Chamber and committees

I agree very much with that, and that is the point that I was seeking to make in response to the previous question. The urgent suspicion of cancer referral route is really important, but it refers people who have symptoms that are most traditionally and commonly indicative of cancer. The early cancer diagnostic centres seek to add to that and provide primary care with access to a new fast-track diagnostic pathway for patients who have non-specific symptoms that might be suspicious of cancer, such as weight loss and fatigue, which could be cancer but may be other things. That widens the ability of primary care to get people who might have cancer into that fast-track pathway as quickly as possible. The centres add something very important and I hope that they will give additional reassurance to people who may be worried that the symptoms they are suffering are indicative of a cancer diagnosis.

No, that is not the case.

Let me reflect on Anas Sarwar’s first point, which is that, 10 months ago, I stood here and accepted that that would be the case and said that we were focusing, at that point, on getting the NHS back to normal and back on track. Ten months ago—if my memory serves me correctly—we had not had the delta variant, nor, of course, had we had the omicron variant. This pandemic has dealt us two significant additional blows since that time, 10 months ago.

I accept that that means that what we had hoped would be the case—

Anas Sarwar says that it was after delta. That may or may not be the case, but what I am saying—which any reasonable person who is listening to this would accept—is that the pandemic has continued to deal us blows that we were not necessarily anticipating. Yes, that means that our NHS is still struggling with the weight of Covid in a way that we all hoped would not be the case by now. However, every single day, our NHS boards and those who work in the NHS are undertaking the task magnificently.

NHS Lanarkshire has operationalised level 2 of its general practitioner escalation framework. That is not the most serious level—there are levels 0, 1, 2 and 3. The health board has said that level 2 is initially for a four-week period, but we have asked it to review that weekly and to report to the Scottish Government on the status of that. The health board previously had to do that at an earlier stage of the pandemic, in 2020. That ensures that, given the staff absences that are being experienced right now, the health board can continue to focus on the patients who most need care.

None of us wants to be in this position. We hope that we will be out of it sooner rather than later, but that involves all of us continuing to take the responsible action to get Covid under control so that we can get our NHS fully back to normal.

As we have just seen, I have big political differences with Douglas Ross, but even I am not as derogatory about him as his own Tory colleagues. The comments that he is “not a big figure” and “a lightweight” are not just personal insults directed at the leader of the Scottish Conservatives but say something much deeper about the Westminster establishment’s utter contempt for Scotland. If they cannot even show basic respect for their own colleagues, what chance do the rest of us have?

Westminster thinks that Scotland does not need to be listened to and can be ignored, and now we are being told that we have to follow a Prime Minister whose own colleagues think he is not fit for office. Independence is fundamentally about empowerment and aspiration, but an added benefit of being independent is that we will no longer have to put up with being treated like something on the sole of Westminster’s shoe. Today, I suspect that even Douglas Ross finds that a really attractive proposition.

I am delighted, as I am sure many people are, that applications are now open for free bus travel for young people under 22. The scheme will go live from 31 January, and it will make public transport much more affordable for children and young people.

Obviously, local authorities are key delivery partners, so we have already provided them with a toolkit to help them to communicate the scheme to local residents, including providing information on the range of ways in which people can apply. As Mark Ruskell has said, schools in some areas are co-ordinating applications on behalf of pupils. Councils are using public libraries. All partners are working hard to make the application process as accessible as possible.

We know that some people might need additional support, so we are working with delivery partners to ensure that all young people and their families can be reached so that they are aware of the scheme and know what they need to do to make an application.

I hope that everyone across the Parliament recognises the substantial social and economic benefits that the scheme will bring for children and young people and families and, crucially, for our climate and environmental policies, and I hope that they will help to promote it to young people and families in their own constituencies.

First, I agree strongly that data is important in all sorts of areas, and particularly in this one, to make sure that we are diagnosing cancer as early as possible and treating it as quickly as possible after that. I spoke in my initial answer about the data on staging that Public Health Scotland publishes. I will certainly speak to Public Health Scotland about the additional data that it may be possible to gather and collect.

We put a big focus on early diagnosis, for reasons that everybody understands. Through the “Detect cancer early” programme, we have focused on some of the most common cancers, but one of the functions and purposes of the new early diagnostic centres is to make sure that symptoms that are perhaps not the ones that people may suspect are cancer are also treated more urgently. We are trying to widen that net as much as possible.

Staging is really important in anybody’s cancer journey, to make sure that they are diagnosed as quickly as possible, but so too is access to treatment. Even during the Covid pandemic, once the decision to treat was made, cancer patients waited between two and five days on average for treatment. All of those different stages are important and data is vital to understanding performance now and how we improve performance. I will certainly take back the points that have been made and discuss them further with Public Health Scotland.

That is an important area of work and all the different justice agencies are focused on doing it. As Elena Whitham and other members will recall, the recent budget announcement included significant funding increases for the justice portfolio, which will help to reduce the backlog and also support community justice services in recovering from the pandemic. We have also established a justice recovery fund for the next financial year to further help with recovery, renewal and some longer-term transformation activity across the justice system. That will include the ability to maintain enhanced court capacity and remote jury centres, which have been very important in dealing with the situation so far. Again, there are challenges facing the justice system, as is the case across all aspects of Government responsibilities, but investment is being made and action has been taken to get those services back to a normal operating basis as quickly as possible.

We are working closely with the sector to do exactly that. I will not stand here and pretend that every single organisation, business or agency on which there has been a financial impact will get full compensation for it, but all the packages of support that we have put in place are designed to try to ensure that help goes to those throughout the supply chain, whichever sector we are talking about. That very much includes the events sector, and we are working with the sector to try to ensure that it happens.

As I said in my statement, we intend to publish a revised framework as quickly as possible, and I hope that we will do so over the next few weeks. We also want to consult as widely as possible. Principally, we will consult with members and parties across the chamber, but the Scottish Government teams that are responsible for the relevant areas will also ensure that stakeholders in the economy, education and across the wider public health community have the opportunity to feed in their views.

“Living with Covid” has become a shorthand phrase. When I say it, I am not sure that I mean the same things that, for example, Boris Johnson means when he says it. Different people will mean different things by it. That is not a pejorative statement; it is just a statement of fact.

It is important that we consider carefully both what living with Covid means and the different trade-offs that might be involved in enabling us to do so. That means that we need to listen to views from across society and ensure that we take the best possible advice and expertise that we can. That is what we will seek to do, albeit in a relatively short timescale.

That is an important issue, so it is important that we do not misunderstand the situation. I have made the point before that whether somebody who is in hospital gets the vaccination is down to clinical decisions and judgment. There is no blanket prohibition on people in hospital being vaccinated, and it is important to understand that.

In relation to people who are in hospital when they could be discharged, our focus is on appropriate discharge as quickly as possible. That is better for the individual, not just because they can be vaccinated normally but for all sorts of other reasons. It is also in the interests of the wider national health service, because it alleviates some of the pressure that comes from delayed discharge.

Let me stress again that whether somebody who is in hospital is vaccinated is not the result of some blanket policy—it is down to clinical decision making.