Chamber and committees

The four harms framework to which Mr Mason refers, which we put in place in the summer of 2020, has been an essential guide in ministers’ decision making. It has enabled there to be a transparent and open conversation with the public and a range of interested parties about the nature of the decisions that have had to be considered.

In March and April 2020, direct Covid health harms were exclusively determining the decision making, because we were in such an acute moment of crisis. From the summer of 2020 onwards, we have sought to strike a balance across the four harms. That is reflected in the strategic purpose of the Government’s agenda, which is to try to manage the Covid pandemic in a way that enables people to appreciate and enjoy as many aspects of normal life as possible, and it remains the rational and considered approach that the Government should take.

If we disregarded direct health harm, the health service would be overwhelmed before we knew it. That would have been the case in December with omicron. If the Government had ignored the direct health harm, the health service would have been overwhelmed—there is no doubt about that in my mind—and the degree of direct health suffering would have been much greater for members of the public. Not many people in society would think that that was a rational approach for the Government to have taken.

The strategy that we have adopted has been to take difficult but evidenced and considered decisions on the balance of the four harms in order to protect public health while enabling people to appreciate and enjoy as much of normal life as we could hope to achieve in the context of a global pandemic.

In the interests of time, I will not put any further points on the record.

Thank you, convener. I am grateful to the committee for the opportunity to discuss a number of matters, including the updates to the Parliament on Covid-19. I will make a brief opening statement.

As the First Minister set out on Tuesday, although omicron continues to cause high levels of cases and we must maintain proportionate protective measures, the data that we are seeing gives us confidence that we have turned the corner on the omicron wave. Although the number of cases remains high, we continue to see a reduction in cases across most age groups. Admissions to hospital of people with Covid, albeit still too high, are now falling.

The success of our vaccination programme, the willingness of the public to adapt its behaviour, and the temporary protective measures that were introduced in December have all helped to limit the impact of the omicron wave. That is positive news but, given how infectious omicron is and the impact that it is having on our society, we must remain careful and cautious as we continue to lift additional protective measures in a phased approach.

The First Minister confirmed that, from Monday 24 January, the remaining statutory measures that were introduced in response to omicron will be lifted. Those include the requirement for table service in certain hospitality settings and the closure of night clubs. Non-professional indoor contact sports can also resume from Monday.

Although it remains sensible to stay cautious in our social interactions and to prioritise whom we meet, the First Minister also confirmed that the guidance asking people to limit indoor gatherings to three households will be lifted. Our advice remains to take a lateral flow test, and to report the result, whenever meeting others. Reporting test results, including those that are negative, will ensure that we are able to make better assessments of the trends in infection.

The Covid vaccination certification scheme will remain in place for events and venues that were previously covered by it, and we are asking event organisers to check the certification status of more people who are attending events. This week, the Cabinet agreed not to extend the certification scheme, given the improving situation. For the time being, baseline measures, such as wearing face coverings in indoor places and working from home, when that is possible, will remain in place. The requirement for businesses, service providers and places of worship to take reasonable measures to minimise the spread of Covid on their premises will be retained, at this stage, to help keep Covid contained as the current wave recedes.

Our vaccination programme continues, and I encourage anyone who has not yet had their first, second or booster dose to do so as soon as possible. Getting fully vaccinated is the most important thing that we can do just now to protect ourselves and each other.

The First Minister said on Tuesday that we are entering a calmer phase of the epidemic. That will allow us to consider the adaptations that we might need to make to build our resilience and to manage the virus less restrictively as we move into an endemic phase in the future. We have not yet reached the endemic phase and must remain cautious, given the uncertainties that lie ahead.

I am happy to answer questions from the committee.

The last cost that I saw was something of the order of £3 per test, but I stand to be corrected by one of my officials.

I recognise the significance and sensitivity of the points that Jackie Baillie is raising with me. I will draw on input from Professor Leitch in addition to what I say, but first I will try to provide some reassurance.

The advice that emerged from clinicians—I stress that it was clinical advice that led to the decision to pause fertility treatment—was based on what was overwhelming evidence that indicated that the necessity for vaccination was critical in those circumstances. That was certainly my reading of it. I do not have all the details in front of me, but research was undertaken on the proportion of pregnant women who were admitted to critical care as a consequence of Covid. From my recollection, well over 90 per cent of those cases were women who were unvaccinated. The clinical evidence was overwhelming in that respect, which led to the pause. I quite recognise the distress and upset that that would have caused to the individuals who were affected.

There should be good explanation of the rationale. I have looked at the material and I have seen very clear and well-expressed clinical opinion and evidence on the subject. That should be shared with individuals in all circumstances.

The second question that Jackie Baillie asked was on the resumption of fertility treatment. That will happen as soon as the vaccination programme has delivered the degree of protection that we consider necessary in the context of the omicron wave.

I will seek clarification from Jason Leitch but, on the last question, I think that the Government has made it clear that there will be no disadvantage to any women who were going through fertility treatment. They will not in any way lose out on the opportunity to pursue that fertility treatment because of the pause in arrangements that has been put in place. I would be grateful for Professor Leitch’s input on that question.

