Chamber and committees

Everyone recognises that it is important to have consistency in schemes that operate across the UK so that citizens can travel easily between different parts of the UK. Our app is designed to offer interoperability across not just the UK but the common travel area, including Ireland and the Crown dependencies.

That said, it is right and proper that we have designed a scheme that is right for Scotland, works first and foremost in our context and offers us the flexibility to adapt to changing circumstances. Work is well under way to ensure that, where a person has their first and second vaccinations either side of the border, that is fully recorded. I will ask the health secretary to submit further information on the detail of that to the Scottish Parliament information centre.

The advice for someone in that position is to get the second dose of vaccine but, obviously, I do not want to say too much about the individual case because, clearly, the person has received input and advice from their GP. I am happy to look into the issue in more detail and come back with a considered answer rather than answering before I have had the opportunity to consider the matter properly.

The default position is that we would encourage people to complete their second doses but, if there are circumstances where, for good reason, that cannot be done, we would want to take account of that. I will ask the health secretary to write to the member once we have had an opportunity to consider the issue further.

It is taking a bit of time because we are doing what Conservative members usually ask us to do and say that we do not do enough, which is consulting with businesses in affected sectors to make sure that we get the granular detail of the issue correct. We will finalise the definition very soon; it will take account of whether, for example, settings are open between particular hours, whether they are serving alcohol between those hours, whether there is space for dancing and whether there is live or recorded music. We are taking the time to make sure that we properly consult with the Night Time Industries Association to get the detail of that right, and we will publish the definition soon, once that work has concluded.

There is regular official-level dialogue on border health measures, and there is due to be a four-nations ministerial meeting this week that will address the regular review of country risk ratings and look at wider policy issues. We expect that that meeting will take place on Thursday morning, as usual. I know that there is a lot of speculation in the media about the UK Government’s intentions. That speculation is happening before those intentions have been properly discussed with counterparts in the devolved Administrations. We want to work on a four-nations basis wherever we can, and we will aim to make further announcements on any future changes on a four-nations basis after, I hope, proper consideration and discussion.

I will give an update on the latest Covid situation. I confirm that the Cabinet met this morning and decided not to make any immediate changes to the regulations that are currently in place. I will give an update on certain other issues, most notably the mitigations that are in place for schools, including our approach to the vaccination of 12 to 15-year-olds, and the issue of a vaccine booster programme, on which we received final Joint Committee on Vaccination and Immunisation advice this morning.

First, I will recap the latest statistics. Yesterday, 3,375 positive cases were reported, which was 11.4 per cent of all tests. Currently, 1,064 people are in hospital with Covid, which is 16 more than yesterday, and 89 people are receiving intensive care, which is one person fewer than yesterday.

Sadly, a further 21 deaths have been reported in the past 24 hours. Under the daily definition, the total number of deaths is now 8,263. As always, I send my condolences to everyone who has lost a loved one.

Good progress continues to be made in the vaccination programme. As of this morning, 4,144,904 people have had a first dose and 3,788,551 have now had both doses. Of people aged over 40, 95 per cent are now fully vaccinated with two doses, as are 73 per cent of 30 to 39-year-olds and 60 per cent of 18 to 29-year-olds. Around 76 per cent of 18 to 29-year-olds have had a first dose, so the proportion in that age group who will become fully vaccinated will continue to increase in the weeks ahead. In addition, 65 per cent of 16 and 17-year-olds have now had their first jag, which is five percentage points higher than at this time last week.

Although the level of infection in Scotland remains too high, there are continuing signs that the recent spike in cases is slowing down. We are now seeing early signs not just that the rate of increase is slowing but that the number of cases is starting to fall slightly. That can be seen in the past three weeks of data. In the week to 28 August, there was an average of 5,651 new cases a day, which was an increase of more than 80 per cent on the previous week. In the week to 4 September, the average number of cases was 6,290 a day, which was still an increase but one of just 11 per cent. However, in the seven days to 11 September—the most recent seven-day period—the number of cases has fallen to an average of 5,506 per day, which is 12 per cent lower than last week.

It might be worth providing some detail on the age breakdown of cases. In the past week, more than 70 per cent of cases have been in the under-45 age group, which is consistent with the pattern that we have seen throughout the latest wave.

The picture varies across different age groups, but there are broadly positive signs in all of them. Two weeks ago, in the week to 4 September, the number of cases in the zero to 14-year-old band rose by 51 per cent. However, in the past week, the number of cases in that age group has fallen by 5 per cent. Among 15 to 24-year-olds, the number of cases fell by 16 per cent two weeks ago, and the number has fallen even further—by 34 per cent—in the most recent week. Two weeks ago, the number of cases in the 25 to 44-year-old age group rose by 7 per cent, but, last week, the number fell by 14 per cent. Finally, the number of cases among the over-65s has risen slightly, but, again, the rate of increase has slowed over the past week.

