Chamber and committees

On hybrid working, a lot of businesses implemented a hybrid approach quite successfully in the autumn last year, before we had to pull back again and tighten the guidance on home working in response to omicron. We are asking businesses to consider going back to that again and to talk to workers and trade unions about how workers can best do that in their own circumstances. In summary, that means people being in the office sometimes and working from home at other times, and perhaps a mix of office-based and home-based staff. The Government cannot and should not seek to mandate what that looks like in every working environment, but it is important that we are moving from heavy work-from-home-whenever-possible advice to something that is much more about enabling a phased return to the office.

Willie Coffey is right. I know that many businesses are already taking the unfortunate and unwelcome experience of the pandemic in the past two years to think afresh about the best configuration for their workforces in the future. Many people will be sick of working from home and will want to get back to the office, and many businesses will want that. That has knock-on benefits for people in the office and city centre economies, for example, but there are also many people who think that working from home is more productive and that it improves their work-life balance. That also has environmental benefits, of course. Getting the balance right in the months and years to come will not be easy, but there is an opportunity to rethink things and not simply go back to the status quo as it was before the pandemic.

There are big challenges, but I suspect that there are also big opportunities for our economy and our society.

I think that I set out the Government’s position on that at quite some length last week, when I made a statement. I refer members and anybody else who is interested to that answer.

I go back to the question that I was asked earlier on about the vaccination of pregnant women. We know that the risks for a pregnant woman and an unborn baby are significantly increased if there is no vaccination and the pregnant woman gets Covid. The judgment was made that there should be a pause on fertility treatment for those who are unvaccinated. However, I said last week that people should discuss the situation with their clinical advisers.

We keep that under careful review. I absolutely and fully understand the stress and anxiety that any woman or couple will go through as they seek fertility treatment. It is important that we enable and facilitate that as much as possible, but we also have to understand the wider risks that exist around Covid, particularly for those without vaccination.

In terms of the legislation that is in place, I am sure that what the Deputy First Minister set out on the expiration is the case. If we consider that there is a need to extend that period, we will come to Parliament in the normal way and set that out.

Nobody wants any of these measures to be in place for any longer than necessary, but I think that we can safely say that it is because we have been prepared to take sensible and proportionate steps and the public have responded so magnificently that we are managing again to send Covid into reverse. We need to continue to be responsible about the matter. If asking people to show Covid certificates keeps nightclubs open and allows sporting events to go ahead, that is a much more proportionate measure than restricting or closing such venues and events again.

I go back to a point that I have made regularly. I think that the facts bear me out here. The Conservatives have opposed almost every sensible measure that we have taken in order to control the virus. To be honest, we would be in a much more difficult position if we had followed that advice. I think that the public support the cautious and proportionate approach that we are taking. We will take that approach for as long as necessary, and we will lift measures as soon as it is possible to do so.

I am not able to put a precise figure on that today, but we know that intensive care is the most resource-heavy form of NHS in-patient care. It is essential for the treatment of the sickest patients, and it costs several thousand pounds per day because it uses more staff per patient than any other type of in-patient care. Our intensive care teams are among the best in the world.

We do not and should never make admission choices based on consideration of resource in that way, but, of course, if there is something that all of us can do, in the face of the virus, to minimise our chances of needing intensive care, then we should—for all sorts of reasons—do that. Right now, vaccination is one thing that we know reduces our chances of getting seriously ill if we get the virus.

For that reason, as well as because of the unnecessary risk that you are posing to yourself and others, if you are choosing not be vaccinated right now without good reason, you are being deeply irresponsible. I urge you to change your mind and get vaccinated as soon as possible.

Yes. We had a focus on that—particularly child and adolescent mental health services—before the pandemic, redesigning the way in which services were offered with much more focus on community services and preventative early intervention services such as counsellors in schools. That work will continue. The member is right to say that that is even more important now than it was before the pandemic struck.

I recognise that physical restrictions have a mental health impact. Everything that we have had to do in response to the pandemic, to stem transmission of a virus, has had impacts in other ways. I am not suggesting that this is what Jamie Greene is putting forward, but the fallacy that we often hear is that, if we had not introduced restrictions, there would have been no impact. Without restrictions, transmission would have got more out of hand and the mental health and wellbeing impact of that would have been considerable, too.

This has always been a difficult balance to strike, for Governments everywhere. We continue to do it as well as we can, and we absolutely recognise the work that needs to be done to recover from the impacts that our response to the pandemic has had. Mental health is one area in which that is particularly important.

Cancer is a core part of the NHS recovery plan. Cancer treatment and surgery are cancelled only as an absolute last resort. Cancer has remained a priority throughout the pandemic. We are focused on getting cancer services that have been disrupted back to normal for patients as quickly as possible. We are taking action to improve early diagnosis and cancer services. I think that eight out of 10 people are seen within the 62-day period, which is a whole journey waiting time. The 31-day target is being met, but we are working to improve the position on the 62-day target and to meet it.