The Government’s position is that we will not mandate people to have a vaccination. It is a voluntary programme. An individual organisation is free to take such an approach, but I would counsel that it needs to engage constructively with its employees on such questions, because the issues around approaches of that type will undoubtedly have an effect on who would be eligible and available for employment in such a context. It is up to individual employers to undertake those discussions.

Professor Leitch can provide some of the epidemiological information. A huge amount of surveillance data is still available to Government. Substantial numbers of PCR tests are still being undertaken, there are wider studies, and scientific information is exchanged across a number of jurisdictions, all of which enables us to create a commanding picture of the available information. The detection of the omicron variant was made far more practical by the correlation with the S-gene dropout element of the assessment.

There will be a range of scientific interventions that we can make to ensure that that situation continues. Professor Leitch can provide more data.

I am not sure that it would be necessary to have the provisions in one act. The provisions in the 2008 act for the purposes of a small localised outbreak are a perfectly sustainable and effective set of provisions. The gap relates to pandemic provisions, where there is a more extensive requirement. It is entirely fair and appropriate for Mr Mason to raise the longer-term issue.

The bill ensures that health boards are protected from the significant financial and administrative burdens that they would face if the modifications were not to be continued. I hope, therefore, that Parliament will agree to the general principles of the bill.

I move,

That the Parliament agrees to the general principles of the Coronavirus (Discretionary Compensation for Self-isolation) (Scotland) Bill.

I encourage Jackie Baillie to get over the difficulties that she had in the previous session of Parliament, because the Government was more than transparent and open with Parliament. I encourage her gently, in the nicest possible way, to move on. She will have a happier life if she does so.

I thank members of Parliament for their engagement on the issue. It is a substantial issue, because there was a danger that the important work of our health boards in focusing on and addressing management of the health emergency could have been diverted by the application of provisions that would have been an administrative and financial burden on them. I appreciate that members across the political spectrum have recognised the importance of that point and are committed to supporting the bill.

The Government will engage on the issues that arise at stages 2 and 3. I look forward to engaging on those points with Parliament, in due course.

I am pleased to present the Coronavirus (Discretionary Compensation for Self-isolation) (Scotland) Bill and to set out the rationale for introducing it.

I am grateful to the COVID-19 Recovery Committee for its consideration of the bill and for the opportunity to discuss the bill with it, and I am grateful to the Delegated Powers and Law Reform Committee for its assessment and valuable contributions. I am also grateful to the various stakeholders and members of the public who have provided their views.

The bill relates to provisions in the Public Health etc (Scotland) Act 2008, which confers a duty on health boards to provide compensation to people who have been notified to isolate as a result of an infectious disease and to carers of such people. That power was intended to apply to small-scale outbreaks, such as E coli outbreaks, in which a small number of households may be isolated for a short period of time and may lose out on income as a result. It was never intended to apply in a global pandemic such as Covid-19. Had the duty not been suspended at the start of the pandemic, health boards would have faced the need to deal with a significant financial and administrative burden, rather than managing essential care and fighting a pandemic.

For that reason, in March 2020, the UK Coronavirus Act 2020 modified the duty on health boards to pay compensation so that it became a discretionary power. Health boards now have the option to provide compensation to those who are isolating, and to their carers, should they wish, but they are under no obligation to do so. The bill maintains that position until the end of October 2022 for coronavirus isolation only, with regulation-making powers included for Scottish ministers so that they can either enable the early expiration of the modifications or prolong them as required. Should we want to keep them beyond the expiry date for which the bill provides—31 October 2022—an affirmative vote of the Parliament would be required.

The Scottish Government recognises that people who are notified to self-isolate as a result of Covid-19, especially those on low incomes, may require support. That is why we have put in place financial and practical support for people who are self-isolating. That support includes the self-isolation support grant, which is a one-off payment of £500 for those who are isolating as a result of Covid-19 and earn the real living wage or less, and practical support such as the local self-isolation assistance service, which helps with food and essential medical deliveries, social support and practical advice. That support has been distributed to those in most need on low incomes.

As of the end of November 2021, the latest month for which we have data available, 56,317 grants of £500 each have been provided to people on low incomes who have been asked to self-isolate. That means that more than £28 million has been awarded in self-isolation support grants. That established support for isolation as a result of Covid-19 will continue for as long as necessary. The bill relates purely to whether the current suspension of the compensation duty in the 2008 act should remain in place.

The Scottish Government has conducted an indicative analysis of what the cost to health boards would be should the bill not be passed and the original 2008 act compensation duty be restored. According to that indicative analysis, the cost of reverting to the 2008 act would be approximately £320 million per year.

In addition to the cost of compensation, health boards would require significant administrative resource for processing and evaluating each claim. Those are not additional challenges that health boards, which are rightly focused on managing pandemic pressures and providing essential care, should be required to meet, nor could the Scottish Government provide that financial support from within our fixed budget without a substantial impact on public services and on the financial support that we have provided to business in response to the pandemic.

The Scottish Government has conducted a public consultation and engaged with key stakeholders on the bill. A full consultation analysis and response is available on the Scottish Government’s website. We have ensured that any requirement to extend the modifications of the 2008 act under the bill is subject to appropriate parliamentary scrutiny. Should the modifications still be required after October 2022, an affirmative vote of the Parliament would be required. Scottish ministers would also need to lay a statement of reasons before Parliament, explaining why the modifications were being retained for a further period of time.