Chamber and committees

We certainly need to make sure that individuals are aware of the provision. After I did my lateral flow test this morning before I left the house, I received an email from the NHS to confirm that it was negative, thankfully. That email also gives a link to information on self-isolation support, so there is a direct connection that promotes the information regularly.

I accept that there are other avenues for us to communicate the messages. Members will hear from the advice that the First Minister gives in parliamentary and media briefings that there is a significant emphasis and attention on the provision of the self-isolation grant. However, I will certainly take away Mr Mason’s point that there might be a case for us to look in greater depth at how we can further promote the availability of the grant, and I will endeavour to do that.

I am grateful for the opportunity to discuss a number of matters, including updates to Parliament this week and last week on Covid-19. As the First Minister set out on Tuesday, omicron is spreading rapidly and presents a significant challenge. We know that omicron is significantly more transmissible than delta. As it becomes the dominant strain, its much higher reproduction number, or R number, will also dominate, which will drive a steeper increase in cases.

It is important to be clear that, even if omicron proves to be milder than delta in terms of severe illness, a much more transmissible infection is likely to place a significant burden on the national health service. More people infected will result in more serious illness and, tragically, more people will die as a consequence.

A significant rise in cases will also result in many more people being off work due to mild illness and isolation. The impact on the economy and our ability to deliver critical services will also be severe. That is why we must take omicron extremely seriously and respond appropriately to mitigate its impacts on our society and economy.

Our vaccination programme is central to our response. Getting fully vaccinated is the best thing that we can do to protect ourselves and our loved ones. Scotland remains the most vaccinated part of the United Kingdom, and we are taking steps to deliver boosters even faster. That is the Scottish Government’s top priority. Everyone aged over 18 can now book their booster through the online portal; our aim is that everyone who is eligible will be able to book an appointment by 31 December.

In addition to vaccination, the Scottish Government has introduced further proportionate protective measures that are necessary to slow the spread of omicron. We are requiring businesses, service providers and places of worship to take reasonable measures to minimise the incidence and spread of coronavirus. Guidance will be issued this week to make clear what that means for different sectors, but it will include physical distancing and other protective measures, and enabling staff to work from home wherever possible. The First Minister outlined the additional support that is being made available for businesses—particularly in hospitality and food supply—that are affected by advice regarding work Christmas parties. We will work to make that support available as soon as possible.

We are also asking everyone to reduce their interactions with others as much as possible and limit the number of households meeting together to a maximum of three. Omicron has a very high attack rate, which means that if just one person in a gathering is infectious, they are likely to infect many more people in the group than was the case with the delta variant. Reducing the numbers of people and households gathering together will help to limit the extent of its spread.

The First Minister made clear that Christmas is not in any way cancelled and that we are not asking people to change their plans for Christmas day—or Christmas eve or boxing day, if that is when they celebrate. We want people to be able to celebrate with their loved ones as safely as possible. That means that we all need to limit the number of people and households we meet indoors, take a lateral flow test regularly, wear face coverings properly where required, maintain good hygiene, work from home wherever possible, and ventilate indoor spaces.

I am very happy to answer any questions that the committee may have.

The central point of and necessity for the bill is that the provisions of the Public Health etc (Scotland) Act 2008 were designed for isolated requirements of self-isolation. Those were envisaged for an E coli outbreak in a small locality or a case of that nature.

In general, over the years, about 30 payments have been made under the terms of the 2008 act in those circumstances. The act was not designed for a pandemic. It requires each case to be assessed. The provisions of the act not only provide for a much larger cost to the public purse but would be administratively overwhelming for the national health service. The NHS is absolutely focused on dealing with the pandemic and the wider delivery of healthcare services. For it to then have to deploy massive administrative resources on the evaluation of cases consistent with the 2008 act would, to be frank, overwhelm it.

We have had to make a pragmatic decision to make payment available to those who require it in a way that is sustainable financially and administratively for the NHS. That is why the bill is a necessity.

The First Minister has brought up that issue with the United Kingdom Government and has tried to make progress on the legitimate issues that Mr Mason has put to me. It is right that effort is being made and measures are being put in place across the globe to protect all populations.

The disparity between developed countries and developing countries is, frankly, indefensible. There must be a combined global effort to enable progress, and the First Minister has certainly given her support to those endeavours. She has engaged with those organisations and made representations to the UK Government, and we will continue to do so.

