Chamber and committees

It has always seemed to me to be completely inconsistent to, on one hand, rightly and understandably express concerns about the pressure on our national health service and high levels of infections, while, on the other hand, bemoaning the very limited protective measures that are still in place to help to guide us through the pandemic.

There is very significant pressure on all parts of the national health service, but especially on our accident and emergency departments. In recent weeks, we have set out the range of steps that we are taking, backed by significant investment, to support the national health service through the pandemic and into recovery. That is about investment and continuing to increase the number of staff who work in our national health service, but it is also about reforming how care is delivered, so that people get timely access to care in the places where they need it.

The most immediate and important thing that we need to do to relieve pressure on our national health service is get the number of Covid cases down. We think that that is now happening, which is why I have given the statement that I have given today.

It is not the case that legal measures are not in place in any other part of the UK. Just yesterday, I spoke to the First Minister of Wales, which has different legal protections in place from the ones that we have, but still has some legal protections in place.

It is important that we take a cautious approach. All the evidence that I have seen on public opinion on the matter suggests that Douglas Ross is seriously out of step with the vast majority of people. People understand that if we all wear face coverings right now, particularly in public places where people do not always have a choice about whether to be there—people must go to shops, for example—we help to protect one another. For a couple of weeks more, while we see the wave of infection peak and start to fall, that is a sensible thing to do and I think that the vast majority of people agree. Although nobody wants to do it for longer than is necessary, I think that most people accept that it is a sensible precautionary measure.

Lastly, we expect the remaining requirement in schools to be lifted in line with the requirement for the general population.

We continue to work with the health service in a range of ways to support it through an exceptionally challenging period. We are also taking steps to ensure that the public is aware of the right place to access non-critical care and what provision is available. A number of public awareness campaigns have been run, including the general practice access campaign, the right care right place campaign, the NHS 24 winter campaign, and the receptionist campaign, which aired on television and radio in March and focused on the role of the receptionist as a navigator of care. As part of our broader efforts to reform how people access care in a way that is better for them, we will continue to ensure that information is available while the NHS continues to navigate through this incredibly difficult period.

On vaccination in Argyll and Bute, we and those in Argyll and Bute have apologised to the people who have been affected by what was an error. My officials met the Argyll and Bute health and social care partnership and NHS Highland to ensure that the problem was being rectified as soon as it had been identified. Everyone who was affected will be contacted as soon as possible, with a new appointment for the correct local vaccination clinic to follow.

Obviously, in a large-scale programme, errors such as that are deeply regrettable when they happen, but that does not take away from the massive success of the vaccination programme, which is the only thing that is preventing all of us right now from having to live with much greater restrictions, because it is helping protect against serious illness.

On the wider questions about people with compromised or suppressed immune systems, they are, of course, being offered additional boosters. That is the first line of protection, and I set out the broad timescale for that in my statement.

After the population-wide testing programme ceases in its current form, testing will be used to ensure that people who would benefit from, and are eligible for, antiviral treatment get speedy access to it. The treatment is being offered on a fairly restricted basis, but it will expand as more antiviral treatments become available.

We will continue to ensure that we communicate with particular groups about on-going provision of testing. Some of the detail of that provision has already been set out in “Coronavirus (COVID-19)—testing strategy: update—March 2021”, which I think was published two weeks ago.

With regard to schools, we will continue to develop the guidance. It is not testing that is causing young people to be absent, but high levels of infection, so it is important that we get infection levels down so that we reduce the impact of the virus on schools, just as we want to reduce it in broader society.

As we have done all along, we continue to take a balanced approach to the measures that are in place in schools. We will continue to ensure targeted access to testing on the basis that is set out in the testing strategy, and we will go beyond that as far as we can if necessary, given the constraints on funding that I have set out previously in the chamber.

The number of people in hospital is obviously a concern to me, to the Cabinet Secretary for Health and Social Care and to the Government, which is why it is important that we continue to exercise a degree of caution.

We know from the journey of any infection and from our experience of Covid that, as we start to see case numbers come down, as I hope that we are beginning to do with the latest wave of infection, we will start to see the pressure on hospitals easing as well. We are keen that that happens as quickly as possible. We have an early indication in the hospital admission figures that we are starting to see a slight easing of pressure, but we want that to intensify in the days and weeks to come.

Of course, vaccination is providing significant protection against serious illness. Although the hospital numbers that we are seeing right now are putting severe pressure on the health service, those numbers would be much higher, but for vaccination. Because of vaccination, the number of people who need treatment in intensive care is lower than it has been at previous stages of the pandemic.

I am not complacent, nor should any of us be complacent, about the pressure on our national health service, but we know that, if case numbers fall—if the current wave has peaked, the fall in case numbers will become more pronounced in the days ahead—the pressure on our NHS will start to ease some days after that.

