Chamber and committees

Accident and emergency services, like health services in general, are under intense pressure because of the pandemic. Again, that pressure has been exacerbated because of the rising number of cases, so we come back to the essential point, which is that we must get the number of cases to come down again to relieve the pressure. That is direct health pressure and also the pressure that comes from staff absences.

In the week that was cited, there was no exemption from self-isolation for the NHS, but there is one now. To an extent, that will help to alleviate the pressure. However, the only way of properly alleviating pressure—not just in the health service but in the economy—is to get the number of cases down, which comes back to the reason for the difficult decisions that I have set out today.

The short answer to that question is yes. We work with different sectors to make sure that the challenges that are being faced because of staff absences are being mitigated as far as possible. There are exemption arrangements in place for critical sectors, and we keep them under review. Officials and ministers engage with different sectors, and I will make sure that we are engaging closely with oil and gas to address the particular concerns that have been raised.

That is an important point as well. Obviously, all parts of the NHS are under severe and increasing pressure right now, but the NHS remains open for people who need it. If anyone needs to contact their GP or other parts of the health service, they should do that. We have worked hard to ensure that GP capacity for medical care is preserved. That is one reason why we deliberately limited the involvement of GPs in the Covid vaccination programme. Let me stress that they have not had no involvement in it and that I am very grateful to them for what they have done for the programme. However, we have not relied overly on GPs to deliver the vaccination programme.

We are also increasing funding for the expansion of multidisciplinary teams, and we have provided additional funding to primary care specifically to support services through the winter, in order to increase as much as possible the availability of face-to-face appointments. Nevertheless, we recognise that, for many reasons in addition to Covid protection, patients will also benefit from other ways of accessing their GP, whether online or through telephone services.

We will continue to work with and support GPs as much as we can.

Pam Duncan-Glancy illustrates very well a challenge that I have articulated on occasion in the chamber, not least when I have been challenged by members—understandably—-to have more mass vaccination centres. Mass vaccination centres have a part to play, but we need a balance of provision, so that we have much more community availability as well. That is why we have tried to get a balance between big-scale but sometimes more remote places and smaller-scale places that are easier for people to access in their communities. The balance is difficult to get absolutely right.

My advice to people who are struggling to get to a vaccination appointment is that they contact the helpline and seek advice on how they can get the vaccination in a way that is more accessible. There are a variety of appointments and different ways of booking appointments, and a person does not have to book an appointment in their own area.

We will ensure that health boards make sure that appropriate assistance is given to people who are really struggling to get to vaccination appointments. We will ensure that the issue continues to be borne in mind.

We adopt four-nations approaches. Some of the advertising right now is being done on a four-nations basis. There have been periods during the pandemic when we have not thought that the messages from the UK Government were appropriate or right, and therefore we have had messaging that we thought was appropriate for Scotland. I reserve the right to do that, just as the UK Government would reserve its right in that regard.

The Government and I try to communicate as clearly as possible. We do not always get that right. We test messages and we learn from that. We will certainly learn from the FACTS advice campaign. That campaign is no longer in use, as we are not currently advising people to follow all of its components—although we are getting closer to that at the moment.

I take the whole public communications aspect of this seriously—people sometimes criticise me for taking it too seriously—because I know how important it is. We absolutely will learn any lessons, as we go, about how we can improve it.

I am very grateful for the opportunity to update Parliament on today’s Covid cases and to repeat my assessment of what we must do in response to the current situation.

Yesterday, 5,951 cases were reported, and 45.4 per cent of cases now show the S-gene dropout that is indicative of omicron. It therefore seems likely that, by tomorrow, omicron will be the dominant strain circulating in Scotland. Omicron’s much higher transmissibility will drive an even more rapid increase in cases.

Omicron is spreading exceptionally fast—much faster than anything experienced so far in the pandemic. I am profoundly concerned by the scale and immediacy of the challenge that omicron poses. In response, we are already rapidly accelerating the delivery of boosters, and we will continue to do so. Yesterday, 59,437 boosters or third doses were administered—a further increase on the day before.

We must understand that omicron is currently running faster than even the fastest roll-out of vaccines. A key point is that the immune protection from vaccination is not immediate; it takes a few days. As we speed up the delivery of vaccines, we must also act to slow the virus down. If we do not, the consequences will be significant. Even if omicron’s impact on individual health is milder than that of other variants—let me stress that we have no evidence of that yet—many people will still become severely unwell and die, and the sheer number of people infected will present a massive challenge. Indeed, in London, where transmission of omicron is currently the highest in the United Kingdom, hospital admissions are now rising sharply. If we do not act now, what we have feared all along but so far avoided—the overwhelming of the national health service—could happen.

Let me be clear: this is not a choice between protecting health and protecting the economy. A surge in infections will cause—indeed, is already causing—staff absences that will cripple the economy and other critical services.

This is a really serious situation and we must respond accordingly. I therefore strongly underline the advice that I gave on Tuesday. Please reduce your contact with people from households other than your own as much as you possibly can. For now, please stay at home much more than you normally would and as much as is feasible. Right now, the risk of getting Covid from interactions with others is high and it is rising. Before doing anything that you might have planned over the coming days, ask yourself whether it is as safe as it needs to be and whether it is vital enough to you to justify that risk.

I suspect that what is most important to most of us, over the next couple of weeks, is having time with our families at Christmas. Every interaction that we have before then increases the risk of our getting Covid and so possibly losing that.

More generally, I suspect that what matters most to us—this is strongly my view—is protecting children’s education. By acting to reduce community transmission, we will also be helping to keep schools open—and open safely.

