Chamber and committees

Where I agree with Liam Kerr—I will try to find points of agreement here—is that we must make the transition not only in a way that is just for workers, which is fundamentally important, but in a way, and at a pace, that does not become counterproductive because it inadvertently increases reliance on imports. In principle, that point is important; I have made it many times myself. Underneath that, though, there is greater complexity. Right now, we export a significant proportion of what is produced in the North Sea, and we already import a lot of the oil and gas that is used, so there is often greater complexity lying beneath the headline claim.

We need to engage properly with these issues. We are in a transition, whether we like it or not, from fossil fuels to renewable and low-carbon sources of energy. We owe that to the planet, and none of us can—nor should we try to—escape that responsibility, but we need to do that in a way that is fair and just and which actually has the intended effects.

These things require a lot of careful consideration and a large amount of careful work, but we cannot escape our moral and economic responsibility to make the transition and to meet our net zero targets. The Government is incredibly serious about doing that, and about, on occasion—not just on this issue but, I am sure, on a whole range of other issues—facing up to the difficult challenges that it entails.

Most people who are watching this will probably breathe a sigh of relief that Anas Sarwar is not standing here. Clever quips might sound good in a student union, but when we are trying to deal with a global pandemic, it is more important that we have the solutions that help to keep people safe.

Let us take some of Mr Sarwar’s points in turn. He appears to be saying that negative test results should be used in place of proof of vaccination. We suggest to people that they test themselves regularly. Lateral flow device testing is an important part of our overall response, but one of its constraints, which means that it does not make sense to put too much reliance on it for the kind of thing that we are talking about here, is that it is a self-reported test. I heard the United Kingdom vaccines minister make that point yesterday in the House of Commons. We have to be careful that we do not introduce false security around such a system.

The other point is that people can still get the virus if they are vaccinated. Anybody looking at the current statistics knows that, but vaccination reduces people’s risk of getting the virus. Do you want to be in a nightclub in which some people are unvaccinated or do you want to be in a nightclub in which everybody is vaccinated? In the latter, your risk of getting the virus is going to be significantly lower than in the former. Is the risk eradicated? No, but no single measure will eradicate risk.

This is about having a basket of measures. It is about testing and making sure that people isolate when they are required to. It is also about ensuring that we use vaccination to its fullest effect. We need to drive up vaccination rates and then ensure that we use the protection of vaccination as effectively as possible. This measure is one part of a solution.

Anas Sarwar says that we are rushing this through in Scotland. Actually, in Scotland we are behind the curve on this, as so many countries in Europe are already doing it and finding the benefits of doing so. Let us get on with it and discharge our responsibility to keep this country as safe as possible.

I will give a detailed update today on the Scottish Government’s most recent assessment of the state of the pandemic and on progress with vaccination. I will also outline the latest positions on three specific vaccination-related matters on which there have been significant developments in the past week, namely the on-going consideration of possible vaccination of all 12 to 15-year-olds, the Joint Committee on Vaccination and Immunisation recommendation of booster vaccination of people who are immunosuppressed, and our proposal—to be debated by Parliament tomorrow—for a limited and targeted system of vaccine certification.

First, I will summarise today’s statistics, which were published in the past half hour or so: 5,810 positive cases were reported yesterday, which is 10.8 per cent of all the tests that were carried out; 883 people are currently in hospital with Covid, which is 78 more than yesterday; and 82 people are receiving intensive care, which is five more than yesterday. I am sad to have to report that a further 17 deaths were reported in the past 24 hours, which takes the total number of deaths registered under the daily definition to 8,198. As always, my sincerest condolences are with everyone who has lost a loved one.

The figures show clearly that we are still experiencing a surge in cases and a very high level of infection in the population. However, the latest data also gives us some early, albeit tentative at this stage, indication that the rate of increase might now be slowing down. That can be seen from an analysis of the past three weeks of case numbers. In the week to 22 August, based on the date when test samples were taken, an average of 3,374 new cases per day were recorded. In the week to 29 August, that had risen to an average of 5,763 cases a day—an increase of more than 70 per cent. However, figures for the most recent week, to 5 September, show a daily average of 6,304 cases—an increase of 9 per cent. The seven-day average test positivity by specimen date has also fallen back slightly from a peak of 13.4 per cent on 29 August to 12.7 per cent as at 5 September.