It is critical that we handle the matter with a dispassionate, evidence-based approach. Throughout the pandemic, we have listened with care to expert opinion. Mr Whittle is correct to say that experts will debate some elements, but I am satisfied that our chief medical officers and other senior advisers have produced a body of well-considered, thoughtful and accurate advice on the nature of the pandemic.

The advice in the briefing last night by the United Kingdom chief medical officer, Professor Chris Whitty, and in the evidence presented by our own chief medical officer and national clinical director and their teams, is absolutely consistent. I do not accept the idea that there is a lack of clarity or consistency in the messaging about the severity of the threat that we face, because the advice is clearly marshalled for the public to see.

The question, then, is what we should do in the light of that advice. That is where there are some genuine difficulties. The First Minister was clear on Tuesday that she would have liked us to have gone further, but we are constrained from going further because of our inability to adequately compensate people who would be affected by certain decisions.

That is not me in any way making a partisan remark; it is a recognition of the reality that the measures that we consider to be appropriate, given the gravity of the circumstances, are not reflected in the United Kingdom Government’s decision making. That is despite the fact that the clinical and epidemiological advice that we and the UK Government are receiving is absolutely consistent about the severity of the threat that we face.

It might help if I place on the record some detail.

Following the clinical concerns about the levels of the omicron variant being reported across Africa, the international travel instruments that are before the committee reintroduced restrictions to allow the joint biosecurity centre more time to engage with African authorities and access richer data to inform its risk assessment.

The Health Protection (Coronavirus) (International Travel and Operator Liability) (Scotland) Amendment (No 8) Regulations 2021, the Health Protection (Coronavirus) (International Travel and Operator Liability) (Scotland) Amendment (No 9) Regulations 2021 and the Health Protection (Coronavirus) (International Travel and Operator Liability) (Scotland) Amendment (No 11) Regulations 2021 added 11 countries to the red list in line with the latest UK Health Security Agency risk assessment, with changes being agreed on a four-nation basis. Travellers from those countries are required to enter managed quarantine hotels on arrival into Scotland and take tests on day 2 and day 8 after their arrival.

The Health Protection (Coronavirus) (International Travel and Operator Liability) (Scotland) Amendment (No 10) Regulations 2021 removed the option for travellers to take an LFD test and required that they must take a PCR test within the first two days of arriving into Scotland and self-isolate until the result of the test is known.

The Health Protection (Coronavirus) (International Travel and Operator Liability) (Scotland) Amendment (No 12) Regulations 2021 reintroduced pre-departure testing for all travellers regardless of vaccination status and extended it to new groups, including some children, that were previously not included. They also reduced the period within which a test can be taken before travel from three days to two.

As the committee is aware, the international travel rules are subject to regular review on a four-nations basis. That review took place at the start of this week. The temporary additions to the red list were proportionate as an immediate response to limit importation of the new variant, but the rapid growth of omicron cases across the world meant that it was appropriate at this point to remove the 11 countries from the red list from 4 am on Wednesday 15 December.

Following clinical advice from senior clinical advisers, it was also considered appropriate that individuals in managed quarantine with a negative day 2 test and no subsequent positive test should be eligible for release from 4 pm on Wednesday 15 December.

Those are among the central dilemmas that ministers wrestle with at all times. I have been open with the committee about the fact that the Scottish Government would like to take more substantive measures, but we must be mindful of our obligations across all the various harms that are associated with Covid. If we take action to address the direct health harm of Covid, as Mr Rowley reasonably suggests that we should, that may result in social and economic harm to members of society, which the Government must be in a position to defend as proportionate or to ameliorate through some form of compensatory intervention.

We are trying to maximise the compensatory interventions that we can make through the resources that we have allocated, but we would be in a stronger position if the approach that we believe is necessary, which the Welsh and Northern Ireland Governments also believe is necessary, was shared by the UK Government. Candidly, the challenge that we face here is that we cannot align the scale of intervention.

I have said to the committee that there might be circumstances in which the Government has to take further action. We might well have to do so because of the gravity of the situation, but we must be cognisant of the various harms that people might suffer.

