sites, and to reopen sites only when it is safe to do so. That is a sensible approach. As we move through the different phases, we want to make sure that companies, when they reopen, do so safely, with the confidence of their customers and, most important, of their staff.

We are calling for businesses that are not essential to close on a precautionary basis in order to make sure that staff are safe. The recommendation is that they close unless and until they can give evidence to everybody, including to their staff and the unions, that they can operate safely.

The way for businesses to reopen safely at the appropriate time is to work with their staff. For the safety of the country, they must do so in a way that everybody has confidence in. That is our very strong message to employers; we cannot force it, but it is a very strong steer.

Look at what has happened with Walkers Shortbread and Tunnock’s, for example. Many such companies have taken the decision, for the good of the country, to close until such time that it is safe for everybody to go back to work. That is the type of company—those that are showing leadership at this very difficult time—that we should be supporting.

The First Minister will be aware that there has been an extremely positive response from the public for the temporary hospital in the ExCel centre in London being named the NHS Nightingale hospital. In these difficult times, any form of positivity is surely a good thing. Does the Scottish Government have a name for the proposed temporary hospital at the Scottish exhibition and conference centre in Glasgow?

I am grateful to George Adam for that question. The name that has been chosen for that hospital is the NHS Louisa Jordan. That is in honour of Louisa Jordan, who was a nursing sister who was born in Maryhill. She joined the Scottish Women’s Hospital in 1914 and served in Serbia during the first world war. The daughter of a painter, she cared particularly for typhus patients; however, unfortunately, she contracted that disease herself and died at the age of 36. Every year, she is remembered in Serbia for the care and commitment that she gave to them. As such, it is very good that she will now be remembered in her native Glasgow.

My question is for the Cabinet Secretary for Health and Sport. Over the past few days, I have been contacted by constituents who, believing that they had coronavirus symptoms, tried to contact the NHS 111 number, but had great difficulty in getting through. In some cases, they waited for hours to have their call answered, which was, as the cabinet secretary can imagine, a very distressing situation to be in. Can the cabinet secretary put more resource behind that particular phone line?

I understand very well how distressing that will have been for Murdo Fraser’s constituents, and that others have had the same experience. We have made significant additions to NHS 24, which staffs that helpline, in relation to both the number of people who answer the initial call, and the clinical specialists who take the call forward and make the decisions about what additional advice to give the individual and whether they should go through the hub, which is also clinically staffed, to a particular appointment at an assessment centre. NHS 24 has been scaled up significantly through a number of steps since this all began. We hope that the additional resource will now make a difference.

It is really important that people do not call 111 to get the sick line that they need for their employer but use the NHS inform website, where they can do that. We have tried very hard to get that message out, and it would be very helpful if members could assist us in that messaging. In addition, if further problems with the 111 line are raised with members, they should ensure that they let me know; we will do everything that we can to resolve them.

The cabinet secretary for the economy will be aware that the Fraser of Allander institute last week highlighted the disproportionate economic impact that the pandemic will have on rural communities, where there are sectors such as tourism and hospitality as well as a large number of people who are in the self-employed workforce. It is clear that there are gaps in the existing support, whether in relation to a self-employed person who has set up in the last year or a guest house that pays council tax and not rates.

Will the cabinet secretary therefore bring forward additional support now to support those businesses in relation to which we know that those gaps exist? For those businesses, the issue is not their economic recovery but their very survival in the days and weeks ahead.

Colin Smyth made a very important point. We are also looking at the geographical impact. In relation to the schemes that have been put in place, the small grants scheme affects—as I said—80,000 businesses, and the retail, leisure and hospitality scheme around 9,500. We know that the self-employed scheme that the UK Government has established also reaches a large number of people.

However, we also know that there are gaps in that system. That is why my colleague Kate Forbes is looking at the different areas to see whether there is anything that we can do to supplement it. However, resources are tight. We have been given the Barnett consequentials, which we have used and will continue to use to support businesses. The member makes an important point and I will make sure that it is brought to her attention. As he reflects, it is also about speed and the impact is being felt now. Therefore, anything that can be done should be done.

Every second day, I have been having meetings and teleconferences with the banking sector to relay issues in relation to small businesses. Some of the packages could be simplified to help people through a difficult period. If loss of income will never be recovered and is replaced by a loan, businesses will not be able to repay that further down the line. Therefore, we are looking carefully to identify the gaps and to see what measures can be brought in to help support the type of people that he described.

At the moment, neighbours, carers, councils, charities and retailers are meeting the emergency food needs of many vulnerable people. However, as the First Minister acknowledged, other vulnerable households remain hidden—particularly those with no support networks in place, no ability to order food online or to get to a shop and, in some cases, no money to buy food. How will the Government ensure that emergency food provision is put in place consistently across Scotland so that it gets to every hungry household?

We are giving active consideration to that issue, because, increasingly, we want to ensure that no one falls through any gaps in the Government provision. The First Minister has already talked about those who are in the shielding group but she also mentioned that there are wider groups in society who will need assistance.