It is worth providing a bit more detail about the age breakdown of the latest case figures. Over the past week, 75 per cent of all cases have been in people aged under 45. That is consistent with the broad picture that we have seen throughout this current wave of infection. However, further analysis of the under-45s shows variation between different age bands and gives scope for some very cautious optimism. For example, in the most recent week, the number of cases in the 0 to 14-year-old age band has risen by 44 per cent. Although that is a significant increase, it represents a significant slowing in the rate of increase from the previous week, when cases in that age group increased by more than 150 per cent.

Cases in the 25 to 44-year-old age band have also continued to rise but, again, the rate of increase has slowed quite considerably. It was 6 per cent in the most recent week compared with almost 70 per cent in the week before. Among 15 to 24-year-olds, cases have actually fallen in the most recent week by 18 per cent, from just under 11,000 to just under 9,000. That fall of 18 per cent compares with an increase of 29 per cent in that age group in the previous week.

We can take from all of that that it appears that the rate of increase has slowed. That might well suggest that the appeal to individuals and businesses over the past two weeks to improve compliance with basic mitigations and for all of us to be more cautious in our everyday behaviours is having some impact. The on-going work of test and protect is also vital and hugely appreciated.

I take the opportunity to say a heartfelt thank you to everyone for all the considerable efforts and sacrifices that continue to be made. I also issue a strong and equally heartfelt appeal to, please, keep it up. The data that I have just reported, which shows what seems to be a slowing in the rate of increase in new cases, gives us more cause for cautious optimism than we have had for a few weeks. However—I am afraid that this is always the hard part—cases are still rising week on week, and they are currently at their highest level since the start of the pandemic.

Of course, part of that reflects the significantly higher numbers of tests that are being conducted now compared with earlier stages of the pandemic, and indeed compared with other parts of the United Kingdom. Recently, testing rates per head of population in Scotland—for polymerase chain reaction tests and lateral flow device tests—have been significantly higher than those in England and Wales. However, that reflects the fact that, since around the time of our schools returning, our levels of infection have also been higher.

That is the key and fundamental point. The levels of infection across the country—albeit that we may be seeing some potential and very welcome signs of stabilisation—remain far too high. That is why we must continue to monitor the situation very closely and be prepared, as any responsible Government must be, to take any targeted and proportionate action that we consider necessary to keep the country as safe as possible. That means doing everything that we can to protect against serious illness and death. However, it also means protecting the ability of our national health service and those who work so hard in it not just to care for Covid patients, which they do with such skill and compassion, but to catch up on backlogs and give care to everyone who needs it, for whatever reason.

As I have narrated many times before, vaccination has significantly reduced the link between cases of Covid and serious health harm from Covid, and that continues to be true. The proportion of people with the virus who end up in hospital is now much lower than it was before the vaccination programme started, and that fact continues to be hugely positive and reassuring.

However, our current case numbers reflect the fact that the delta variant is significantly more transmissible than previous strains of the virus. Just as vaccines have been a game changer in a very good way, delta has been one in a very bad way. Even a much lower percentage of a very high number of cases will—indeed, it already does—put intense pressure on the national health service. We can see the evidence of that clearly in the latest data on hospital and intensive care admissions and occupancy, although we must remember that there is a time lag between case numbers and hospital admissions: it always takes a week or so before any improvement in the number of cases feeds through into hospital data.

In the seven days up to last Friday, 785 people with Covid were admitted to hospital. That is an increase of almost 50 per cent from the week before, when 530 people were admitted. As a result, hospital occupancy has also risen sharply. On Friday 20 August, 312 people were in hospital with Covid; today, the figure is 883. The number of people in intensive care has also increased, albeit at a slower rate, from 34 on 20 August to 82 today. It is worth pointing out, as we always do, that those figures do not include other forms of serious illness such as people who do not require hospital treatment but suffer long Covid.

The inescapable fact remains that, if we do not see the rate of increase slow further and then fall, many more people will become seriously ill and, sadly, some of them will die. The NHS will also come under even more severe pressure than it is already dealing with, and the pressure that it is already dealing with—this point simply cannot be overstated—is already very severe.

We cannot—we must not—let up in our efforts to stem the current wave of cases. We continue to hope—as I have outlined, recent data gives us more of a solid basis for this hope—that we can turn the corner through continued care and caution, through stringent compliance with existing mitigations, and without having to reintroduce tighter restrictions. However, to do that, as has been the case throughout this experience, we need the help of every business and individual across the country. We need everyone to continue to stick to the basic mitigations that we know are effective in helping to slow down transmission.

