Chamber and committees

Gillian Martin is absolutely right: the QR code that I spoke about that goes live on Friday is not a substitute for the app. The app is currently under testing; it is important that we test it properly. It is scheduled to be released on 30 September. It has been designed to meet European Union standards for international travel, which I referred to earlier, and it will provide access to individuals’ vaccination records that are held by NHS Scotland. The app will be released later in September after all the robust testing that is required; the QR code is an interim measure until that happens.

I did hear the questions. I am not sure what the noise in the background was, but I am sure that it was understandable.

I will try to take the questions in turn. It is important for us all to focus on the detail and the complexities of the situation. We are 18 months in and we are still not in a normal political situation in which who said what, when and whether a politician is still saying the same thing that they said a few weeks ago is as relevant as it is in other times. We are all trying to assess the evidence, learn as we go and make sure that we consider carefully all the pros and cons of every decision. I hope that all politicians will continue to do what most have done throughout the pandemic and engage with that in detail and in substance.

Nobody wants to impose greater restrictions. I absolutely understand the concerns of businesses and individuals that the virus might increase at a pace and in a way that would make them unavoidable, but I do not want that to happen. Nobody wants that to happen. Equally, I do not want people to die avoidably from Covid, and I do not want to see more people becoming seriously ill. I also do not want the pressure on our health service to build such that people who have other conditions cannot be treated timeously. It would be an irresponsible politician who ruled anything out in the face of an infectious, mutating virus, and I am not going to do that.

We all have a part to play here. The Parliament is the collective leadership of Scotland, and we all have to come together to persuade people of what we need to do to avoid further restrictions. Instead of going on about how terrible restrictions would be—we all agree with that—let us focus on saying to people, “Here is what will help us to avoid that.” That is what I tried to set out in my statement today, and I hope that we will all get behind those essential public health measures.

We have been considering the issue of vaccine certification very carefully, as members and those people who watched the two virtual meetings of Parliament over the summer will have heard me say. We have not ruled it out—we have been very clear about that—but we have made sure that we have considered carefully some of the ethical and equity issues and the practical issues that are involved. We have now come to a point where we think that a limited and careful use of vaccine certification can have a role to play.

However, given the significance of the use of vaccine certification, as I said in my statement, I think that it is right that Parliament votes on it and authorises it. If we were to decide to extend its use to other settings, I think that it would be equally important that Parliament had the ability to authorise that. I will therefore set out the details of that, and of what we will ask Parliament to vote on, more fully next week.

We are far from alone—we see this across the UK and much of the rest of the world—in being in a situation in which the delta variant has significantly changed the game. It is a different variant of the same virus, but in many respects, because of its greater transmissibility, it feels like a different virus. We must respond to that properly. As was the case with earlier strains of the virus, the same basic mitigations can help to slow it down. That is why we must continue to get those messages across and to ask people to continue to do all the important things, including getting vaccinated.

No member of the Scottish Government, including the health secretary, has attacked GPs. It is, to be frank, disgraceful to suggest otherwise.

When I launched the NHS recovery plan at the Golden Jubilee national hospital in Clydebank last week, I made the point that GPs have been working extremely hard throughout the pandemic. At the start of the pandemic, I visited a general practice to launch the roll-out of the Near Me service, so even though face-to-face consultations have, understandably, been restricted, GPs have been seeing patients online and in other ways, including home visits.

To say that we do not want to move away from the virtual arrangements that have worked well during the pandemic and get back to a more face-to-face approach in primary care is not attacking GPs. It is incumbent on us all not to engage in such suggestions.

The point about the stress, anxiety and exhaustion of many members of the NHS workforce, though, is very well made and is one that we recognise. That is why a significant part of the NHS recovery plan talks about the support that is being put in place for the mental and physical health and wellbeing of NHS staff.

In our discussions, we often talk about hospitals and health centres—the bricks and mortar of the NHS—but the NHS is nothing without the dedicated people who work in it, so it is vital that we support them. That is one of the reasons why I am proud—much as I would love us to be able to go further—that we have this year given agenda for change staff in the NHS the highest pay rise in any part of the UK.

I thank Jenni Minto for that important question. For people with symptoms, we have extended PCR home test kit coverage and the 119 courier collection service to the islands of Bute and Mull. Local partners have the option of extending provision further, if that is required.