That most recent data underpinned the Cabinet’s decision earlier today not to reintroduce any restrictions. I am grateful to everyone—organisations, businesses and individuals—who has taken extra care in recent weeks to try to stop the spike. It seems that those efforts are making a difference. That said, our position remains challenging. Although the number of new cases has fallen, it remains five times higher than at the start of August. Universities are now returning for a new term. That is welcome, but it also creates some additional risk. I will shortly say more about how we are working to mitigate that.

The key point is that, although the recent fall in cases is welcome, we cannot take it for granted. We must continue efforts to keep cases on a downward track. The national health service is already under considerable pressure, and any further rise in cases would intensify that.

As we know, vaccination has significantly weakened the link between cases of Covid and serious health harm from Covid. The proportion of people with the virus who end up in hospital is much lower now than it was before the vaccination programme started, but current case numbers reflect how transmissible the delta variant is. As we can see already, even a lower percentage of a large number of cases results in a high number of hospitalisations. To illustrate that point, on 20 August there were 312 people in hospital with Covid; today, there are 1,064. The number of people in intensive care has also increased from 34 on 20 August to 89 today. Those figures do not include people who do not need hospital care but who are nevertheless suffering from long Covid.

It is also important to remember that the pressure that the NHS is experiencing falls on staff who have, in many cases, been working flat-out since the start of the pandemic and that it comes at a time when the NHS is working to catch up on a backlog and to care for everyone who needs that, not only Covid patients.

The Scottish Government is working closely with health boards to manage those pressures, but, as has been the case throughout the pandemic, everyone has a role to play. At the start of the pandemic, we constantly emphasised the need to protect our NHS. That is still necessary, and it should give all of us even more incentive to get vaccinated, test regularly and take all the basic precautions that we know can slow down transmission.

An additional reason for continued caution is that it helps to protect those who are most at risk. The United Kingdom Government announced earlier today that it will no longer use its shielding patient list. In the light of that, and to avoid any mistaken assumption, it is important to confirm that the Scottish Government is not following suit at this stage. We will continue to use our equivalent list, which is the highest risk list. We have used that throughout the pandemic to communicate with those at highest risk and to ensure they have advice and support. We will continue to keep that list under review, but, for the moment, we believe that it is important to retain it.

I will provide a brief update on some specific strands of work. First, I can confirm that cabinet secretaries are continuing to engage with representatives from business, the public sector and wider civic society to encourage maximum compliance with the mitigations that are still in place. I will take part in a round-table meeting with a range of stakeholders immediately after this statement in order to underline the importance of that work. I am, again, grateful to all businesses and organisations for the efforts that they are making to follow and promote measures such as the wearing of face coverings, good ventilation and hygiene, and, wherever possible, continued home working.

In addition, as I said, the university term is now starting, and colleges began their return a few weeks ago. We have been working closely with universities, colleges and the wider sector to make the return as safe as possible. As a precaution, colleges and universities will not be holding large, in-person lectures for now. Instead, there will be a mix of online and in-person learning, with institutions themselves deciding the level of in-person teaching that they will offer during this term. In addition, physical distancing will remain in place on campuses and face coverings will be required in indoor public spaces.

We are also encouraging students to get tested regularly. Test kits are available on campuses, and students who are moving to term-time accommodation should book a polymerase chain reaction test before making that move. Above all, we strongly encourage students to get vaccinated if they have not done so already. Mobile vaccination units are being deployed in universities and colleges during freshers weeks, and vaccination will continue to be made available throughout the term. Health board web pages will contain details of local drop-in clinics and clinics that are operating within colleges or universities.

We also continue to work with local authorities to make schools and childcare centres as safe as possible—for example, through support for the use of carbon dioxide monitors and improved ventilation.

We have received further advice from the advisory sub-group on education, and I take the opportunity to highlight two points arising from that advice. First, we indicated at the start of term that secondary school pupils would need to wear face coverings in class for the first six weeks of term, subject to a review at that point. Given the continuing high levels of infection that are still being experienced at this stage, the advisory sub-group has advised that that requirement should remain in place until the October holidays and be reviewed again then. I know how unpopular it is with many pupils and I completely understand why, but, for now, it remains a prudent and necessary precaution.

