Chamber and committees

First, our domestic tourism industry has had a torrid time over the course of the pandemic, but, in more positive news, it is seeing healthy demand over the summer months, which is encouraging. I encourage people who want and are able to take a break to do that at home in Scotland and to support the tourism industry and local businesses the length and breadth of the country.

With every decision that I take, some people will say that I am going too far and some people will say that I am not going far enough. That is fine, because, I am the one, along with my colleagues, who has to come to balanced judgments. We need systems in place for essential travel, and people who are separated from their families will, in some circumstances, see contact with them as essential travel. We need systems in place that allow that to happen as safely as possible and in as proportionate a way as possible.

That is what the risk-categorised system of red, amber and green is intended to do. We take a precautionary approach to the categorisation of countries, and we move countries back up the scale as and when we consider it necessary to do so. Nothing is absolutely safe in this context, but vaccination along with PCR tests on the second day after arrival are deemed to be a proportionate alternative to self-isolation for people who are double vaccinated. That approach helps to strike a balance, although it is not a perfect balance, and we will continue to keep it under review.

In the meantime, my advice to people is that if they do not have to go overseas right now, they should not go. They might not know what the situation will be when they get there, because the situation overseas, in Europe and in other parts of the world, is volatile. For example, in the past couple of days, we have seen the restrictions in the Netherlands that were lifted at the end of June being reimposed. Someone might have booked a trip to the Netherlands thinking that they were going to a restriction-free country, and suddenly found that they were not. The situation is uncertain with regard to the destination, and also in terms of what a person might inadvertently and unwittingly bring back with them.

We will continue to try to get the right balance with the right level of proportionality. The one thing of which I am certain is that we will not keep everybody happy, but that is the nature of such things.

I actually hope that the demand on test and protect will reduce over the coming weeks. As case numbers have plateaued and started to fall, so should the pressure on test and protect. There is a direct relationship between the levels of infection and the level of pressure on test and protect. The most important thing that we can do to reduce the pressure is to get case numbers down. Thankfully, it looks as though we are on that trend right now.

In summary, we have increased resources in terms of staffing in test and protect through the national contact tracing centre, and we have supported test and protect to make appropriate modifications to its approach to contact tracing. If it has not already been done, I will ask the health secretary to put in the Scottish Parliament information centre a full explanation of the exact measures that we have taken to support test and protect, and what we will do in the future should case numbers start to rise again, which I hope will not happen.

We work with health boards on an on-going basis to support them in dealing with the variety of demands on their services. We look to use all appropriate facilities and services. As Edward Mountain knows, the health secretary is working through the NHS recovery plan, which looks at how we will recover the position on elective surgeries. That will mean building new, permanent elective capacity as well as tactically using existing capacity. I will ask the health secretary to provide more detail on that.

The new centre for sustainable delivery in the NHS is looking at how we provide healthcare more efficiently, more effectively and with patient care and benefit at its heart—not just in relation to the immediate pressures of Covid but more generally.

I go back to the fundamental point that I have made to several members. It would be wrong for any member not to be concerned about pressure on our health service right now. We all hear those concerns from constituents, and I am acutely aware of them, as First Minister. However, it is not consistent to be concerned about pressure on our health service while arguing for a faster opening-up from Covid restrictions. I ask people to bear that in mind.

I will ask Government officials to raise that with First Bus. It is important that people are still advised about physical distancing. This is not particularly relevant for now, but the matter has also been raised with me by constituents, so I will no doubt be raising it with First Bus in my capacity as a constituency MSP, as I am sure Bill Kidd is doing.

I will come back to Stephen Kerr with the specific answer on the exact legal position, so that I do not inadvertently get it wrong. My advice to people who are in places where other people are around is to wear face coverings as much as possible, because they provide protection. However, I want to ensure that I get the precise detail on the legal point correct for the member.

I simply do not accept that characterisation, although I am not in any way, shape or form complacent about the issues that test and protect will face as cases are at a high level.

I am always open minded to the idea that changes that have been made to the system should be reversed if they are not the right changes. However, the changes that have been made are not about cutting corners; they are about trying to make the system as effective, efficient, productive and fast moving as possible. The greater use of technology is part of that, as is, for example, the use of digital online contact forms for lower-risk cases. We will keep all those matters under review on a day-to-day basis.