My final point echoes what I said in response to the questions that Mr Fairlie raised with Professor Leitch. I am increasingly concerned about the notion that is being put about that omicron is a less severe variant than delta and other previous variants. That is a complete misnomer, because—this was the central point of my opening remarks—the transmissibility of omicron will result in a discernibly higher level of cases in Scotland and other countries than has been the case before. We are seeing that in the daily numbers, and I am sure that we will see that again today. Even a small proportion of that much, much larger number of people with the virus ending up in hospital will give us a severe challenge in our hospital system and in the delivery of public and private services in the period to come.

I entirely understand where Mr Rowley is coming from. He makes an entirely accurate point that, if cases rise to such an extent that we are seeing happening and which we fear and that our modelling suggests will happen, there will be a massive threat to the delivery of a range of public services. That will affect the NHS, which will face colossal pressures, and our ability to deliver routine public and private sector services will also be severely impaired if omicron develops in line with the worst-case scenario.

I understand the pressure that Mr Rowley puts on me for an assertive stance to be taken with the UK Government; believe you me, that is being done. It is being done publicly by the First Minister and by ministers; it is being done privately by the First Minister and ministers. At all times, we are wasting no opportunity to put that point to the UK Government in our interactions. In the four nations call last night, the First Minister reiterated those strong arguments, as did the First Minister of Wales and the First Minister and Deputy First Minister of Northern Ireland. Those points are being made forcefully to the UK Government. That is the approach that we are taking and we accept the gravity of the situation that we face.

Mr Rowley and I come from different political stables, but he and I share many similar political outlooks. The conclusion that I draw from all this is that our Parliament should be able to take the necessary decisions to deal with all the implications of the health emergency. That is, and always has been, my position. The gravity of the situation that we face—Mr Rowley is raising issues that require me to go into this territory—demonstrates why this Parliament has to be able to have access to much more financial flexibility and responsibility than is currently the case.

The Government has increased the available resources for social care salaries. I value the work that is undertaken by the sector. I do not think that the issues that Mr Rowley raises about the gender composition of the social care workforces are in any way a legitimate issue to drive those questions. We have taken steps to increase pay in the social care sector. As a society, we face enormous challenges in the labour market about the volume and availability of people across a range of sectors, of which the social care sector is one.

The Government will continue to work with local authorities and health and social care partnerships on that. Mr Rowley suggested a task force to address the issues. I am not convinced about that, because we know what the problem is, we have to get on with delivering and we need our health and social care partnerships to be supported to do that. That is exactly what the Cabinet Secretary for Health and Social Care and the Cabinet Secretary for Social Justice, Housing and Local Government are doing to enable that to be the case.

Thank you, convener. I would like to briefly set out the purpose of and background to the Coronavirus (Discretionary Compensation for Self-Isolation) (Scotland) Bill.

At the start of the pandemic, we took steps to suspend the duty on health boards that is set out in the Public Health etc (Scotland) Act 2008 to pay compensation to people that they ask to self-isolate. As it became clear that the coronavirus pandemic would require a very large number of people to self-isolate, the measure was vital to ensure that health boards were not subject to significant financial and administrative resource impacts.

The suspension of the duty is contained in the United Kingdom Coronavirus Act 2020. Many provisions in the 2020 act are due to expire in spring 2022, and the bill takes steps to ensure that the suspension of the duty to pay compensation remains in place. Given the recent increase in cases of omicron, that is vital to ensure that health boards are not subject to additional financial and administrative impacts as they continue to provide key public health and health services.

Members will be aware of the existing support for isolation, which includes the self-isolation support grant. That is a one-off payment to those earning the real living wage or less who are notified to self-isolate. That vital support to those on lower incomes helps them to financially weather a period away from work.

Other forms of practical and social support are available, including the local self-isolation assistance service, which provides help to those who need it with things such as essential medicine and food delivery at a local level, and the coronavirus national assistance helpline, which is available to help with any queries relating to Covid-19.

Scottish Government analysts have estimated the cost of reverting to the 2008 act’s power while we are experiencing high levels of cases to be about £380 million, which is 20 times the budget for the self-isolation support grant. For that reason, and to prevent financial and administrative burdens on health boards as they seek to exit the pandemic, the Scottish Government believes that the bill is a necessary step to ensure that we can continue to provide support and protect health boards as they provide essential care.

The cost estimate was undertaken prior to the recent emergence of omicron and will be revised in line with updated modelling. It is likely that the estimate will increase significantly. At this vital time, it is important that we protect our health boards and ensure that that vital support continues.

I look forward to answering questions from the committee.