The core of this is keeping Covid cases on the downward trend, because that reduces the Covid pressure on hospitals, whether that is in general hospital wards, in waiting times for surgery or in recovery. If Covid case numbers and the pressure on hospitals continue to come down, the need to cancel other operations diminishes. That is why the efforts to get Covid under control are so important to the national health service’s overall wider recovery.

When people need care from the NHS, we want them to get it from the most appropriate part of the NHS. That was true before Covid and it will be true after Covid, but there are particular reasons why we want it to be the case during Covid. A and E is for people who need A and E treatment; many other parts of the NHS—NHS 24, primary care and community pharmacies—are sometimes better placed to give people treatment. I encourage people to access the part of the NHS that is most appropriate for their needs.

Staffing pressures on the NHS are acute now, which is partly because of Covid. Covid-related absences are starting to stabilise; I hope that they will now reduce. The hope is that that will continue, which will ease a lot of the pressure.

As we come out of Covid, part of the recovery focus will be on encouraging people to use the part of the NHS that is most appropriate for their needs, and on giving them the support and the information to allow them to know about that. It is not in the interests of any patient to end up being treated in one part of the NHS when they would get better and more responsive care somewhere else.

I have been asked that question for the past two weeks at First Minister’s question time—rightly so, because it is important—and by Brian Whittle on at least one of those occasions. I have set out the various steps that we are taking to ensure the earliest possible diagnosis of the most common cancers, and we are extending that to symptoms of cancer that are perhaps not as common as the ones that we often think of.

In summary, there is continued investment in the detect cancer early programme; there is continuing work to ensure that those who are referred on the urgent suspicion of cancer referral pathway are seen as quickly as possible within the 31-day and 62-day targets; and there are the new early diagnostic centres that we are establishing to provide a rapid route to diagnosis for people with less-common cancer symptoms, which would not normally be picked up on the urgent suspicion of cancer referral pathway.

We are doing a range of things to ensure that as many people as possible are diagnosed as early as possible. That is critical for outcomes for cancer patients. Of course, diagnosis is not the only consideration: ensuring that there is rapid access to the best quality and most appropriate treatment is important, too. All aspects of the cancer journey are under focus to ensure that we make the progress that Brian Whittle rightly says is vital.

We engage with different groups all the time. I will come back to the member or ask a minister to come back to the member on the detail of that consultation. I recognise and accept the member’s observation, and I stress that the distance aware scheme is voluntary. We are not asking or expecting anybody to comply with it, but I know—I have had representations—that many people say that something such as the scheme would be helpful.

If there is a better way of doing it, I am open to considering it. I am not suggesting that we have come up with the best possible way that we could ever do it. We are trying to strike a balance between the majority, who want to go back to normal and go to pubs and concerts, and the groups—it is not a homogeneous group—in our society who feel nervous about that. People in my family are expressing that nervousness, and people with particular health conditions will especially feel it.

It is about striking a balance and finding practical ways of doing it. It is being done in good faith and for the best of reasons, but, if there are better ways of doing it, I am happy to listen to them and give them full consideration.

First, the situation is very different from March 2020, and people are not living their lives as they were asked to in March 2020. Anybody who suggests that we have not changed our response and adapted to changing circumstances is not paying attention or not wanting to recognise those changes.

We will look seriously at the proposals that Anas Sarwar has put forward, as we will look seriously at proposals that anyone puts forward. I have said before that we will consult widely as we develop the updated strategic framework over the coming weeks. It is important that we get it right. It is also important that we go beyond soundbites such as “pandemic proofing schools”. Yes, we all want to do that, but it comes down to serious investment, such as the investment that we are making in better ventilation and in other mitigation measures.

We would have to take care in relation to having a rigidity of approach around triggers, because we have learned—particularly over the past few months—that different variants do not behave in the same way as previous variants. If we have too rigid an approach, we do not adapt properly to the reality of the situation that we are facing. That is why there continues to be a need for judgment and good sense in how we try to balance things. However, we will consider any proposals that are put forward.

It is not the case that responses are ad hoc or last minute. We respond to changing circumstances—we would be failing in our obligation if we did not. I believe that the action that we took before Christmas has been shown to be worth while because of the much better position that we are in now. Yes, we need to have as much clarity as possible in our future approach, but we would be acting at our peril if we did not retain the ability to be flexible.

I go back to the comments from the head of the WHO that living with this virus does not mean simply giving it a “free ride”. We have to be smart in how we deal with it, which is what we will continue to seek to do, and we will consult as we do so.