We have—to use the phrase that was put to me—surged capacity, principally through the national contact tracing centre, and we will continue to do that.

Those are important issues that I and the health secretary in particular keep abreast of every single day. However, let us not lose sight of the central issue. Test and protect is a key line of defence, but it is not our first line of defence. Our first line of defence is all of us continuing to comply with all the advice and, where they are still in place, restrictions to limit the spread of the virus. That is how we get the virus under control, and we make sure that test and protect can then do the job that it is there to do and that we do not overwhelm our national health service. Let us focus on this proper, responsible and cautious path while we resource test and protect and the other parts of our system accordingly.

I would be happy to look at the paper that the member has published. I mentioned research. Research takes time to conclude, but I am not suggesting that nothing happens between now and then. I am suggesting that, as we develop services for long Covid patients—which we need to do—we do that on the basis of the best advice and expertise about what services will best cater for them. We are absolutely seized of the need to urgently progress that right now, and I am happy to ask the health secretary to engage further on the issues with the member.

My final point is about the central contradiction in the member’s party’s position. I am saying this not for political reasons but because it is so important to the decision making that confronts us right now. The member’s party constantly asks me to emulate what is happening south of the border and to lift restrictions more quickly and in a wholesale manner. As recently as this morning, I read calls for that, as well as criticisms from some members that we are going too slowly. The reason why we want to take a cautious and gradual path through the pandemic is so that we do not unnecessarily increase the number of people who end up living with long Covid and therefore exacerbate the misery for them as well as the pressure on all levels of our health service.

I agree with the member about the need for urgency in long Covid services. However, I find that difficult to align and make consistent with his party’s constant call for us to throw caution to the wind and not bother about what that means for the overall infection rate.

I know that people who are clinically extremely vulnerable are concerned, and I do not imagine for a second that anything that I have said today will take away all of those concerns, because they are real-life concerns. However, I hope that I have given a very strong message that we will not abandon people in that category for the sake of the rest of us getting back to normality and—for example—being able to throw away our face coverings.

We are all experiencing the pandemic differently, but it is still the case that we are all in this together and we have to come through it together. Those who are clinically extremely vulnerable, including those who are immunocompromised, were prioritised for vaccination—I touched on that earlier. The JCVI has also advised that those in the households of adults who are severely immunosuppressed should be vaccinated. The interim JCVI advice recommends that any booster programme should begin in September, to maximise protection in those who are most vulnerable. It is recommended that those who are immunosuppressed be vaccinated in phase 1 of that programme. There is a variety of things that we need to do to build the confidence of people who are clinically extremely vulnerable or immunosuppressed that they, too, can get back a normal way of living, in the way that the rest of us hope to do.

Pre-pandemic, a lot of work was done to increase understanding of, awareness of and confidence in the various roles that make up primary care. Traditionally, we think of primary care as being GPs, but a wide range of people make up our primary care system. We will continue to do that work.

As Stephanie Callaghan is no doubt aware, work has been on-going to promote the need for people, for their own benefit, to go to the best place when they need healthcare, and not always by default to go to accident and emergency departments. Confidence in triaging at GP and other primary care services is an important part of that. I will ask the Cabinet Secretary for Health and Social Care to write to Stephanie Callaghan with the detail of exactly what work is under way.

We have a range of wellbeing support services for staff in our health service, who have gone way above and beyond the call of duty over the past 16 months. They always do, but they have done so especially during the pandemic, which is one of the reasons why we took the decision to give them the best single-year pay rise in the lifetime of the Parliament. The rise was 4 per cent—compared with the rather paltry 1 per cent that Mr Cameron’s colleagues south of the border are offering to the NHS—to acknowledge the debt of gratitude that we owe them. We have also—this is symbolic, and I would not claim that it is any more than that—paid a £500 bonus, which other Governments across the UK have not done.

I come back to the central contradiction that is at the heart of the Conservative argument on the matter. The most important things that we can do to support the NHS are to get Covid cases lower than they are right now and to take a cautious path through the pandemic. That is why the calls that are repeatedly made by the Conservatives to throw caution to the wind and lift all restrictions are so utterly wrong-headed, but also run counter to the absolutely legitimate concerns that they raise about the pressure on our NHS. The calls that they are making, although I take them seriously anyway, would sound more serious if they were backed up by support for the sensible path that we seek to take through the pandemic.