Chamber and committees

Those discussions are under way. As I said, we will be finalising the request for military assistance shortly. That is one of many actions that we are taking. We are providing additional resource, and I think that resource funding to the Ambulance Service is at record levels, with staffing at higher levels than it has been in previous years. There is further recruitment under way.

The problems that the Ambulance Service faces are to some extent caused by pressures elsewhere in the national health service, not least in our accident and emergency departments. A lot of work is being done to try to alleviate those pressures. We will continue to take the actions necessary to support those who work in the Ambulance Service to provide the level of service that patients demand and have a right to expect.

I have already said today that I do not think it is acceptable for anyone to have to wait for the kinds of periods that are being reported at the moment. That is not acceptable even during pandemic conditions. That is why we are focused on finding solutions to allow the Ambulance Service to provide the level of response that it wants to offer and that people have a right to expect.

Yes, that is absolutely correct. We have been warning for months and months about the implications not just of Brexit but of a hard Brexit. Just this week, as the member rightly says, we have seen a further delay to the necessary, though deeply regrettable, infrastructure that needs to be in place to support some of this. It is our food and drink and agriculture sectors that are paying the price. I very much hope to see solutions put in place to alleviate the situation as quickly as possible. However, I do not think that anybody should be in any doubt that those sectors will face the inescapable consequences of Brexit for some time to come. That is, of course, the responsibility of the Tory Government at Westminster.

The buck always stops with me. Whether people agree or disagree with me, I have never tried to shy away from that, nor will I ever.

With the greatest of respect, I say to Anas Sarwar that the Government does not operate only when Parliament is sitting. I will go back to my office after First Minister’s questions to finalise the details of the request for military assistance so that that can be submitted as soon as possible. We will also finalise the other additional actions that we are taking, and which are in addition to those that we have already taken. Government is a 24-hour-a-day responsibility. We will continue dealing with these things in that manner.

I do not at all shy away from how difficult this is. I am not the only Government leader who is dealing with these issues. Health ministers and Governments all over the world are dealing with these challenges. Our job is not just to describe the problem; our job is to provide solutions. My Government is absolutely focused on doing that.

A number of health boards are taking decisions to pause temporarily elective surgery to enable them to deal with emergency services. That is not happening only in Scotland—we are seeing that in parts of the health service across the UK because of the pressure of Covid. We will continue to support the health boards to take the decisions that they consider are appropriate in order to provide care to people who need it.

However, the member should be in no doubt that our objective is to get the health service operating again in such a way that it can deal with the pressures of Covid without that having an impact on non-Covid and elective services. That is the focus of the recovery plan and we will continue to support the health service to do that.

At the heart of that is the imperative to get Covid cases down so that as that pressure reduces, the health service can get more back to normal. That brings me back to the central messages to everyone about all the mitigation measures that we all have to follow to keep Covid cases on a downward track.

We are working closely with a range of partners to deliver a safe and successful COP26. Reviews of Police Scotland’s preparations, including a recent report from Her Majesty’s Inspectorate of Constabulary, offer a high degree of assurance around the ability to balance business-as-usual policing with COP26 operations. The transport demand strategy is in place and the Covid adaptation plan developed by chief medical officers from the Scottish and United Kingdom Governments will be published shortly.

I had a meeting yesterday with the United Nations executive director on climate change to consider some of the broader issues around the COP26 negotiations.

We work closely with public sector bodies to raise the baseline standard of cybersecurity in line with guidance from the United Kingdom National Cyber Security Centre. A dedicated policy team together with a range of partners are delivering the strategic framework for a cyber-resilient Scotland across the public, private and third sectors to further build our cybersecurity and resilience capabilities.

The Government shares cyber threat intelligence, including during real-time incidents, as part of its early warning process; provides regular training, advice and support to the public sector; and encourages regular exercising and cyber incident response planning.

I have already covered much of this in previous answers. The Ambulance Service, like other areas of the national health service, is under considerable pressure as a result of the unprecedented demand, which is caused largely by the impact of the pandemic. Our Ambulance Service staff are doing a heroic job delivering emergency healthcare to the people of Scotland. However, some people—as I have already reflected on—are waiting far too long for ambulance services.