Secondly, we intend to clarify an aspect of guidance on contact tracing in schools in order to ensure fuller understanding of the process. There is no change in the advice for close contacts who are thought to be at high risk of having Covid: they will continue to be advised to self-isolate until they have returned a negative PCR test. For children and young people, a high-risk contact is most likely to be a household member or someone they have stayed overnight with.

However, we will clarify the guidance on the letters that schools send to lower-risk contacts. Those letters should be sent on a targeted basis to those who are most likely to have had low-risk contact with someone who has tested positive. The letters ensure that parents, staff and pupils are aware of those cases, and they offer advice on issues such as looking out for symptoms and using lateral flow testing. Our updated guidance may mean, for example, that it is appropriate to send letters to the classmates of a pupil who has tested positive but not necessarily to everyone in their year group. We hope that better targeting will help to reinforce the importance of the messages in the letters while minimising undue anxiety.

In addition, the advice in the letters will be strengthened in one respect. They will recommend to primary and secondary school pupils and staff who receive them that a lateral flow test be taken before they next return to school. That test should be in addition to the regular twice-weekly lateral flow testing that is recommended for all secondary school pupils and staff.

All those measures reflect our commitment to prioritising the wellbeing of children and young people and our determination to minimise disruption to education. That consideration was also, of course, central to the advice that the Scottish, Welsh and UK Governments and the Northern Ireland Executive received yesterday from our chief medical officers.

Members will recall that the JCVI concluded that the health benefit of vaccination for 12 to 15-year-olds outweighed any risks but that, because it was marginal, the JCVI could not recommend a universal offer of vaccine to that age group on health grounds alone. However, it indicated that it would be appropriate for chief medical officers to consider whether any wider issues might tip the balance in the other direction. The CMOs have now done that. They have concluded that vaccination could reduce disruption to education and that, taken together with the health benefits that were previously identified in the JCVI advice, extending the offer of vaccination to all 12 to 15-year-olds is justified.

Taking that broader view of the benefits and risks of vaccination, the CMOs are recommending that 12 to 15-year-olds should be offered one dose of the Pfizer vaccine, and that advice has been broadly endorsed by the Royal College of Paediatrics and Child Health. I am very grateful to all four chief medical officers for assessing the evidence on the issue with such pace and rigour, and I confirm to Parliament that the Scottish Government welcomes and accepts the recommendation. We believe that vaccination of 12 to 15-year-olds is important, and we will therefore move to implement the advice as quickly as possible. Our supplies of the vaccine are adequate to allow us to do that.

It is important to stress the importance of informed consent. I know that many young people and their parents will have questions. Material will be made available online later this week, and it will be appropriate to both young people and adults. It will seek to answer questions and provide balanced information to help young people and their parents to make informed choices.

I confirm that, from Monday 20 September—that is, Monday coming—drop-in clinics will be open for any 12 to 15-year-old who has read the information and, in discussion with parents and carers, decided that they wish to be vaccinated. It will, of course, be appropriate for parents or carers to accompany their children to clinics, and vaccinators will be on hand to answer any further questions or address any concerns.

Starting in the following week—that is, the week beginning 27 September—letters will be sent to all 12 to 15-year-olds, inviting them to an appointment at a drop-in centre or vaccination clinic. Again, parents and carers will be invited to accompany their children and the appointment will include an opportunity to ask questions and discuss concerns.

Finally, after the scheduled community sessions, there will be a programme of vaccination in schools to ensure that anyone who has not been vaccinated and decides that they want to be will get a further opportunity.

I know that these are important decisions for young people and their parents and that many will have questions. I encourage everyone to read the information that will be provided and not to hesitate to visit a drop-in clinic to ask any questions or raise any concerns. Vaccination is a vital part of our overall protection against the virus. That is why it is important to support people—perhaps, especially, young people—to make informed choices that they feel comfortable with.

In addition to the CMO advice on 12 to 15-year-olds, we have this morning received the final JCVI advice on a vaccine booster programme. That is in addition to the third doses that are already being offered to people who were severely immunosuppressed or immunocompromised at the time of their first or second vaccination. I confirm that the Scottish Government also accepts that advice and that, again, we have adequate supplies for moving ahead.

The booster programme is intended to prolong the protection that vaccines provide against severe Covid illness. It will run alongside our biggest-ever flu vaccination programme, since both programmes are important for individual and public health. Wherever possible, eligible people will be offered Covid and flu vaccines together. Booster vaccinations will be offered to all adults over 50, to front-line health and care workers, to younger adults with certain health conditions that put them at higher risk, and to adult household contacts of people who have suppressed immune systems.

The JCVI has also advised that there should be an interval of at least six months between a second dose and a booster dose.

I will now give a broad outline of the order in which we will implement the booster programme. We will set out more details shortly.