There is also a walk-through local test site and there are a number of mobile testing unit deployments and 10 small-scale test sites across Argyll and Bute. People with symptoms can book a test at those sites or order a home test kit through NHS Inform. People who do not have symptoms can access lateral flow tests by ordering them online, getting them from a community pharmacy or going to a community test site. Local residents can find the site locations and opening hours on their local authority website.

The app is an important part of test and protect, but it has never been the whole part of it. I take every opportunity to remind people to download the app, use it and ensure that it is turned on so that it can provide the support that we want it to. I hope that every member across the chamber will do that, too, and take the opportunity to remind our constituents of that.

We also have to remind people to do all the other basic things: wear face coverings, wash hands, keep a safe distance, even though that is not the law, and ventilate rooms. Based on previous experience to a large extent, I believe that, if we do all those things, we can turn the corner and start to see case numbers level off and come down. Again, we know from experience that that will not happen by itself; it will happen only when we do the things that stem transmission.

The Government takes the lead in having responsibility for doing all the things that we have to do and for persuading the public to do likewise. However, as the collective leadership of the country, all of us across the chamber have a role in ensuring that we get such messages across.

We continue to work closely with universities and colleges on preparing and publishing guidance for the new academic term. That work has been informed by expert advice that the Covid-19 advisory sub-group on universities and colleges has provided.

I can confirm that in-person learning can take place. However, we understand that most universities and colleges will operate a blended learning approach, which will involve some learning continuing to be online at least for the start of the academic year, and I support that. I expect institutions to clearly communicate that to students, because that is their responsibility and there will not be an entirely consistent picture across different courses, given their nature.

In relation to NHS Lanarkshire, we continue to liaise with and provide support to all NHS boards to help them to cope, both in a public heath sense in terms of local outbreak management and through the NHS recovery plan and the winter planning that is already under way. NHS Lanarkshire receives support as part of that.

Face coverings play a really important part in helping to stop the spread of the virus. We will regularly review requirements to wear face coverings, and any reviews will take account of a range of factors such as the impact on transmission as well as social and economic considerations.

Face coverings continue to be worn by staff in all school communal areas and by staff and pupils in secondary school classrooms. In indoor areas of sports stadiums, such as stairwells, toilets and concourses, the wearing of masks also remains mandatory. We continue to meet stakeholders across all sectors to discuss guidance on face coverings. We know, for example, that the issue is particularly important for faith communities.

Face coverings are a measure that, like any measure, should not be kept in place for longer than we deem it necessary. For as long as it is necessary, however, I think that most people—I appreciate that it is not everybody—consider that it is a reasonably small price to pay to help keep themselves and others safe and, we hope, avoid the need for greater and more stringent restrictions.

Anybody who has heard me talk about vaccine certification will know that I understand the concerns and share some of them. This is not a move that any Government should take lightly. However, frankly, I am also deeply concerned and have been for 18 months—as I know that everybody has been—about the harm that Covid does. We therefore need to consider every possible tool at our disposal that helps us to protect people from the harm of Covid. Increasingly, after so long, we particularly have to consider any tools that can help us to reduce the harm of Covid without needing to impose wider and more blanket restrictions on people’s way of life. Using vaccine certification in a very limited way can help us to do that.

The kinds of venue that I have spoken about—large-scale events, night clubs and adult entertainment venues—are important to our economy and to many people’s cultural life. I am not underplaying the importance of night clubs to young people, for example. However, they are venues in which, despite the best efforts of those who run them, the conditions make it more likely that the virus will spread. Taking the proportionate step of asking people to make sure that they are fully vaccinated to protect themselves and others would therefore be an appropriate thing to do.

The IT systems that are supporting our efforts on Covid are not “creaking”. Everybody is under pressure from Covid, but all the systems and back-up arrangements for anything like this have to be robust. That is why we have taken such a careful approach, and it is why we are taking time, for example, to finalise and launch the app that will support some of this, which will happen later this month.

These things are really important. I think that they have a part to play, but I also think that it is important that Parliament gives its authorisation.