Last week, cabinet secretaries engaged intensively with a range of representatives from business, the public sector and wider civic society. They discussed how all of us—Government, employers and the wider public—must play our full part in observing and encouraging maximum compliance with the current mitigations. They include the wearing of face coverings, stringent hygiene, good ventilation and support for continued home working where possible.

Once again, I am very grateful to everyone, including businesses, for everything that is being done to follow and promote those measures. It is making a difference and, although we cannot rule out anything completely, it is also reducing the likelihood of restrictions having to be reintroduced.

The Government will also continue to do everything that we can to encourage compliance, for example through continued support for test and protect, on-going investment in ventilation and in carbon dioxide monitors in schools, and the provision of public information and advice. We are also continuing to do everything possible to maximise vaccine uptake, both in the groups that are already eligible and through readiness for quick implementation of any advice on the extension of vaccine eligibility. Getting vaccinated as soon as we are able remains the single most important thing that any of us can do to protect ourselves and others.

As of today, 4,130,841 people have received a first dose of the vaccine and 3,749,767 have had both doses. That includes 95 per cent of people over 40 who are now fully vaccinated, 72 per cent of 30 to 39-year-olds and 57 per cent of 18 to 29-year-olds. Three quarters of 18 to 29-year-olds have had their first dose, and the proportion in that age group who become fully vaccinated will continue to increase in light of the eight-week gap between doses.

In addition, 60 per cent of 16 and 17-year-olds have now had their first jag, which is 10 percentage points higher than I reported this time last week. We will continue to do everything that we can to encourage more and more people to get their jag—for example, in the last fortnight, we have written to all 16 and 17-year-olds who have not yet been vaccinated to offer them appointments, although, of course, they can also attend a drop-in clinic. And we are ensuring that mobile vaccination units are deployed during university and college freshers weeks.

In addition to that report on the progress of the current vaccination programme, I will briefly update the Parliament on recent advice from the JCVI on possible extensions of the programme. On Friday, the JCVI updated its analysis on offering vaccination to all 12 to 15-year-olds. It concluded that the health benefit of vaccination for 12 to 15-year-olds marginally outweighs any risks, but because it considers children to be at relatively lower risk of serious health harm from the virus, it has decided at this stage not to recommend that vaccination is offered to all 12 to 15-year-olds.

However, and significantly, the JCVI also acknowledged that it would be appropriate for Governments, in coming to a policy decision, to consider any wider benefits of vaccination—for example, whether vaccinating that age group could reduce any further disruption to education. Therefore, the four UK Governments have asked our chief medical officers to undertake a rapid assessment of the latest evidence and provide advice on wider benefits. We expect to receive that advice soon—I hope within days—and the Scottish Government stands ready to act in accordance with any recommendations that we receive.

Last week, the JCVI issued advice to the effect that people with certain health conditions that suppress their immune systems should now be offered a third dose of vaccine. That is because two doses may not be sufficient to enable those with compromised immune systems to mount a full immune response to Covid. We are now moving to implement that advice over the next few weeks and we will provide further information to those affected by it shortly. We still await—and hope to receive soon—the JCVI’s final advice on a more general booster programme and stand ready to implement that as soon as the recommendation is available.

The third point that I want to touch on relates to vaccine certification. Parliament will debate and vote tomorrow on the principle of a limited, targeted and proportionate system of certification as an alternative to the risk of further periods of closure for higher-risk settings. Ahead of that debate, and to inform it, we will publish a paper setting out in broad terms how the scheme will operate and detailing the work that we are doing in consultation with business to finalise the detail and produce sector-specific guidance.

As we debate that, though, it is important to bear in mind that Scotland is far from alone in considering such a scheme. Covid certification has already been introduced by several other Governments, of different political persuasions, in countries across Europe. Indeed, many countries have already gone much further than what the Scottish Government proposes. Covid certification is becoming an increasingly common response to the exceptional circumstances that we all face in this stage of the pandemic.

Neither we nor any other country has the luxury of doing nothing to keep Covid under control. The question, especially after 18 months of restrictions being in place to varying degrees, is how we do so in the most proportionate and least restrictive way possible. In the Scottish Government’s view, Covid certification is a reasonable response to a very difficult situation, and a much more proportionate response than any of the likely alternatives.

Fundamentally, we believe that certification can help us reduce the overall harms caused by the pandemic. It will not eradicate transmission, but it will help to reduce it in some higher-risk settings, and will maximise protection against serious illness. We believe, as has been seen already in some other countries, perhaps most notably in France, that it will help to encourage take-up of the vaccine. It also represents a targeted way in which we can, we hope, enable certain events and venues to continue to operate at times when rates of Covid may be high and even rising.

