Chamber and committees

All health boards, including NHS Ayrshire and Arran, should think very carefully about designing the scheme so that it is as accessible as possible. As I said, there will always be tensions between that and getting the programme done as quickly as possible. It would not be right for me to dictate how that should be done in every local circumstance, because local health boards know their local areas better.

There are, of course, particular considerations in island communities. NHS Ayrshire and Arran should certainly consider Kenny Gibson’s point about Millport and ensure that it gives islanders the ability to be vaccinated without the additional inconvenience that going off the island would entail. I am sure that the health secretary would be happy to follow up that matter directly with NHS Ayrshire and Arran.

The member says that it did not work, but vaccination rates went up and we are now the most vaccinated part of the UK. Self-evidently, we have increased vaccination rates. Had we included testing as an alternative at an earlier stage, we would have undermined the central, primary objective of the scheme. As we have got vaccination rates up and as we move into a different phase, we are including testing.

Anas Sarwar oversimplifies things to such a point that, in my view, it would have been dangerous if we had followed the advice that he would have been giving us over the past number of weeks.

On his points about testing, we are testing extensively. We will continue to do that through PCR tests and, increasingly, I hope, through LFT testing.

Transmission has been falling from the latter of the two peaks that we experienced over the winter, which is a good thing. We now again have the lowest infection rates in the UK, although we are not complacent about that.

We must use all the tools and all the levers in as smart and nuanced a way as possible to bear down on transmission overall. Right now, the combination of things that we are doing is effective, but we must ask ourselves whether it will continue to be effective as the other risks accumulate over the winter. We must be vigilant about that.

As far as ventilation is concerned, if it was the case that all that we were doing was simply telling schools to open windows, Anas Sarwar might have a point, but we have invested with local authorities in carbon dioxide monitors and in assessments of ventilation in schools, so that local authorities can take steps to improve ventilation. We are doing similar work with businesses. Last week, I confirmed the opening of a £25 million scheme to help businesses to improve ventilation.

We are doing and will continue to do all those things. I suspect that the one thing that will stay consistent is that the Opposition will continue to oppose all the things that we are doing to stem transmission.

I suspect that Alex Cole-Hamilton lost the thread of his logic—if he ever had it—in that question. I am afraid that I certainly lost the thread of it.

There might be some force to the argument that the Scottish Government dreamed up a Covid vaccination certification scheme against all the evidence were it not for the fact that increasing numbers of countries across the UK—Northern Ireland and Wales—and across Europe and the world are doing likewise. Faced with a virus, it is very difficult to provide the hard evidence that intervention X leads to effect Y. Cause and effect is very difficult to prove absolutely.

However, we know that vaccines reduce transmission. They do not eradicate transmission—nothing completely eradicates it—but they reduce it, so if we ensure that everyone in a setting such as a nightclub is vaccinated, we reduce transmission. Over the past couple of months, by insisting on it being vaccination, we have helped, among other things, to increase rates of vaccination, which is a good thing. Now that we are going into a winter period, when we want to keep transmission suppressed overall, and we are encouraging people—as I have done today—to use LFD tests more generally and more regularly, it makes sense to include testing.

Such decisions are not easy or straightforward, and they are never black and white, but if we had listened to and based our decisions on the oversimplified, oppositionalist “We say black, they say white” approach of the Opposition, the country would be in an even more difficult situation with the virus than we already are.

I record my thanks again to the military for the assistance that it has been giving to Scotland and, indeed, to health services in other parts of the UK. On whether to request military assistance, that would initially be a decision for the health board. As far as I am aware, there has not been such a request from Forth Valley. If a request is forthcoming, we will, obviously, consider that in the normal way and, should we consider it appropriate, we will submit it to the military for proper consideration.

More generally, we are taking steps through additional funding and other ways of supporting health boards to redesign access to urgent care and to help to ease the flow of patients through hospitals to release the pressure on accident and emergency services. That will continue throughout the winter period.

All our accident and emergency services are working under significant pressure. What we can all do to help is all the things that we know will help to get Covid cases down. Above all, that is what will ease the pressure on our NHS.

We have already given a commitment to ensuring that the inquiry is fully based on, and informed by, human rights and equality principles, and I repeat that commitment today. We are in the process of, and we will shortly confirm, the appointment of a chair for the inquiry, and we will identify the terms of reference and principles that will guide and drive it. We have given a commitment to having it established by the end of the current calendar year.

Once the inquiry is established, its conduct will be entirely the responsibility of the chair, and it will be important that ministers do not interfere with that. The work to establish the inquiry is well advanced, and we will set out details to Parliament shortly.