On the longevity of all of this, I do not think that it is either possible or sensible to be definitive about that right now. This is a global pandemic, which we are still in. For as long as any measure can help us to reduce the harm that Covid does, we should consider having it in place.

Today, I will update Parliament on the state of the pandemic in Scotland, discuss the recent surge in cases and give our best assessment of the current situation. I will also outline the additional action that we are taking to try to slow transmission and reduce the spread of the virus.

I will start with the latest daily statistics, albeit in summary form, as they were published around an hour ago. There were 6,170 positive cases reported yesterday, which is 11.5 per cent of all tests carried out. There are 629 people in hospital with Covid, which is 44 more than yesterday, and 59 people are in intensive care, which is five more than yesterday. Sadly, a further nine deaths have been reported in the past 24 hours, taking the total number of deaths under the daily definition to 8,127. As always, my condolences are with everyone who has lost a loved one.

On vaccination, 4,108,804 people have received a first dose, and 3,691,066 have now had both doses. That includes 95 per cent of people over the age of 40 who are now fully vaccinated, as well as 71 per cent of 30 to 39-year-olds and 51 per cent of 18 to 29-year-olds. However, 74 per cent of 18 to 29-year-olds have had a first dose, so we expect the proportion becoming fully vaccinated to continue to increase in the days ahead. Finally, almost exactly half of all 16 and 17-year-olds have now had the first jag. Vaccination in that age group started relatively recently, and work to increase uptake further is on-going. All 16 and 17-year-olds who have not yet had a first dose should have received a letter yesterday inviting them to an appointment.

As members are aware, we still await advice from the Joint Committee on Vaccination and Immunisation on vaccinating all 12 to 15-year-olds, and I hope that the evidence will allow the JCVI to give a positive recommendation very soon. If that is the case, we stand ready to implement that recommendation.

I will talk more about the importance of vaccination later, but I will first address the surge in cases that we have experienced over recent weeks. Case levels are 80 per cent higher now than they were last week, and are five times higher than they were four weeks ago. Test positivity has also risen, from around 5 per cent at the start of August to 11.5 per cent today. As we indicated at the time, it was always likely that, as restrictions were lifted, we would see cases rise. The virus is highly infectious, so as people mix together more, it will take the opportunity to spread. Indeed, cases are rising across all of the United Kingdom and in many other countries.

However, in Scotland, unlike in England and Wales, schools have been back for some time, and we expected that that would create a further pressure not only as a result of increased interactions in schools, but because we know that there are certain ways—school drop-offs, for example—in which adults tend to mix more when schools are back. Despite expecting to see some increase in cases, the scale of the increase in recent weeks has been extremely concerning. There is no doubt that that underlines the fact that the delta variant is significantly more transmissible than previous strains.

Just as vaccines have changed the game for us in a very good way, delta has changed it in a very challenging way. That has been evident to us in the past few weeks. That is why we have been reminding the public in recent days that, if we are to avoid any re-imposition of restrictions—even in a limited way—as we all want to do, we must all play our part to slow transmission.

We have been urging everyone to comply with all the basic mitigations that are still in place, such as the use of face coverings, and to carefully follow all public health advice. If we all do that—later, I will again set out exactly what we are asking people to do—I am hopeful that we can turn the corner without having to re-impose any restrictions. However, I stress that the next few days will be crucial in our assessment, and it is inescapably the case that we must turn the corner and see the sharp increase in cases level off and then come down.

I will explain again why that is important, even with vaccination levels as high as they are. It absolutely remains the case that vaccination has significantly reduced 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 pre-vaccine. Indeed, that is why the record number of new cases that has been reported in recent days has not caused a record number of hospital admissions. That is very positive, but it must not make us complacent.

Although the link between new cases and serious health harm is now much weaker, it has not been completely broken—either here or anywhere else in the world; like us, many countries are grappling with the delta variant. We can see that clearly in the recent data. On Friday 20 August, 312 people were in hospital with Covid; today, there are 629. The number of people in intensive care has risen more slowly, but it has risen. On 20 August, it was 34; today, it is 59. Of course, hospital figures do not capture all the health harm caused by Covid. For example, they exclude people who do not require hospital treatment but still go on to suffer long Covid.