Front-line health and social care workers will be able to book their booster appointment online through NHS Inform from Monday 20 September. Also from next week, residents in care homes for older people will be offered both flu and Covid booster vaccinations. Adults aged 70 or over, and everyone aged over 16 who is on the list of those at highest risk, will be contacted shortly either by letter or by their general practitioner. Other eligible groups—all adults over 50, all those aged 16 to 49 with underlying health conditions, adult carers, unpaid and young carers, and adult household contacts of people who are immunosuppressed—will be able to book online from October.

These two announcements represent a very significant and very welcome extension of the vaccination programme and will help us considerably in our on-going efforts against the virus. I therefore say to anyone who is eligible for vaccination: please take up the opportunity.

The final point about vaccination that I want to touch on very briefly is certification for certain venues, which Parliament approved in principle last week. We are now working with businesses, events organisers and sports governing bodies to finalise both the detail of the regulations and sector-specific guidance. Covid certification has, of course, already been introduced in countries across Europe—indeed, many of those countries have already gone much further than we are proposing to do. We know that it is not a magic wand, but we believe that, as part of a package of measures, it can help to reduce transmission while keeping our economy and society open—which, of course, is what we all want to see.

Presiding Officer, I will close by emphasising again the key things that we can all do to help and to ensure that we keep infections on a downward track.

First, as I have already been talking about extensively, please get vaccinated if you are eligible and have not yet done so.

Secondly, please test yourself regularly with lateral flow devices. You can order those through NHS Inform or collect them from a local test site or pharmacy. If you test positive, are identified as a close contact or have symptoms of Covid, please self-isolate and book a PCR test.

Thirdly, and finally, please continue to comply with the mitigations that are still in place: wear face coverings in indoor public places such as shops and public transport and when moving about in hospitality settings; think carefully about the number of contacts that you have—and, perhaps, reduce any that are not strictly necessary; meet outdoors as much as possible; indoors, open windows if you can; although it is no longer required by law, try to keep a safe distance from people of other households, especially when you are indoors; and remember to continue to wash your hands and surfaces thoroughly.

As we can see from the most recent data, all of that really makes a difference, so please stick with it so that we can get cases down even further.

The Cabinet did not consider any additional restrictions this morning, because the data—as I have narrated—suggest that cases are starting to fall. We keep such things under weekly review; it would be deeply irresponsible of us not to do so. However, the decision of the Cabinet today was that it is not necessary to introduce any further restrictions at this stage.

I will quickly run through the other questions.

First, forgive me if I heard wrongly—I was struggling to hear Douglas Ross, at points—but I think that he said that I do not accept that there is pressure on the national health service. Not only do I accept that there is pressure on the national health service, but I spend a significant and considerable amount of time—as, indeed, does the Cabinet Secretary for Health and Social Care—reminding people of just how much pressure there is on the NHS.

That pressure is why it is so important that the Government does everything possible through resources and support for health boards, and through co-operation and collaborative working with health boards, to support those who are on the front line of the NHS. It is why it is important for all of us to behave in a way that reduces Covid cases, which helps to alleviate the pressure, and it is why, although none of us likes such things, it would be irresponsible of us not to take advantage of all the levers including, of course, Covid certification that we have at our disposal to try to push cases down.

This Government takes the issue of drug deaths extremely seriously. Although Douglas Ross might not agree with it—as is his right—a significant package of work is under way right now, backed by significant additional resource, to tackle drug deaths. The Minister for Drugs Policy, who reports directly to me, is overseeing that work daily. It includes work on new standards for treatment, including same-day access to treatment, a wider range of treatment options and more funding for community organisations and for rehabilitation, including residential rehabilitation. We will continue to take the action that is necessary to bear down on the unacceptable figures.

On vaccination, we received the chief medical officer’s advice on 12 to 15-year-olds yesterday and the JCVI’s advice on the booster programme this morning. Finer and more granular detail will be available in the coming days, but we are today giving the start date for vaccination of 12 to 15-year-olds and the start date for the booster programme, which is this Monday coming.

Drop-in clinics are already available right across the country; there are drop-in clinics in every mainland health board area. Those will be available to young people from Monday. Appointment letters with specific appointments will be issued for those who do not take advantage of the drop-in clinics, and we will use school vaccination to make sure that we reach as many young people as possible.

The judgment that has been made is that, in order to facilitate and support maximum informed consent and involvement by parents and carers, it is better in the initial stages to use clinics and appointments than to vaccinate through schools. Our aim is to reach as many people as possible and to encourage as many as possible in that age group to take up the offer of vaccination. We will use all the existing resources—mobile clinics and the other resources—to maximise uptake.