The member says that we are making it up as we go along. We are not doing that. We are trying to take the best, most balanced and most proportionate judgments as we go. We are not always getting it right. I have said all along that, in such a complex and unprecedented situation, mistakes and errors of judgment will be made, and I will always be candid about that.

However, if we are making it up as we go along, that has taken us—I am not complacent—to a position of having the lowest infection rates and the highest vaccination rates in the UK. [Interruption.] A member is telling me, from a sedentary position, that we once had the highest rates. There have been a couple of periods in which we have had the highest rates but, overall throughout the pandemic, we have had a lower infection rate than any other part of the UK.

Everybody is grappling with a difficult situation. We are all taking difficult decisions; however, we are taking them in the interests of keeping the country as safe as possible.

I will briefly address points of detail. Our booster programme is going exceptionally well. We are looking every day at how to accelerate further the pace and progress of that. We are using the available workforce as effectively as possible and, at the moment, our judgment is that the programme is being delivered in the correct way.

Of course, we keep an open mind to other approaches. It is worth noting that mass vaccination clinics, albeit that they have played an enormously important part in previous phases of the programme, also had the highest do-not-attend rates of all settings in which we did vaccinations, if memory serves me correctly. We are progressing with the vaccination programme and will continue to take such judgments, based on best considerations.

The vaccination programme is the biggest and most complex ever conducted—that is true, I am sure, for all countries—so there will be issues and problems with it, and we will address those as far as we can and as quickly as we can, when they arise, to make sure that not only is it happening quickly but it is as accessible and convenient as possible for the people who are accessing it. I thank everybody who is delivering the programme and everybody who has so far come forward for vaccination.

On Covid certification, it is absolutely right that we have in place the system that we have right now. Equally, it is right, now that we have vaccination rates at a certain level, to move to its being open to testing as well as vaccination or as an alternative to vaccination. We were right to consider extending the system further, and we are right to keep that under review. In the face of the virus, the most foolish thing that any Government can do is to rule things out before we have the evidence. It is always difficult, with a virus, to draw lines between cause and effect, but sometimes we have to use common sense about what reduces transmission and what has been proven to be successful in doing that.

On the Covid app, we are, as I think that I said last week, doing work right now to include boosters in the app. The reason we developed our own app was that we were told by the Department of Health and Social Care south of the border that to be part of the English app, which we initially explored doing, would take 12 months. Against this virus, we do not have 12 months, which is why we moved ahead to develop our own app. I think that that was the right thing to do.

My answer is based on clinical advice. The clinical advice is that people who have had a positive PCR test within 90 days need not participate in twice weekly LFD testing. The clinical view is that in the 90-day window after a positive test, given the low rate of reinfection, it is significantly more likely that a positive LFD test would be a false positive result rather than someone being reinfected, which may cause people to isolate unnecessarily.

If someone recovers from Covid and later develops new symptoms, they must book a new PCR test at NHS Inform and follow the advice on self-isolation and household isolation. People should not use an LFD test if they have symptoms or are self-isolating, and anybody who wants further guidance on when to use an LFD test and when to use to a PCR test can find it on the NHS Inform website

Again, that is a really good and helpful question. We consider on an on-going basis how we can reach parts of the population in which uptake rates are not as high as they are overall. Young people are, of course, one of those groups.

There is a variety of reasons why people will not yet be vaccinated. Some people will have chosen not to be vaccinated. I urge them to think again. There will, of course, be some people who are not yet vaccinated because they have recently had Covid. As we know, if a person has had Covid, there will be a period of four weeks between having the virus and getting vaccinated. Some people, particularly in the younger age groups, will be facing that. However, we are continuing to take steps to say to people that, if they are not vaccinated yet with a first, second or booster dose and they are eligible, it is not too late, and they should come forward for that. I encourage MSPs across the chamber to do everything possible in their constituencies to reiterate and emphasise that message.

Guidance on seasonal events is already available to local authorities—if my memory is wrong about that, I will correct what I have said in writing to Rona Mackay. The current guidance advises that there should not be live audiences for Christmas concerts and nativity plays in schools, but I know that schools are using alternative means of ensuring that such events are available and accessible to parents. The guidance remains under review and will continue to be informed by the advisory sub-group on education.

On vaccination certification, Anas Sarwar is fundamentally wrong. The error that he makes is to suggest that we can always pick one thing over another and not, at different stages, have a combination of things. In the early stages of the vaccination certification scheme, one of the primary objectives was to drive up vaccination rates—