Chamber and committees

That is a very significant and legitimate question. In my answers to Mr Rowley’s completely legitimate questions about expanding the scale of the vaccination programme, I made the point that one of the options could be turning down the dial on elective work and putting more resource into the vaccination programme. If I do that—I do not wish to personalise this, but I will use these distinguished members of Parliament to illustrate my point—Mr Rowley might be more happy, but Mr Whittle will not be. Mr Whittle’s primary concern is the treatment of what I will call non-Covid conditions that are perhaps leading to early mortality because health services are unable to undertake all that we would ordinarily hope they would be able to.

That is why we have to invest in all the precautionary measures possible to avoid the virus circulating. We are not in any shape or form powerless with regard to omicron circulating, because people can come forward for vaccination, which they are doing in substantial numbers, and they can observe the baseline measures on a routine and rudimentary basis in order to put up barriers to circulation.

There are all sorts of steps that we can take. It is incredible to watch what our contact tracers are doing in response to the early cases of omicron. It is jaw dropping to see the degree of intensity with which they are looking at where people have been, whom they have been close to and what is happening around them, to try as much as possible to interrupt the circulation of the virus.

We have to use a variety of devices because, the more we do that, the more activity we will have to try to address the core point that Mr Whittle puts to me.

Yes, the issue has been resolved. I very much regret that some individuals had that experience yesterday. The guidance has changed and it should have been applied in all vaccination centres and scenarios.

In light of what emerged yesterday—I am advised that the issue arose in a limited number of cases—we have reiterated the guidance to all health boards to ensure that all vaccination centres are operating to the new updated guidance, which emerged only at the start of the week.

I regret that some individuals were inconvenienced in that way. The fact that people are so willing to come forward for the booster jag at such an early stage after the change of guidance is an indication of public attitude to participation in the programme, which is welcome. That makes it doubly disappointing that people were inconvenienced in the way that they were.

There is no issue regarding vaccine capacity. Obviously, we have to go through the process of vaccination in an orderly fashion to ensure that it is done efficiently. We have already expanded significantly vaccine availability as part of the programme.

The change in JCVI guidance on Monday increased the number of people who are eligible for a booster vaccination. If memory serves me right, an additional 1.3 million individuals immediately became eligible. Colleagues will understand that we cannot vaccinate 1.3 million people in one day, so we have to increase capacity to move through that as efficiently as possible. Work is under way to ensure that we satisfy the understandable demand that there will be in the community.

Prior to the new JCVI guidance, we were confident that all eligible individuals would be able to secure their booster vaccination before the turn of the year. We are confident that, with the new guidance in place, we will be able to reach that point by the end of January. There will be a period during which people will have to wait some weeks to secure their booster jag, but they will certainly get it earlier than would have been the case in other circumstances, such as if they had to wait 24 weeks after their second vaccination.

I will bring in Professor Leitch because of the clinical nature of some of the points.

Obviously, the vaccine will wane. Over the past few weeks and past two months, there was an increase in cases in the older age groups. Then, when the booster vaccination programme started to kick in for those age groups, the number of cases for them came down more aggressively than for other age groups. Professor Leitch can tell me if I have got this wrong, but I deduce from that that the vaccine was waning but the booster arrested that and gave more protection.

I think that members of Parliament have wrestled with that question for a considerable time. Indeed, Mr Fraser and a number of other members have been pressing the Government to take that step for some time.

The Government wanted to have a scheme in place that would help to boost vaccine take-up, which is why we resisted that move to begin with—it does not suit the purpose of our scheme. For completeness, however, I put on the record that, at the same time, we indicated the risk that Mr Fraser puts to me.

There is a risk here. I cannot deny that. However, the approach is part of the culture that we have to take forward if we are serious as a society about resisting the spread of the virus. We need to test ourselves and follow what the one or two red lines tell us when the test is complete. I encourage members of the public to take the process deadly seriously, and I know that many are doing so. There is very high demand for lateral flow tests, thankfully.

I return to the questions that the convener put to me at the beginning about how seriously people are taking the testing approach. Testing is a very important tool in stopping the circulation of the virus, and it would not be right for somebody to report a test result that was inaccurate. If Mr Fairlie will forgive me, I am not sure that it is for me to decide what is fraudulent and what is not, but that would not be the right thing to do, because it would undermine the purpose of the scheme and the taking of the test. I encourage members of the public to test and to report the findings accurately.

It is everybody. Personally, I am now undertaking lateral flow tests much more frequently. I was doing them twice a week, but I am now doing them much more frequently because of the degree of interaction that I have in the course of my work. I have no social life, but—

It would be best if Professor Leitch responds to those.