The time that I have again devoted to vaccination today reflects the fact that it remains absolutely key to our progress out of the pandemic, not just in Scotland but across the world. For each of us as individuals, getting vaccinated remains the single most important step that we can take to keep ourselves safe, to keep others safe and to reduce the need for restrictions to be reintroduced.

However, although getting vaccinated is the most important step, it is not the only step that all of us need to take right now. I will therefore close by stressing the three key things that each of us can do as we all play our part in getting cases back under control. As I have stressed and as I will keep stressing, the first is to get vaccinated if you are eligible. If you have not been vaccinated yet or if you had your first dose eight or more weeks ago and have not yet had a second dose, please get your jag. It is straightforward to do—there are drop-in centres in every mainland health board area or you can book an appointment.

Secondly, please continue to test yourself regularly with lateral flow devices. You can order them for free through the NHS Inform website or collect them from a local test site or pharmacy. The point of regular testing—this really matters—is that, if you have the virus but are not aware of that because you are not displaying symptoms, taking a test gives you a chance of finding out that you have the virus before you inadvertently pass it on to others. Regular testing is a key and important way of interrupting chains of transmission. If you test positive through one of the lateral flow devices or if you are identified as a close contact or have symptoms of the virus, make sure that you self-isolate and book a PCR test.

Thirdly and finally, please continue to follow all of the remaining rules and guidelines that are still in place. For example, it is still a legal requirement to wear face coverings in indoor public places such as shops, on public transport and when entering and moving about hospitality settings. Face coverings are a simple but important and effective way in which we can help to protect one another.

More generally, continue to think carefully about the number of contacts that you are having and perhaps reduce any that are not really necessary. Meet outdoors as much as possible. If you are indoors, open the windows, because good ventilation makes a big difference. Even though it is not the law any more, try to keep a safe distance from people in other households if you can, especially when you are indoors. In addition, for the time being, try to minimise direct physical contact such as handshaking, and wash your hands and surfaces regularly and thoroughly. Having to take those steps is frustrating, but we know that they make a difference and help to limit the spread of Covid. Indeed, as I said, it may well be that, in our most recent data, we are seeing the evidence of the difference that those measures make.

I again thank everyone who is helping us to turn the corner in this latest wave of the virus. Please keep up those efforts so that we can continue to keep each other as safe as possible.

The issue is important at any time but, given the tragic death of Sarah Harding earlier in the week, it is uppermost in the minds of many people, particularly many women.

I will ask the Cabinet Secretary for Health and Social Care to write in detail about the different referral pathways and put the letter in the Scottish Parliament information centre. One of the things that we are in the process of doing, which is relevant to all cancers, is establishing early diagnosis cancer centres, and the first three are already operational. The centres are intended to be an alternative to the existing urgent referral pathway, and identify the less common symptoms of cancer, so that there is another route in. A lot of work is being done there.

As I know because I have recently entered the eligible age group, the breast screening programme is operational. It was paused for a period at the height of the first wave of Covid, but it has been up and running again for some time.

Urgent care, and in particular cancer care, continues to be prioritised during the pandemic, but there are efforts under way in cancer care across the whole health service to ensure that any backlogs are addressed as quickly as possible. However, given the importance of the issue, as I said, I will make sure that further information on various referral pathways is put in SPICe.

If he was here, we could hear it.

Just in the past couple of weeks, we have recruited 100 more tracers. We do not do emergency recruitment drives; we recruit and support test and protect as we go along, depending on the need for the system. Alex Cole-Hamilton is right that it is not talking down test and protect staff to raise legitimate concerns or scrutinise the Government, but it is doing down the efforts of test and protect to cite misleading figures that suggest that it is performing at a level that is not reflective of the reality. The 43 per cent that was cited last week—which is, in reality, 82 per cent—is a case in point. Today’s report shows that 84.4 per cent of positive cases are being interviewed within 48 hours of them being in the case management system and that, based on provisional figures, the WHO target this week is being met, although the figures will be finalised next week. Yes, the system is under pressure, but it is operating and performing well, and every one of us in the chamber owes every one of those staff members a deep debt of gratitude.

There is a pretty basic reality for all countries: we cannot wave a magic wand and make Covid go away. It continues to circulate, and we are about to enter the winter period, when it will pose significant challenges for us all. Therefore, the question for all of us is not whether we can get away with doing nothing, but how we can protect the country in a way that is as proportionate as possible and which is least restrictive.