We should possibly all remember—despite the wall of abuse that came from the Conservative section of the chamber during that question—that, although we might have disagreements, we are dealing with a pandemic of an infectious virus and perhaps we can try to deal with the issues in a more civilised way than some members in the chamber are demonstrating.

Christine Grahame is right. The wearing of a face covering is about giving other people protection. When we are in a supermarket, we do not know who might be close by who is more clinically vulnerable to the virus. While infection levels are as high as they are right now—we hope that they will reduce in the days and weeks to come—if wearing a face covering in a supermarket, for example, might reduce the risk of passing the virus to somebody who, if they got it, would become, or be at risk of becoming, seriously unwell, that is a price that most of us are willing to pay at this stage of the pandemic.

I believe that it is important to continue to take balanced judgments. I hope that we are getting to a point at which the pandemic is behind us but, right now, while levels of infection are as high as they are, my job—my duty—is to take decisions that are right for the people of Scotland. That is what I will continue to do. No doubt that will meet a wall of criticism, whatever I do, from the Conservative members. However, my job—my duty—is to do right by the people of Scotland, and that is what I will always seek to do.

Cancer care was rightly a priority throughout the pandemic, and it continues to be so. The 31-day cancer treatment target has been met consistently, and there is a real focus on ensuring that the 62-day target is met. Of course, median waiting times for access to treatment are very short, but we recognise the importance of doing more about early detection of cancer, which is why the detect cancer early campaign has the investment and support that it does. The new early diagnostic centres that I have spoken about previously are also being developed.

This is a really important area of care and I end my answer with a very strong message to anybody who has symptoms that are indicative of cancer, or anybody who has symptoms causing them concern that they might have cancer, to seek medical attention urgently and contact their GP. Cancer is and will continue to be a clinical priority in the national health service.

I will set out the Cabinet’s decision on the timescale for converting the legal requirement to wear face coverings in certain indoor settings into guidance.

First, though, to set the context for that decision, I will give a brief update on the current Covid situation. The most recent Office for National Statistics Coronavirus infection survey, which is for the week ending 20 March, indicated that one in 11 people in Scotland had Covid. That is the highest level of infection so far recorded by the weekly survey, which reflects the impact of the highly infectious BA.2 subvariant of the virus. The daily case numbers also show a very high, though perhaps stabilising, level of infection.

Today, 9,610 new cases identified through polymerase chain reaction tests or lateral flow tests will be reported. Again, it is important to set those figures in context. Two weeks ago, on average, just over 12,400 new cases were being reported each day. One week ago, the average case number was still high, at around 12,000 a day. However, over the past week, that has fallen to 10,200 a day, which is a 15 per cent reduction in the past seven days. The reduction is fairly consistent across all age groups. That gives us grounds for optimism that the latest wave of infection may now have peaked.

Of course, the daily numbers on their own need to be treated with a degree of caution. However, the result of waste-water sampling, which is an important strand of our on-going surveillance, also gives some cause for optimism. The sampling does not yet indicate a fall in the level of infection, but it suggests that the situation has stabilised since mid-March.

We will therefore continue to assess the data closely, including, of course, the results of the latest ONS survey, which are due later this week. We are hopeful that the current wave has peaked or is now peaking. Indeed, that is being observed already in Northern Ireland, which, unlike England and Wales, appears to have been ahead of Scotland in the transmission of BA.2.

Although the BA.2 variant is highly infectious—indeed, it is more infectious than the original Omicron variant—it is important to stress that vaccination continues to provide strong protection against serious illness, which underlines the importance of getting all doses of vaccine that we are offered.

The programme of additional boosters for certain groups started three weeks ago in older people’s care homes and, as of last week, appointments are being offered to everyone aged 75 and over.

People with suppressed immune systems will have appointments for additional boosters scheduled during spring and summer, starting from 18 April. Appointment letters will be issued by post. Anyone who is unsure about eligibility for an additional booster should, of course, contact their doctor for advice.

In addition, the vaccination programme for five to 11-year-olds is under way. Children in that age group with specific medical conditions and those who are household contacts of someone who is immunosuppressed were already being vaccinated in line with Joint Committee on Vaccination and Immunisation advice.

Vaccination of the wider five to 11-year-old age group started on 19 March and will continue over the coming weeks. Older children are being given appointments first, but families are being invited to get vaccinated together whenever that is possible.

Obviously, with case rates being so high recently, some young people who are invited for a vaccine will recently have had Covid, so I will briefly summarise the guidelines for those circumstances.

Those aged five to 17 with specific medical conditions or who are household contacts of someone who is immunosuppressed should wait four weeks after first testing positive, or from the onset of symptoms, before being vaccinated. Four weeks is also the recommended gap for adults who get the virus. All others aged five to 17 should wait 12 weeks after having the virus before being vaccinated.