We are in constant dialogue and engagement with the Ambulance Service. We have provided additional funding, and we have already taken a number of actions. As I set out previously today, a number of additional actions are currently under consideration.

I do not challenge in any way, shape or form the extent of the pressure on our Ambulance Service and all parts of our national health service. It is incumbent on me, as First Minister, and with all my colleagues across the Government, to support the service as it faces up to the current challenges.

Those challenges have, largely, been caused by Covid pressure, which is increasing the overall pressure that our health services are under. Obviously, it is my responsibility to deal with those challenges in Scotland, but such challenges are mirrored in health services across the United Kingdom and in many parts of the world, because of the realities of Covid.

The fact that anyone in our country has to wait an unacceptable period of time for an ambulance when they need urgent care is not acceptable to me or to anyone. That is why we will work closely and intensively with the service to support it to meet the challenges, which I expect will continue for a period as Covid pressure continues and we go into the winter months.

Last week, I set out some of the actions that we have already taken. We have provided significant additional funding to support significant extra recruitment of paramedics and technicians to the Ambulance Service. With the service, we are considering a range of additional actions, including provision of more support for rural ambulance stations; alternative transport arrangements for lower-risk patients, to make sure that the Ambulance Service resource is there for higher-risk patients; deployment of more hospital-ambulance liaison officers to help with transfer from ambulance to hospital and discharge from hospital; and temporary admission wards to ease the bottleneck that exists at the moment between ambulances and our hospitals. In addition, as I said earlier, we will consider seeking targeted military assistance.

I do not in any way underestimate the extent of the challenge that faces the service and, by extension, people across Scotland. It is the latest in a number of significant challenges that have been posed for us as a result of the pandemic. Our responsibility is to take the action to support the service to meet the challenges. That is what I, the Cabinet Secretary for Health and Social Care and the entire Government are focused on.

I think that what people are looking to me and the Government for is action to deal with the situation that we face. That is more important than what we choose to call it. I am not in any way trying to evade the reality that we and our front-line health workers are currently experiencing. It is probably the most challenging combination—or, at least, one of the most challenging combinations—of circumstances that our health service has faced since its establishment. There is no sense in which I am seeking to underplay that.

Douglas Ross said that the Scottish Ambulance Service should declare a major incident. The service operates at various levels of escalation; it is currently operating at level 4 of its escalation plan—the highest level. Again, terminology should not be allowed to mask reality. The service is operating at its highest level of escalation, and as part of that it is, for example, deploying a national command and control centre in order to utilise resources better across the country. We will continue to consider all ways in which we can utilise and deploy additional resources. I have already set out some of what we are considering with the service.

Finally, I turn to the health secretary’s comments. The health secretary was saying something that health secretaries have said many times—I remember saying it myself when I was health secretary—and I have seen comments from ambulance services in every part of the United Kingdom over the past few days saying exactly the same thing, which is that when people require an intervention from the health service that would better come from parts of the service other than the Ambulance Service, we should encourage them to seek that. When people consider that they need an ambulance, they should never hesitate to call one, if that is the intervention that they think is required.

As First Minister, I make it very clear that the Scottish Ambulance Service exists to provide emergency assistance to those who need it. It is facing the most intense challenges and some people are not getting the service that they should get. The answer is for Government and the service to work to ensure that it is meeting the challenges, so that no one who needs an ambulance hesitates to call for one and—which is just as important—so that they get the ambulance timeously, as they have a right to expect.

I thank Audit Scotland for the work that it has done on the issue. However, with the greatest respect to Audit Scotland, I do not think that any Government is under any illusion about the threat of cyberattacks in our countries to the public sector, the private sector and, indeed, Governments themselves. We take the risk extremely seriously.

There have been significant cyberattacks on public sector organisations in Scotland—obviously, SEPA is a case in point—and the question whether we are satisfied that public sector organisations are taking all the appropriate steps is a reasonable one. We are working with them to ensure that that is the case. I would hesitate to sound as if I am complacent about the matter—indeed, every Government should hesitate to do that—because there is a real, present, ever-changing and evolving risk. We must ensure that, on a day-to-day and week-to-week basis, we provide the protections and support the public sector to do likewise. We will continue to do that.