With a programme of such magnitude, there will be a phenomenal number of operational issues. We must bear in mind the numbers that we are talking about. More than 10 million vaccinations have now been undertaken. What has been achieved in the programme has been a colossal undertaking. I pay tribute to the staff who are delivering the vaccinations and those who are organising the programme, because it is not a simple logistical exercise.

Mr Rowley raised several points that need to be addressed, the first of which relates to the tweet that he mentioned. We have reiterated the guidance to health boards, and it is important that that guidance is applied in all scenarios and circumstances on the ground. I will take away the fact that an example has been raised with me where that message has clearly not reached all the distribution points for the vaccination programme. Obviously, there has been a change of circumstances and the advice is relatively new, and it takes time for those messages to be put across. However, I will make sure that the issue that Mr Rowley raised is taken up.

The second point concerns the capacity questions. When I answered Murdo Fraser, I said that there was certainly capacity in terms of the availability of vaccines. There is adequate provision of vaccines; the question is about the best means of administering the programme at a local level. Of course, there is a range of options for how we might go about doing that. There are probably three main options: a drop-in service; self-selection of appointment via the online portal; and setting appointments via letters from health boards.

There are upsides and downsides to each option. For example, sending out letters gives an order and an organisation to the programme, but the downside is that it takes time to get the infrastructure in place to administer and distribute the letters, and there will be a reasonable level of did-not-attends.

The portal option, which we are using, can give people a choice about when their appointment is. I was able to choose to go to Blairgowrie town hall on Sunday morning, which suited me down to the ground, and I have now had my vaccination. However, for some people, digital access is a challenge and other people might find that they cannot find an appointment that suits their choices.

The drop-in option, as Mr Rowley has recounted, can be quite challenging if too many people decide to drop in at the same time. The vaccination centre in Kirkcaldy was quiet this morning, as we heard from the member of the public whose tweet Mr Rowley quoted, but the vaccination centre in Dunfermline that Mr Rowley went to on Tuesday night was busy. The smoothing of demand is difficult with a system that has only drop-in appointments.

We have tried to opt for a means of balancing out the best of those options as far as possible. When I went on Sunday morning for my vaccination, the couple after me were drop-in candidates. They were not in a different queue; they were right behind me and they got taken right after me.

We are trying to work through every possible practical permutation to maximise access. Obviously, if the 1.3 million people who are now eligible for a vaccine decide to drop in for a vaccination today, there will not be adequate places. We are therefore trying to balance the vaccination programme over the country with a number of mechanisms to enable us to maximise participation in it.

We have a mass vaccination programme, which is under way. We are distributing in excess of 60,000 vaccinations daily in Scotland. We are the most vaccinated part of the United Kingdom, with the highest levels for first, second, third and booster vaccinations. We have a comprehensive mass vaccination programme.

The Government is looking at the situation from health board to health board, and the health boards have submitted plans to intensify the vaccination programme. Dialogue continues between the Government and health boards to maximise that capacity. The programme must take place in a variety of geographies and scenarios across the country. I assure Mr Rowley that we are trying to maximise the capacity of the vaccination programme, but he must accept that there is a challenge.

The two pieces of information that Mr Rowley has just given the committee highlight that challenge: before 11 this morning it was quite quiet at the Kirkcaldy vaccination centre, but last night, between five and eight o’clock at the Dunfermline vaccination centre it was very busy. That illustrates the challenge of operating such a programme. We are providing capacity. In Kirkcaldy this morning, drop-in appointments could be fulfilled because it was quiet, but in Dunfermline on a Tuesday night that becomes more problematic. I assure Mr Rowley that every step is being taken to maximise the programme.

Professor Leitch has been involved in work to expand the pool of individuals coming forward to deliver the vaccination. I will ask him to say a bit about that in a moment. The more that we draw in people from within the health service from other disciplines to administer the vaccination programme, the more that we will have to address the issue of what other services the national health service can deliver. If, to deliver the vaccination programme, we draw in healthcare staff who usually deliver elective activity, we will obviously reduce the capacity for the elective work of the national health service. I know how much it matters to the public and to members of the Parliament that we do as much elective work as we can. Jason Leitch might need to get more detail on that.

That last point completes the proportionality argument. At some point, we have to make a call that, on the basis of the best clinical assessment that we can get of the three factors of vaccine escape, transmissibility and serious illness, this is the moment to act. I accept that we might not have all the demonstrable evidence—or, indeed, the conclusive certainty—to support such a conclusion, but the fact is that the Government has been making such judgments since March 2020.