Aileen Campbell mentioned the food fund, which was part of her £350 million announcements. That is partly for public sector responses but also to fund national third sector partners that deliver community-based responses. That is an important aspect; the other aspect is the volunteers that we now have in place. I encourage members to publicise further readyscotland.org to ensure that we get more volunteers, because they can play a part in this. How they play that part is down to the local resilience partnerships and local volunteers. We have not reinvented the wheel but we are using the networks that are already in place and their contacts. By doing so, we are confident that we will be able to breach any gaps. Yesterday, I had a useful conversation with third sector organisations about the fact that they might know that there is a need but they are not the people who will meet that need. Where necessary, we must use those local resilience partnerships and volunteers to deal with that.

I welcome the First Minister’s assurances in relation to testing and PPE.

I have a question for the economy secretary. As Colin Smyth rightly pointed out, there are gaps between the various grant and support schemes, particularly for businesses in rural and island areas. I welcome the Scottish Government’s decision last week to reverse the earlier exclusion of all self-catering businesses but the eligibility criteria remain tighter than elsewhere in the UK, which leaves self-catering businesses in Orkney and across Scotland unable to access the support that they need. In order to make sure that self-catering businesses, which are key to our tourism sector, get the support that they need at this difficult time, will the economy secretary work with her finance secretary colleague to address not just the point that Kenny Gibson legitimately made—that also affects my constituents—but the eligibility criteria?

Provided that it was their primary source of earnings and that the property was let for more than 140 days, self-catering and caravan businesses will be eligible for grants. I have given the commitment that, reflecting the UK scheme, all the consequentials of the £2.2 billion for businesses will be distributed. However, because of the nature of Scotland’s economy, proportionately, we have more small and medium-sized enterprises than the rest of the UK—not least in the constituency that the member represents—so our funding has to stretch further. We are conscious of that and we are looking at other mechanisms. That might mean repurposing and reorganising the Scottish budget more generally; Kate Forbes and Ben Macpherson will be looking at that work.

This is a health question. I have an 88-year-old constituent who is self-isolating but needs to go for dialysis three times a week to Stobhill hospital. His family is worried because he goes in a car with three or four other patients and the driver, which is a problem.

Work is under way—I encourage the member to pass on this information to his constituent—to ensure that, where patients in such a situation require transport to take them to their treatment, they go singly and are not required to share cars or any other transport. I am very happy to take on the issue and pass him the specific details with regard to Greater Glasgow and Clyde, and to ensure that members across the chamber know what is happening in their health board areas.

My questions cross justice and health. Covid-19 has meant delays in granting guardianship orders and intervention orders, which impacts on the health, social and financial needs of individuals, many of whom are affected not only by Covid-19 but by things such as might frequently arise in normal circumstances. Has the Government had any discussions about how the Adults with Incapacity (Scotland) Act 2000 might be temporarily amended to enable guardianship orders to be progressed? Would the Government consider a draft amendment to include advance directives, which could help with patient triaging?

I will get back to Michelle Ballantyne, because I do not have detail to give in answer to her question. The Scottish Courts and Tribunals Service has detailed guidance on specific court orders. We will carefully consider draft amendments to any legislation that are brought forward to help vulnerable people, in particular. I am more than happy to address offline the detail of the question that she has asked, and will come back to Michelle Ballantyne with a fuller answer, if she does not mind.

I ask the First Minister what proportion of key workers are now benefiting from childcare? Can she also update us on how distribution of PPE is being managed to ensure that key workers who urgently need it, regardless of whether they are in the public sector or private sector, can access the equipment?

Key workers who want to access childcare should contact their local authority. I can tell Parliament—we are monitoring this daily—that the number of children who are in formal education settings each day is pretty low. We want it to be low, because the reason for closing schools was to limit spread of the infection. Under 1 per cent of all children have been accessing childcare daily, so there is some room—although it is not unlimited—for people who are in the key-worker category and vulnerable children to access childcare. All members can relay to their constituents that individuals or organisations that want to access childcare should ensure that they contact their local authority.

We continue to make sure that we are providing guidance on PPE to various groups of workers. We will provide additional guidance to those groups so that there is understanding of what is needed. When PPE is needed, we will make sure that we work with organisations, companies and individuals to ensure that it is supplied.

The clear advice to stay at home has been a very powerful and important message to everyone. However, for many victims of domestic violence, home is often not a safe place. Can the First Minister reassure people who are at risk that they should continue to report crimes during the crisis, and that they can still access services including Scottish Women’s Aid and Rape Crisis Scotland if they need them?

This is a really important point that cannot be emphasised enough. As we encourage people to stay at home, and as more of our lives are lived at home, people who were already vulnerable to domestic abuse and violence are now even more vulnerable, and might feel even more isolated and alone. Yesterday, I announced additional funding for Rape Crisis Scotland and Scottish Women’s Aid to help them to ensure that they have capacity to deal with the situation. I also took the opportunity to make it clear—I ask all members to use all their channels of communication to do likewise—that the Scottish domestic abuse and forced marriage helpline continues to be available 24 hours a day. Nobody in such a situation need wait until after the crisis to seek help: help is available to them now and they should access it.