Given what I am being advised about the risk that omicron poses to health and the economy, if I failed to give that advice, I would not be fulfilling my duty or acting in good conscience. I am acutely aware of and deeply concerned about the considerable impact of that advice on businesses, but I repeat that businesses will also suffer if we do not act to slow the virus. Business now needs the type and scale of financial support that was available earlier in the pandemic, but no mechanisms are available to the devolved Administrations to trigger the scale of finance that is needed to support such schemes. We need the UK Government to act urgently and in the same way as some other countries are already doing.

I made that point again yesterday at a COBR meeting, which was chaired by Michael Gove and attended by the Chief Secretary to the Treasury, but it now needs the urgent engagement of the Prime Minister and the chancellor.

We must not sleepwalk into an emergency that, for both health and business, will be much greater as a result of inaction than it will be if we act firmly and strongly now. Therefore, this morning, I wrote to the Prime Minister, appealing to him to put the necessary support schemes in place. Such is the urgency, I have asked to speak directly to him later today.

None of us wants to be in that position, but omicron presents a renewed and very real challenge for the whole world—the World Health Organization could not be clearer about that. Once again, the duty to protect the NHS, lives and livelihoods must be uppermost in our minds and it must drive our actions. All of us—Governments and citizens—must do what is required. I ask everybody across the country to play their part again by following the advice that we are giving.

Let me deal directly with all those questions.

First, the regulations come into force at one minute past midnight—tomorrow morning—on Friday. We are trying to introduce them as quickly as possible, and perhaps even more quickly than we first thought would be needed. That is because of the central point, which is that omicron currently rages around the country and cases double every two to three days. Every 24 hours matters with regard to saving people’s lives and protecting the health service, which is why we are going very fast and are communicating with business organisations as we go.

Secondly, the Deputy First minister was right to say that the guidance was still being finalised. I think that I said in my first answer to Douglas Ross that I had signed off the guidance just before I came to the chamber, so that it could be issued before we leave the chamber today.

Douglas Ross is, of course, entitled to scrutinise me about anything that he wants to scrutinise me about, but regardless of whether the Deputy First Minister accidentally said that guidance would be published tomorrow instead of today, I have clarified that it will happen today. I am not sure that that is the most important thing that we face now. [Applause.]

Lastly, we will get the £100 million—which we have managed to find from other budgets with great difficulty—as quickly as we can. When I last stood in the chamber, we had heard that the Treasury was going to give us additional money, as we know from many exchanges here. Douglas Ross seemed to think that that was a great wheeze—I will leave others to think whether we should focus on wheezes now. We now know that we are poorer after that Treasury announcement than we thought we were previously. We will get the money as quickly as possible—

First, anybody who has an appointment and is not able to have that appointment fulfilled should phone the helpline to rebook, because that is what is required. That is my advice.

We are seeking to do everything to avoid such situations happening. That is one of the reasons why we need a balance of facilities. If we had only drop-in clinics, people would queue, and it would be hard to match supply and demand. I do not want people to be queueing, but if a person turns up and there is a queue, they should wait there and get their vaccination, because it is important. We certainly do not want people to be turned away.

We are working every day to resolve these issues and to ensure that the vaccination programme continues apace. I am not minimising the impact on people who have that experience, but the programme is a massive logistical effort that is being delivered in an excellent way by staff throughout the country, and we will continue to support it as best we can so that everybody who is eligible and comes forward gets a vaccination.

I thank Anas Sarwar for repeating the advice to the public at the start of his question. We have many differences in the chamber, and this session is of course about scrutiny, but I hope that we can also come together, as we did at the start of the pandemic, to communicate with one voice to the public. That point is very important, so I am grateful to Anas Sarwar, and to Douglas Ross, for doing that.

I agree that businesses are terribly anxious right now, and I understand why. I also agree that this is not about politics. In a different context, the comments that I am making about funding would be political. However, here they are not. I have to make those comments because they are statements of fact. I ask Anas Sarwar to reflect on the fact that what I am saying here today about funding support from the UK Government for business is exactly the same as what his Labour colleagues in the House of Commons are saying right now. It is not about politics; it is about all of us, within our own responsibilities, doing everything that we can to meet this challenge. I will do everything within my responsibility, but I must urge the Prime Minister and the chancellor to do more within theirs.

It is absolutely the case that every death from cancer is a tragedy at any time, and it is obviously tragic that anyone, whether they have cancer or any other condition, has had treatment delayed over the course of the pandemic. We are working through investments, particularly investments in early diagnosis through the early cancer diagnostic centres, to ensure that there is speedy, timeous treatment for cancer.

The NHS remains under sustained pressure, which will grow in the weeks to come. However, in the most recent quarter, more patients were treated within the 62-day waiting time standard than were pre-Covid. That is an indication that we were starting to catch up on some of the backlogs. We must keep a focus on that, but if we are to protect the ability of the NHS to do it, we must bear down on the pressure that is being put on the NHS because of Covid.

Progress has been made since March, but since then we have had the delta variant, which set back the ability of the NHS to recover, and now we are dealing with omicron. Health services all over the world are struggling to get back to normal because of the continued and, at times, increasing pressure that the virus is placing on us.

We have invested and we continue to invest in the detect cancer early programme. I absolutely agree that the earlier we detect cancer, the more able the NHS is to save lives. In recent times, we have established the first three early cancer diagnostic centres in NHS Ayrshire and Arran, NHS Fife and NHS Dumfries and Galloway. They are about providing a referral route for patients who do not have standard cancer symptoms. We are making significant investments in other parts of the cancer journey to speed up the time for diagnosis and the time from diagnosis into treatment. All that has continued and will continue.

For cancer and other care, we will get the NHS more firmly on the road to recovery the more able we are to bear down on Covid cases. That comes back to the central messages that we all have to communicate: please cut down on your contacts so that we avoid any opportunity that we can for the virus to spread.