Chamber and committees

My ministers and I report regularly to Parliament on the range of NHS pressures and the actions that are being taken to address and resolve them. That will continue—in fact, I strongly suspect that it will only intensify over the winter.

I will address the specific points that were raised. Last week, I explained the issue that led to a relatively small number of people being turned away from vaccination centres. We were in the process of changing the protocols and guidance—instead of saying that there had to be a 24-week gap between second doses and boosters, we were saying that there had to be a 12-week gap. As we now know, we had that problem for a short period because we made that change more quickly than other Governments. In England, for example, that advice might not be in operation before 13 December.

In addition, some people were turned away in parts of Glasgow on Friday, for example, because of the busyness of vaccination centres. Again, action has been taken to ensure that there is the capacity in clinics, in terms of vaccinators, to enable such issues to be dealt with.

I have always said that, with a programme of the scale and complexity of this one, there will be problems at times, and we are working to resolve those problems as quickly as we can. Again, however, I ask everybody to acknowledge—not for the sake of the Government, but for the sake of those who are working so hard to deliver the programme—that we are the most vaccinated part of the UK. I suspect that, when the figures are published today, we will see that more than 40 per cent of the over-12 population have now received a booster vaccination. That is considerably ahead of any of the other UK nations, to the credit of those who are organising the programme and resolving the problems when they arise, as well as those who are administering vaccines in the centres in every part of the country.

On the point about the festive season, part of the work that we are doing right now is ensuring that we avoid, as far as possible, what often happens over the Christmas and new year break, which is that activity drops, and that the rate of vaccinations per week is maintained at the level that we have right now, so that we keep the flow through to the end of January, by which time we want to have completed the booster programme. Every effort is being made to ensure that all of that is fully taken into account.

On staffing in the health service, recruitment in our health service and social care, similarly to recruitment across our economy right now, is a significant challenge, partly because of the pressure that has come from the ending of freedom of movement. That is affecting the national health service, and we must be blunt about the reasons for that. Notwithstanding that, however, the figures that were published today show that we have a higher number of people working in the national health service than we have ever had before. I think that we have almost 30,000 more people working in our national health service than we did when this Government took office, and this is, I think, the ninth consecutive year of an increasing NHS workforce.

That is what this Government has delivered, and we are focused on delivering more of that. We are looking to accelerate recruitment, and I note that, when I came into the chamber this afternoon, the health secretary was talking about some of the work that is under way.

We continue to focus on those challenges as we go through this winter, and I remind people that all of us have a part to play in helping to relieve the pressure on the NHS.

Right now, small businesses in certain sectors in Scotland have 100 per cent rates relief, which they would not have if they were situated south of the border under the Conservative Government. We can therefore take from the actions in place just now that that is a key priority for the Government. I also know that it is a particular priority for the Cabinet Secretary for Finance and the Economy, who will of course set out the budget to Parliament later this week.

I will come back to the clinical guidance on GP access. Let me run through the other points.

On accident and emergency, as in probably every country in the world right now, the pressure of the pandemic is creating challenges in unscheduled care, as well as in scheduled and planned care, in our NHS. We are no different from other countries in that respect. Notwithstanding that, although our A and E performance is nowhere near where we want it to be, our A and E units are still performing better than their counterparts in the other UK nations. We will continue to support our A and E departments and our NHS in general to cope with the current pressure and then to recover to normal as we come out of the pandemic.

In order to do that, it is really important not just that we first contain, then—I hope—drive down Covid case numbers, but that we take measures to keep the NHS as safe as possible from the ingress of Covid cases.

Let me come to the issue of GP clinical guidance. It is clinical guidance, not a Government policy. It is about screening patients to ensure that, if they are physically accessing general practices, we minimise the risk of Covid getting into the practices and creating outbreaks. GPs have expressed some concerns about that. We will listen to those concerns to see whether the process can be done more flexibly. However, in the midst of the pandemic and dealing with a variant that might be significantly more transmissible than any previous variant, it is inescapable that we need such protective measures.

I am not surprised to hear Douglas Ross oppose what we have in place, because he has opposed pretty much everything that we have done up until now to keep the country safe from Covid. We will continue to take appropriate and proportionate protective measures to keep our NHS and the country safe.

Finally, on schools, it is absolutely the case that protecting the education of children remains a top priority. We are not discussing the national closure of schools; the Government will do everything that can be done to avoid that. That is a really important principle that will drive everything that we do.

However, that means doing other things that, again, Douglas Ross has opposed time and again. First, it means ensuring that there are sensible mitigations such as face coverings in schools. Nobody likes that, but such mitigations are essential. Douglas Ross has repeatedly opposed the use of face coverings in schools. Secondly, we must do what is necessary in the wider community to keep control of Covid. Again, most of the things that we have done in trying to achieve that have been opposed by the Conservatives.