There is a matter of basic arithmetic at play. If the recent surge in cases was to continue—if, for instance, cases were to rise to 10,000 or more a day, which is something that I hope will not happen but is by no means impossible—that would have serious consequences. A lot of people would fall seriously ill and, obviously, some people would die. Also, the national health service would come under even more severe pressure.

To reiterate, that is a matter of basic arithmetic. At the start of the year, daily reported cases peaked at around 2,600, and, at that time, which was pre-vaccine, around 13 per cent of cases were ending up in hospital. Today—this is good news—around only 2 to 3 per cent end up in hospital. However, 2 to 3 per cent of 10,000 cases a day will cause similar pressure on our NHS as 13 per cent of 2,600.

This pressure is building at a time when many staff have been flat out for more than 18 months and when the NHS is working hard to deal with the backlog of other cases that has been caused by the earlier waves of the pandemic.

The situation that we face is fragile and serious. We must stem the rise in cases. Obviously, it would not be responsible for any Government in the face of the virus and the harm that it can still do to rule out reintroducing any restrictions. Indeed, in my view, that would be grossly irresponsible. However, we do not want to reimpose restrictions, even in a limited way. We know only too well how much harm restrictions cause to businesses, young people’s education and to our overall wellbeing. If that is to be avoided—as I very much hope that it can be—it will take all of us again making a conscious and concerted effort to comply with all the basic mitigations that we know from experience can slow down transmission. Of course, that applies to individuals as well as businesses.

I will set out some of the work that the Government is doing, including on one particularly significant issue, and what we are asking everyone to do.

Over the past two weeks, cabinet secretaries have been engaging closely with business and sectoral organisations across the country to encourage significantly increased compliance with existing baseline measures. That, of course, includes the wearing of face coverings, encouraging stringent hygiene and support for continued home working where possible.

I am very grateful to businesses for the efforts being made to keep staff and customers safe, and I am particularly grateful to those businesses that are continuing to support home working. It is vital that those efforts continue. I know that they are not easy for business, but they are much less onerous to them than any further restrictions would be.

We are continuing to support urgent measures to improve ventilation in schools—for example, the purchase and use of CO₂ monitors. We are also looking urgently at options to support better ventilation in priority workplaces.

We continue to do everything possible to drive up the already high uptake of vaccine. Getting vaccinated remains the single most important step that any of us can take to keep ourselves and others safe. Therefore, ensuring that as many people as possible get vaccinated remains an absolutely key priority.

As I have mentioned, we expect updated advice from the Joint Committee on Vaccination and Immunisation soon on vaccination of 12 to 15-year-olds and on booster jabs for vulnerable groups such as older people and those with compromised immune systems.

We will, and stand ready to move to implement any such extensions to the vaccine programme as soon as we get the JCVI recommendations to do so, which I hope very much will be soon.

We are also taking targeted steps to increase uptake among groups who are already eligible for vaccination. I mentioned earlier that an invitation letter has recently been sent to all 16-year-olds and 17-year-olds who have not yet had a first dose. Mobile vaccination units will be used during university and college freshers weeks to encourage students who have not already done so to get vaccinated.

We will also concentrate further effort in the days ahead on encouraging anyone in the under-40 age group who has not yet had the vaccine, or has not had the second dose, to do so now.

It really is impossible to overstate the importance of vaccination in getting us safely through this phase and the winter months ahead. By getting vaccinated, we help to keep ourselves and others safe. The reverse of that is equally true: not getting vaccinated, if you are eligible, puts you and others at greater risk, and it makes it less likely that we can make it through the winter without having to reintroduce some restrictions. To everyone out there who has not already had their jags, I say, “Please do your civic duty—please get vaccinated now, for your own sake and for all of us.”

The final issue that I want to address is vaccine certification, for when entry to venues is dependent on people being able to show that they have been fully vaccinated. In recent months there has been a lot of discussion about vaccine certification. As I have indicated before, the Government has been considering very carefully whether—notwithstanding the understandable equity and ethical concerns—vaccine certification could, in some settings, help to protect public health, reduce the necessity for any further restrictions and, of course, boost vaccine take-up.

The Scottish Government has made it clear that we do not believe that vaccination certification should ever be a requirement for receipt of any key services or in settings where people have no choice over attendance—for example, public transport, education and access to medical services or shops. We continue to hold very firmly to that position. However, we consider that limited use of vaccine certification could help to control spread of the virus as we head into the autumn and winter.