Parents or carers of children who have been unable to be vaccinated due to having Covid should call the helpline, on 0800 030 8013, to reschedule appointments if that is necessary. The advice to everyone remains as important as ever: please take the opportunity to get vaccinated as soon as you are able and make sure that you get all doses of the vaccine for which you are eligible. That remains the most important thing that any of us can do to protect ourselves and others, and it is never too late to get vaccinated.

Despite the effectiveness of vaccination, the high level of infection has put the national health service under even more severe strain in recent weeks. We are seeing the impact of that in all parts of the NHS, not least in our accident and emergency services. The number of people in hospital with Covid reported today, at 2,344, is, I am pleased to say, 39 fewer than yesterday, but yesterday’s figure was the highest that it had been since the start of the pandemic. Therefore, today’s number is still exceptionally high and it is significantly above the previous peak in hospital cases, which was 2,053, back in January 2021.

More positively—again, this is evidence of the power of vaccination—the number of patients in intensive care with Covid remains relatively low, at 26 on today’s figures, which is a fall of 15 in the past two weeks. Nevertheless, the volume of people in hospital with Covid is causing very significant pressure for a health service that has been dealing with the pandemic for more than two years now.

That means that we cannot and should not be complacent. For the period up until Easter, therefore, we are continuing to ask everyone to take a lateral flow test twice a week, to take a test daily for seven days if you are a close contact of someone who has tested positive, and to take a test before visiting someone who is vulnerable. If you have symptoms, you should continue to get a PCR test, either at a testing site or by post. If you test positive, you should isolate and follow the advice from test and protect.

Using the approach that we set out a few weeks ago in the revised strategic framework, and based on the Government’s clinical advice, our assessment is that the virus at this stage continues to present a medium threat. However, we remain optimistic that it will move to being a low threat during the course of the spring. We have already largely moved away from reliance on legally imposed protective measures, and we are now relying instead on vaccines, treatments and sensible public health behaviours and adaptations.

Indeed, nine days ago, we lifted all bar one of the remaining Covid legal requirements. However, at that point, we retained in law the requirement to wear face coverings on public transport and in certain indoor settings. I said two weeks ago that we would review that requirement before the Easter recess, which we have now done. We have taken account of the very high level of infection and the pressure on the NHS, and of the fact that face coverings provide an important layer of protection against transmission of the virus from one person to another. However, we are also mindful that the data may now be indicating a peaking of the current wave of infection, which should, we hope, become more pronounced over the next couple of weeks.

We have therefore concluded that, subject, as always, to the state of the pandemic, the legal requirement to wear face coverings will be replaced with guidance on the following phased basis. From next Monday, 4 April, it will no longer be a legal requirement to wear a face covering in places of worship or while attending a marriage ceremony, civil partnership registration or funeral service or commemorative event. Then the wider legal requirement that applies to shops, certain other indoor settings and public transport will be converted to guidance two weeks later, on 18 April. We will of course continue to encourage the wearing of face coverings in certain indoor places, especially where significant numbers of people are present.

That phased approach strikes a sensible balance between our desire to remove the one remaining legal measure and the commonsense need for continued caution, not least for the sake of the NHS, while the current wave of infection subsides. I recognise that face coverings are an inconvenience. However, given all the sacrifice of the past two years, and in view of the current pressure on the NHS, I believe that the vast majority of people will accept that, for a further two weeks, it is a proportionate precautionary measure while we pass the peak of the latest wave. It also provides some additional protection to those who are most at risk from the virus.

In conclusion, I want to take this opportunity to thank the public again for the patience and responsibility that continue to be demonstrated by the overwhelming majority of people across the country. Life has returned to normal for most of us, but Covid has not gone away. Indeed, in recent weeks, very few of us will have been untouched by the virus—either ourselves or within our families or networks of colleagues. That in itself is a sign of how infectious the virus continues to be, so while the level of infection remains as high as it is, I ask that people, please, continue to take sensible basic steps to protect themselves and others.

The Scottish Government is not in the same position on testing as the UK Government. A cursory look at the position of the UK Government will testify to that. We still support testing in ways that are currently not being used in the rest of the UK. We will continue to support appropriate and targeted use of testing for the purposes that are set out in the testing strategy, and when we advise people to take tests, we will not expect them to pay for those tests, but will continue to ensure access to testing free of charge.

Of course, we will continue to have discussions with people who care for others and people who visit loved ones in particular settings in order that we ensure that there is appropriate access to testing as we move beyond the population-wide approach that we have taken until now.

Yes, I think that we should see those who can afford it contribute the most. However, a wealth tax, like a windfall tax, is not something that this Government has the power to put in place. If Labour wants these things to happen in Scotland, it cannot just talk about the ends that it wants to see—it has to actually equip this Parliament and this Government with the means to do something about it. That is what is called making this Parliament independent.