On nightclubs and the night-time industry, I absolutely recognise that nobody wants a system of vaccine certification, and nobody wants it to be in place for any longer than is necessary. However, the alternative, particularly in higher-risk settings, is not to do anything, which might well lead to our facing the situation of having further periods of closure of some of the higher-risk settings.

That is, I am afraid, the hard reality that Governments simply cannot escape. This is about what is the most proportionate thing to do to keep people as safe as possible and keep the venues open, even during what is likely to be a very challenging winter period. We cannot escape that reality and those choices.

People who argue against vaccine certification—as I said, certification is working in many countries across Europe—have to then say how they think higher-risk settings should be kept open, given that cases might increase during winter, without facing further periods of closure. I am afraid that Governments have to face those hard realities—we cannot simply put our heads in the sand and ignore them.

A Scottish citizen who has received one or more of their vaccinations outside Scotland but in the common travel area can phone the status helpline that I mentioned a moment ago—0808 1968565. On-going collaboration is taking place between the Scottish Government and NHS Digital to establish appropriate data-sharing agreements in the common travel area. We are working to rectify the situation as soon as possible. Those who live in Scotland but have been vaccinated outside Scotland or England should obtain proof of their vaccination from the country in which they have been vaccinated.

I do not have a figure for how many people might have their information incorrectly recorded—I would not expect there to be a significant proportion—and I will check to see whether the information can be made available. More important, if any data on anyone’s vaccination status record is incorrect, they can phone the Covid-19 status helpline and the matter will be investigated and rectified as quickly as possible. The helpline number is 0808 196 8565.

Let me take test and protect, accident and emergency and vaccine certification in turn.

First, on test and protect, Douglas Ross has quoted figures today—as was done by others last week—in a way that does a real disservice to those working in test and protect. The publication that he has quoted, which cites provisional figures, actually tells us why it is not reliable to quote provisional figures, because the contact tracing is on-going. Therefore, it is the figures from the following week, when they are finalised, that matter.

To take the provisional figures—I think it was Jackie Baillie who quoted them last week—the provisional figure for completed cases was 43 per cent; it is up to 55 per cent this week, I think. The 43 per cent figure that was quoted last week to do down test and protect is, in the finalised figure this week, 82 per cent. Politicians who, perfectly legitimately, want to have a go at me and the Government, do a real disservice if, in doing so, they do down the efforts of those working in test and protect.

In this week’s provisional figures for test and protect, which, again, I stress are provisional figures that will be updated and finalised next week, 89 per cent of cases closed within the 72-hour target—the World Health Organization’s target of 80 per cent within 72 hours—which is up from 85.5 per cent in the provisional figures last week.

Yes, the organisation is under pressure. How could it be otherwise with the pandemic and the level of infection right now? However, it is an organisation that is working hard every single day, it is playing a valuable and vital part in helping to get this country through, and I think it is wrong for figures to be quoted in way that unfairly undermines the efforts that test and protect staff are making. This Government is supporting the NHS through the recovery plan and through the resources that have been identified to back it, in addition to the overall commitment to increase NHS funding.

This is interesting, and it will be relevant to the point that I am about to make on Covid certification. Regarding the plan that Douglas Ross derides, which is the Scottish Government plan to increase NHS capacity by 10 per cent, backed by investment, he says here that that is insufficient, and yet yesterday the Conservative Government at Westminster announced its own plan, and guess what that plan was? I do not know whether Douglas Ross is at Westminster right now, but I suspect he will support it in that context, because that plan was to increase NHS capacity by—guess what?—10 per cent.

Again, we have Douglas Ross backing things that are done by the Conservative Government in Westminster while criticising exactly the same things when they are done here in Scotland.

That takes me on to vaccine certification. We will set out the work to which I have alluded today in advance of the debate tomorrow. Parliament has, rightly and properly, been asked to endorse the principle, and it is absolutely right and proper that—just like the UK Government for England—we continue to work with stakeholders to ensure that we take account of their views and concerns as we finalise the detail. In fact, we would be criticised if we were not to do that.

Of course, vaccine certification is already being used in many countries across Europe and around the world, and what we are proposing is also being proposed by the UK Government for England. I suspect that we are hearing from Douglas Ross a justification for the ridiculous position that he is going to end up in, where the scheme that he opposes in Scotland is exactly the same one that he supports when a Conservative Government introduces it in England.

By all means—[Interruption.] By all means, scrutinise this Government, but—for goodness’ sake—try to have a single ounce of consistency as you do it.