My question is for the Cabinet Secretary for Health and Sport.

Some testing is happening many days after symptoms have been displayed, with tests of some people who are concerned that they might have had Covid-19 coming back negative. The guidance that was issued last week gives flexibility to NHS boards in respect of whom, when and how they test.

Is the cabinet secretary confident that we are getting an accurate picture from the current testing regime? The First Minister referred to the possible roll-out of new antibody tests that will determine who has already had Covid-19. Will the cabinet secretary confirm that NHS staff and other front-line workers will be given priority for any such testing?

The testing is as accurate as it can be. As the First Minister has said more than once, and as the chief medical officer has consistently made clear, we know that the numbers are an underestimate of the prevalence of the virus in the community. That is why the First Minister has outlined measures, including our being part of the UK-wide testing initiative, that will allow us to increase our testing capacity.

As was said in an answer to Jackson Carlaw, we have begun to consider how testing can assist us in getting from the current delay stage to the containment stage, during which we will manage the prevalence and impact of the virus as best we can.

The current test says whether the person is positive or negative for the virus today. A person who is told today that they are negative might develop symptoms in a week, and test positive then. It is, if you like, a binary situation that does not give anyone the assurance that if they are negative today they will be negative from now on.

The antibody test that Jamie Halcro Johnston mentioned will be key. We are working with the other three nations of the UK, and hope that we will have a reliable and robust antibody test in the near future. We will make effective use of that to assist us not only with testing the health and social care workforce, but in making decisions about the steps that we must take in order that we can come out of the current delay stage, with its necessary restrictions, and move forward to the stage in which we contain spread of the virus.

It is right to acknowledge the role of NHS staff. However, I am sure that the First Minister and the health secretary agree that we do not need just to applaud them, but must also support and resource them. We must also support other front-line workers—social care workers, postal workers, all those who are involved in food distribution and production, people in our call centres who handle calls about domestic abuse and benefits, people who run advice lines, and many more. It is important that we recognise those people, but making sure that they have adequate protection and access to PPE is also fundamental. Can the Government commit to supporting such companies and organisations and their supply chains with provision of adequate amounts of PPE?

Can we be updated about progress in discussions on making death-in-service payments to NHS workers?

I will answer about PPE, then hand over to the health secretary to talk about death-in-service payments.

This will be a short answer, because I have already covered the subject in some detail, although it is a heartfelt answer. I want to do everything in my power to ensure that we support people who are on the front line. I have said that before. I have close family members who are—probably as I speak—on hospital wards around the country, so I know personally how important the matter is. Everybody who has a family member or friend in such circumstances will know how worried we all are about them, given the situation that they are dealing with. We will do everything that we can do, by working with organisations and with the supply chain, to ensure that supply, distribution and use of PPE are exactly as we expect them to be.

We almost have a finished proposal on how we can extend death-in-service benefits to all those in the health service who might need such provision. I can also tell Anas Sarwar, and other members, that we now have an agreed position on indemnity for all our health and care workers.

My question straddles justice and health.

The justice secretary is considering early release of some prisoners who are coming to the end of their sentences. I fully understand why. For those who are being released who might have a variety of vulnerabilities, will the Scottish Government seek to put in place support, including housing solutions, financial support and particular support for those who are living with addiction or mental health challenges?

I thank Bob Doris for raising that exceptionally important issue. I have had communications from the Howard League and many other organisations that are pressing the Government to look at early release. We are actively exploring options, the foremost of which is the home detention curfew. Of course, we will have stages 2 and 3 of the Coronavirus (Scotland) Bill this afternoon. If the bill is passed, the legislation will give the Government emergency release powers.

Bob Doris is absolutely correct. If we release people when they do not have accommodation—I confirm that I have spoken to the housing minister about that—if the appropriate benefits and social security services are not in place, and if we do not work with addiction services and others, we will see those people return to the criminal justice system and prison, rather than staying out. I confirm that such conversations are taking place with our local authority partners, addiction services and ministerial colleagues. We hope that if we must increase the number of prisoners whom we release through HDC or via emergency release, we will set them up well on the outside, so that they do not go back into the prison system.

I am conscious that a number of members still wish to ask questions, but I am afraid that I must draw proceedings to a close.

Before I suspend the meeting, I draw members’ attention to the fact that the deadline for lodging amendments to the emergency Coronavirus (Scotland) Bill has passed. We have received a significant number of amendments from several members. Officials are working to get the amendments in order so that they can prepare a marshalled list and groupings. Because of the number of amendments, it will not be possible to reconvene at 2.30 pm. I therefore advise members that the Committee of the Whole Parliament will not start until 3 pm, at the earliest. I will ask the clerks to ring the division bell 10 minutes and five minutes before we plan to start the sitting.

I impress on members that every effort is being made to get the necessary documents ready for members’ consideration.

I suspend the meeting, and assure members that the canteen will be open throughout the day.

13:37 Meeting suspended.  

16:35 On resuming—