I think that Douglas Ross made a point about flu vaccination and mass clinics. The flu vaccination programme will be delivered through a combination of GPs and vaccination clinics. Health boards will not all do it exactly the same way, but the flu vaccination programme will be first, together with the Covid booster vaccine, in our older residents’ care homes. That is a massive undertaking for health boards, but given how well they have progressed the Covid vaccination programme so far, I think that we should all have great confidence in their plans to deliver the next stages of the programme with flu vaccination.

Finally, we work with businesses on an on-going basis and will continue to do that. None of us wants to be in a situation in which we are still having to deal with the virus, but it is important that we deal with it resolutely and that we continue to do all the things that we are doing now to keep downward pressure on cases.

First, on 12 to 15-year-olds—because that is probably the most important issue that we are covering today—we received the final advice yesterday. Any 12 to 15-year-old who wants to be vaccinated will be able to be vaccinated from Monday. That is less than a week away.

Why are there a few days in between? That is because we have to make sure that, taking account of the final advice, which we got only yesterday, we make available the information that young people and their parents and carers will want to consider before they make an informed choice. That is why there are a few days before vaccination will start. I think that most reasonable people—that might or might not include Anas Sarwar—will think that that is a pretty speedy start to the programme.

We have made the judgment that, in the initial stages, it is better to use drop-in clinics and vaccination appointments, because that better facilitates the involvement of parents and carers in decisions and allows them to accompany young people when they get vaccinated, so that questions can be answered and concerns addressed. Doing it that way will be quicker than trying to put in place a new programme—in effect—in schools. Doing it through the mechanisms and infrastructure that have been available for most of this year will allow us to get the programme under way more quickly.

We will then use school vaccination to make sure that nobody is losing out on the ability to be vaccinated. Having spent a fair bit of time with the health secretary looking at those plans in detail, I think that that is the best and quickest way to proceed.

On the booster campaign, Anas Sarwar said that he would like teachers to be included. Teachers in the over-50 age group, and those in the under-50 age group with particular underlying health conditions will, of course, be included. I suppose that the key point of difference here between Anas Sarwar and I, perhaps it is because I have responsibility for implementing the decisions, is my belief that we have to base our decisions on expert advice—on the recommendations that come from those who have the expertise to give us such recommendations. I am a politician. It is not for me to second-guess the experts when it comes to vaccination.

Test and protect is functioning well. When cases are high, it is under significant pressure and we support it to do its work. As cases reduce—as they are doing now, thankfully—that pressure will reduce. Test and protect has never stopped functioning in schools, and it is not correct to say that it has. It is functioning on a more targeted basis in order that it can protect people from the risk of infection without undue and unnecessary disruption to young people’s education. That is an important aim.

Lastly, vaccination certification is not “instead of” doing all of the other things; it is in addition to them. One of the things that we know, and that we have learned, is that we need to use all the levers that are at our disposal to bear down on cases to maximum effect. We will continue to take proportionate targeted action to keep cases coming down and, I hope, to get through this winter without the need to impose any restrictions, but instead keep our economy and our society open.

When we are desperately trying to keep cases under control, while keeping our economy open, it would be a foolish Government that simply ruled out anything. The scientific advisory group for emergencies recognises that vaccination certification can play a part in reducing transmission. Indeed, after a fanfare at the weekend of suggesting that it had ruled them out, the UK Government has been very clear today that it is keeping the option of vaccination certification open and, even without doing it on a mandatory basis, is encouraging venues to do it voluntarily.

It is really important that we do not limit our options here, because we want to get through this winter with everything open and with cases at a manageable level. That is what we will continue to try to do, and I make no apology for that. We will, of course, continue to involve the Parliament fully in the detail of that.

No, I will not, because it is really important that we do not rule out measures that many people accept. Even Steve Reicher who, yes, on balance, has decided that he does not think that vaccination certificates are a good idea, recognises—[Interruption.]—that they have advantages and that there are benefits to them. We are facing a situation right now where cases have been high—[Interruption.]

Bullying in the national health service is unacceptable, just as it is in any setting.

There is no hesitation. I think that the Cabinet Secretary for Health and Social Care said that our priority right now—most people would understand this—is to deal with all the various Covid-related issues, not least the extension to the vaccination programme. I am perfectly happy for a debate to be held in the Parliament in Government time, if that is the view. I think that the Tories have Opposition business tomorrow. It would have been an option for them to debate that issue in their time. That is entirely up to them. However, I am happy to repeat the commitment that, when we are able to, we will bring forward a debate on that issue in Government time.