We need to continue to take sensible and proportionate actions. We are, again, at a really serious juncture of the pandemic. It demands serious government and serious decisions; it certainly not does demand opportunistic opposition.

We have said that our clear aim and target—we have a lot of confidence in delivering this, given the progress of the booster programme so far—is to complete the booster programme for those who are over 18, including for under-40s, by the end of January, and that is what we are working to do.

That involves doing all the things that I spoke about in my statement, including increasing the vaccination workforce—we have already increased it, and we will seek to go further—and increasing the capacity for vaccinations but also making sure that we are doing what is necessary to generate the demand. That involves making sure that, when people are eligible, they come forward and get vaccinated. All of that is important work, and of course all MSPs can help us with that by getting those messages out in their constituencies.

Yes and, if there is still work to do to make that clear, we will make sure that that is done. Anybody who has been asked to isolate for the longer period because they are a close contact or a household contact of a close contact of an omicron case is eligible for the self-isolation support grant if they are otherwise eligible for the scheme, and we will make sure that the guidance is properly updated to make people aware of that.

We will continue to take all opportunities to get those messages across, including statements here and in the media. We are also asking members across the chamber to communicate those messages in their constituencies.

In addition, our public awareness campaign will intensify over the winter period. The current campaign, living safely for us all, which reinforces the importance of key safety behaviours, will run until 12 December. A new campaign, living safely this winter, will launch on 13 December and run throughout the festive period. That campaign will focus on the behaviours that we are asking people to adopt over the festive period to help to protect each other. Those behaviours include testing before travelling, socialising, visiting busy places and visiting other people in their houses; taking a PCR test if showing symptoms; getting vaccinated; and, of course, wearing face coverings and following all the necessary hygiene advice.

With the greatest respect, that is a gross mischaracterisation of the position. In the period between much earlier this year and now, we have gradually eased up some of the measures in place to avoid the need for mass isolation of classes and closure of schools. Many members across the chamber raised concerns about school closures because of the undeniable impact that that had on children’s education.

That is not the same as saying that test and protect—it is not test and trace—has disappeared from our schools. That is not the case. There have been continued targeted approaches to contact tracing and isolation in our schools. Given the new variant, there are now enhanced contact tracing and isolation requirements, which will, unfortunately, as we are already seeing, be likely to have an impact on classes and schools in different parts of the country. That proportionate, targeted approach, in which we scale back, when we can, to reduce the impact on education, and scale up again when necessary—as is the case now—is the one that we will continue to take.

On testing, we cannot force children or staff to test but, as we are doing for the entire population, we strongly encourage them to test regularly and repeatedly, using an LFD test. Again, I ask all members to help us to get that message across in their communications in their constituencies.

The Government would certainly be happy to talk to trade unions about any concerns that they have about the issue. Understandably, concerns have been raised about seafarers in the past and we have looked at those. It is clear that there is a need to have protective measures in place, but we do not want to have measures in place that are any more onerous than necessary. We look at these matters regularly, and I will write or ask the health secretary to write to the member with an update on particular considerations around managed quarantine for seafarers. I would be happy to discuss any remaining concerns with trade unions.

What I would tell Beatrice Wishart’s constituent and indeed anyone across the country is that the Government is investing in the additional staffing and additional capacity to ensure that we are recovering and reducing the backlog that has been created by Covid as quickly as possible, and that work is continuing to intensify.

The second thing that I would say to everybody is that the more we reduce the pressure that Covid is putting on the health service and the more we reduce Covid’s ability to delay and pause other treatments, the less of a backlog we will create. It comes back to my central point today: we are again at a critical juncture. I wish that we were not facing that again in the shape of the new variant, but it is a moment where all of us have a part to play to reduce that pressure and reduce the number of cases overall. That will help to reduce the pressure on the NHS and allow it to do more to recover the backlog as quickly as possible.

The omicron variant has a mutation that leads to, as people have heard me refer to previously, the S-gene dropout. Although the S-gene dropout in a PCR sample is not conclusive of omicron, it is highly indicative of it. Previously, that was what indicated presence of the alpha variant. However, because that variant has more or less disappeared from circulation in Scotland, if a PCR test has the S-gene dropout, it is indicative of omicron and gives an early indication of the presence of that variant.

All PCR samples from test sites in Scotland are processed by the Glasgow Lighthouse lab, which can detect that S-gene dropout. Health protection teams are right now treating all such cases as if they were omicron confirmed in their public health response, which influences the approach to contact tracing and isolation. Many PCR cases that have that S-gene dropout then go through whole genomic sequencing, which confirms absolutely the presence or otherwise of the omicron variant. The absence of the S-gene in those PCR tests is an important way of quickly identifying that a case might be omicron and then ensuring that the public health response is appropriate on that basis.