For any decision of that nature to have an impact before winter, we would have to take and implement it quickly. However, I recognise that it is a significant decision so, in my view, it should be expressly authorised by Parliament. I therefore propose that, subject to the Presiding Officer’s agreement, we have a full debate and vote on the matter next week. To help to prepare for that, I will set out now what the Government, after much consideration, has concluded would be appropriate.

We propose that, subject to Parliament’s agreement, vaccination certification should be introduced later this month—once all adults have had the opportunity to be fully vaccinated—for the following events and venues: first, nightclubs and adult entertainment venues; secondly, unseated indoor live events with more than 500 people in the audience; thirdly, unseated outdoor live events with more than 4,000 people in the audience; and lastly, any event of any nature that has more than 10,000 people in attendance. We do not currently consider that it would be appropriate to introduce certification for the hospitality industry as a whole, and we hope that it will not be necessary to do so. However, we will keep that position under review.

We are also very aware of the need to take account of people who, for good reason, cannot get fully vaccinated with both doses of the vaccine. For example, we envisage that children and people with particular medical conditions would be exempt from certification requirements. However, we consider that in order to help to protect individuals and the country as a whole, and to reduce the risk of further restrictions becoming necessary, people over 18 years old who are eligible for vaccination should be required to show that they have received both doses before entry to premises and events such as I have mentioned.

It is already possible to request that a paper copy of your vaccination record be posted to you to allow you to travel. From this Friday onwards, well in advance of any certification scheme coming into operation, we will also provide a QR code. That means that you will be able to download a copy of your vaccination record to keep on your phone or to print.

The introduction of Covid vaccine certificates, even in the limited circumstances that I have set out, is a significant move and not one that we would ever take lightly. That is why I believe that it should have parliamentary approval in advance. However, it is worth stressing that although we have had to weigh the decision carefully, we would be in no way unique in taking the step. The UK Government has announced its intention to introduce certification for England, and several European countries—including France, Italy and Ireland—have already introduced certification. In fact, the certification rules in several other countries cover a far wider range of venues than those that we are currently considering for Scotland.

Many of the events and venues that will be covered by a certification scheme are important—they matter to our economy and to our cultural and social life, which is why we want to enable them to stay open safely. However, they are not essential services, and their nature, which involves bringing together many people in relatively small areas, means that despite their very best efforts—I know that they make their best efforts—they can contribute significantly to spread of the virus. By ensuring that people who enter those settings are fully vaccinated, we would be taking a proportionate step to help to make those settings safer for everyone attending and, by extension, for all of us.

As I said, I fervently hope—vaccine certification aside—that we will not have to impose any further legal restrictions. Of course, that depends on all of us making a concerted effort now, through our own behaviours, to stem transmission. We know that we cannot let cases continue to rise at the pace of recent weeks. We must slow down the pace. That is important for all of us as individuals, but especially for those who are most vulnerable to Covid.

We know that many of the people who are at highest risk, including many of those who were advised to shield at the start of the pandemic, are particularly anxious about the current situation. They worry that if they go out of their homes, especially with the number of cases being so high, they could be put at risk by people not wearing face coverings, not washing their hands or not trying to keep a safe distance. That should be a reminder for us all. When we take basic precautions, we are not simply protecting ourselves—although we are doing that, and it is important—we are making life easier and safer and helping to reduce anxiety for many others, too.

I will close by once again stressing the actions that each and every one of us needs to take in order to do that and to help to get cases down without further restrictions. First, as I stressed earlier, if you are eligible and have not yet done so, please get vaccinated. That remains the single most important thing that we can all do to keep everybody safe. There are drop-in vaccination centres in every mainland health board area. If you have not been vaccinated yet, or if you had your first dose eight or more weeks ago and have not had a second dose, you can just turn up at your nearest centre and get the jag.

Secondly, please test yourself regularly with lateral flow devices. If you do that and if you have the virus but do not have symptoms, you still have a chance of finding that out before inadvertently passing on the virus to others. You can get free lateral flow tests through the NHS Inform website. They will be sent to you in the post or you can collect them from local pharmacies or test sites.

If you test positive through a lateral flow device or if you have symptoms of the virus, make sure that you self-isolate and book a PCR—polymerase chain reaction—test. If you are a contact of someone who has tested positive, you might also be told to self-isolate pending a PCR test, as I was at the start of the week. In any of those situations, please make sure that you self-isolate. That remains a really important way in which we can all slow down the spread of the virus.

Thirdly and finally, please follow all the guidance that is still in place. Please remember that 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 in hospitality settings. That is a simple but important way in which we can all protect one another.

More generally, please meet outdoors as much as possible. I know that that gets harder as the weather moves into autumn. If you are indoors, open the windows—good ventilation makes a big difference—and avoid crowded places. Indeed, for the next couple of weeks, perhaps all of us should think carefully about the number of contacts that we are having and, perhaps, reduce the number of those that are unnecessary. Even though it is not the law any more, keep a safe distance from people in other households if you can, especially indoors. Minimise direct physical contact such as handshaking, and keep washing your hands and surfaces thoroughly.

Having to take those steps is frustrating for us and for people across the world, but it really does make a difference—we know that from experience. It helps to limit the spread of the virus, and we must do that. We must do it to keep ourselves and our loved ones safer, and to help to ensure that we can avoid the need for any further restrictions.

The next few days are crucial. The Government is doing everything it can, and will continue to do so, but as has been the case throughout, we need your help, too. So, please, get vaccinated, get tested and tighten up again on following all the rules and guidelines. I again thank everyone across the country who is doing that.

Anas Sarwar should know the answer to that last question, because it was set out in our revised strategic update. I announced it to Parliament and he asked me questions about it at the time. Our strategic objective is to reduce the virus and keep it at levels that are sufficient to reduce the harms from the virus. If that was not known to Anas Sarwar, I gently suggest that it should have been. [Interruption.]

Anas Sarwar says that our strategy is not working. Every country is grappling with a highly transmissible strain of the virus. We had a spike in cases in early July, when our case levels were the highest in the UK. We then had a period throughout the rest of July and much of August when we had the lowest case levels in the UK. Our schools have gone back ahead of those in other parts of the UK, so we are again seeing a rise. The situation that we are grappling with is not different from the one that most other parts of the world are grappling with.

Anas Sarwar is wrong. I also take issue with his point about winter planning in the NHS. If he is saying to me that we should be starting winter planning now, I could not disagree with that more strongly. We started winter planning a long time ago. If we were starting it only now, that would be seriously remiss of us. Last week, we set out the NHS recovery plan, which is integral not just to the medium to longer-term recovery of the NHS, but to ensuring that the NHS is equipped to deal with the variety of pressures that it will face in the winter.

Test and protect is working, and it is working extremely well. PCR test kits come via the UK Government and they have been received. There have been some pressures on them in recent weeks, but those pressures have been met by new supplies arriving. Most people are getting their PCR test result within 24 hours. Test and protect is working well and contact tracing is being targeted on the highest risk areas first. That system will always be under pressure when case numbers are high, but it is working well and I am deeply grateful to those across the system who are putting in so much effort to make sure that it is working well.

On the booster campaign—again, I have said this so many times directly to Anas Sarwar and others—we await the JCVI recommendation. If we did not take the JCVI recommendations on this, we would simply be taking decisions that many people would rightly turn around and tell us did not have the right evidential base. However, we are ready to get the booster campaign under way as soon as the JCVI gives its final recommendation. We have interim recommendations, which have been the planning basis for that.

People can hear—and will have heard before—that I am frustrated that we have not yet got updated advice on 12 to 15-year-olds. I hope that, like many other countries, we can start to vaccinate in that age group soon and that the JCVI soon feels able to say that the evidence allows it to recommend that. Again, we stand ready to do that as quickly as we are able to.

We are looking at different ways to reach 16 and 17-year-olds. Some health boards are already looking at taking vaccination directly into schools, and that process will continue. We will continue to do all those things.

However, to come back to the central point, this is an infectious virus that has got a lot more infectious. All of us need to make sure that we are playing our part, and as politicians and leaders of the country, all of us need to play our part in getting those messages across. The Government will continue to lead by example in doing that.