Chamber and committees

I want to helpfully engage with Mr Whittle’s question, but I want to push back on one bit of the terminology that was used. Mr Whittle suggested that the Government was focusing on Covid rather than on other health conditions. I reject that as a characterisation of what the Government is doing. The Government is trying—and this relates to my answer to Mr Fraser earlier—to wrestle with all the health challenges that we face as a country. Some of them are about Covid and some of them are about other factors. I accepted in my answer to Mr Fraser that some of the other conditions that have always been with us, are still with us and will be with us tomorrow are attracting less attention and capacity in the health service because the health service is also having to deal with Covid. That is my pushback on the characterisation. We are trying to deal with everything, but Covid presents an extra volume of activity. Professor Leitch’s response to Mr Fairlie about ICU in a sense makes that point. We had 200 ICU beds before Covid. We now have 270, but 70-odd are occupied by Covid patients. We have expanded the capacity of the health service beyond what we would normally have, but all the extra capacity has been taken up by Covid.

I think that underlying Mr Whittle’s question is a fair and reasonable observation, which is that the longer what one might call routine procedures, such as a knee replacement or a hip replacement, are delayed for an individual, the greater is their recovery from the weaknesses and challenges that they may be facing now. For somebody who is finding it difficult to be mobile because they need a new hip, it will become more acute and more challenging the longer they have to wait for a hip replacement. Obviously, if they have a hip replacement—I know, because my father has had a hip replacement—the difference in mobility pre and post is colossal. My father has had years and years of extra ability to scoot about, which has been good for him in every respect. That is the fundamental problem, but we do not have an easy answer to it because Covid has to be addressed and other cases have to be addressed. Then you will have examples such as the case of Mr Fairlie’s constituent, which are life threatening; we have to make sure that they have priority over some other conditions that are enormously painful for individuals but are not immediately life threatening.

I would have thought that the collection of data is appropriate, but I will take that point away and take further advice from health officials. Professor Leitch might want to add to my comments, but I will look at that. I would have thought that the data gives us information. For example, we will know from existing data the number of patients who are considered to require particular treatments. We will know how many patients are waiting for hip replacements, for example, and who have been referred through the system. We will know how long they have been waiting and how much longer they are waiting than they would have waited pre-Covid. Such data will exist, but I will explore the points that Mr Whittle raises with me.

Mr Whittle and I are in agreement that the question is fundamentally about balance. It is about how much of the resource of the health service is required not just to support people with Covid but to do other things associated with it. To vaccinate 65,000 people every day, we need trained clinical staff to be not in hospitals but in places such as village halls. We need them to transfer to do that because vaccination is an important bulwark against the virus. However, if clinical staff are delivering vaccinations, they are not delivering other kinds of healthcare that we might want them to deliver in another setting.

We are trying to maximise the available resources to ensure that all health conditions are adequately met and addressed, but I have to accept that that places increased strain on existing health services and the way in which they operate. The consequences are that patients may well have to wait longer for treatment.

This varies to some extent around the country, but health boards have looked at the scale of the challenge that is involved in rolling out the booster vaccination programme and the performance has been quite extraordinary. Yesterday, more than 65,000 vaccinations were undertaken in Scotland, and that is now a pretty routine daily figure between flu and the booster jag. There is a range of different models, involving larger centres, smaller facilities in smaller communities and also distribution at very local levels to individual homes or care homes and those who cannot access other centres. That programme is being pursued and rolled out. I assure you that everybody who needs to be covered will be covered by that programme. It may take slightly longer to get around a volume of home visits at the same time as we are taking forward large-volume distribution of the vaccine, but I am certainly very happy to explore what additional steps can be taken to address the issue that Mr Fairlie raises to ensure that individuals are receiving the vaccine when they are required to.

I am engaging actively with bereaved families in preparation of the inquiry’s remit. The families have had the opportunity to submit responses to the consultation that we undertook on its terms of reference, and I have had a number of meetings with different groups of bereaved families. We will continue that engagement as we progress towards agreement of the remit.

Once the inquiry is established, it will be for the chair of the inquiry to determine the role of particular relevant parties, and it would be wrong for ministers to prescribe that. That approach is set out in the terms of the Inquiries Act 2005, and any chair who is appointed will operate on that basis. My view, and what the Government will set out to the inquiry’s chair, is that we want the families who were bereaved during Covid to be central to the issues that are raised in the inquiry.

Part of the judgment is about ensuring that we have sufficient resilience in the measures that we have in place to protect the population against wider impacts that could be damaging to the public health of the country.

On many occasions, we have gone through the dilemmas that the Government faces. The principal dilemma is about the damage to health, and—[Interruption.] We have had countless demands, even from heckling Conservative members, for us to protect public health. When the Government comes forward with measures to protect public health, we are criticised for bringing forward those measures. Such are the dilemmas that we face.

Mr Simpson says that there is no evidence. If Mr Simpson wants to ask me a question, he is perfectly entitled to appeal to the Presiding Officer to be invited to ask a question. I am always here to answer questions. What evidence does Mr Simpson need? How much evidence of the harm to public health does he need for the Government to have to act? If Mr Simpson wants to stick his head in the sand, he is free to do so, but the Government has a duty to act proportionately to protect the health of the population.

Mr Rowley is correct to say that he and I have had exchanges on the issue. I know the seriousness that he brings to these exchanges.

The challenge that the Government, our local authority partners and service providers are facing up to relates to having adequate capacity to deliver the social care support that is required in the community. That is partly because there are few people around to do that because of the ending of free movement. Mr Rowley acknowledges that that is part of the problem, and I accept that it is part of the problem.

The Government has already taken steps to increase social care workers’ pay. I appreciate that Mr Rowley does not believe that that is sufficient, but we have taken steps to do it. We will continue to keep the matter under review, and we are in active dialogue with our local authority partners on what further steps we can take to improve the situation.

Mr Rowley is absolutely correct. If we do not address the fact that some people are currently in hospital who could be at home with an effective social care package, we will have greater congestion in our hospitals and will therefore weaken our resilience in dealing with winter pressures and Covid, as the months pass. I take seriously the points that Mr Rowley has raised and I assure him of our determination to address them—

The Scottish Government is committed to publishing a plan for how we will deliver and report on the actions set out in the Covid recovery strategy before the end of 2021, and for subsequent quarterly reporting of progress, thereafter. The plan will be agreed with the Convention of Scottish Local Authorities to ensure successful and collaborative delivery to support the people across Scotland who have been most affected by the pandemic.

The impact of Covid-19 on Scotland’s public services, people and places is well understood, and it has driven the Scottish Government’s response to tackling the wide-ranging harms that the pandemic has caused.

We continue to work closely with our partners across local government and service providers to monitor closely the impact of the pandemic on services across Scotland, particularly as we prepare for wider winter pressures. The “Scottish Government Health and Social Care Winter Overview 2021-2022” outlines a package of over £300 million of investment in national health service and care services this winter to help to address those pressures.

The recently published “Covid Recovery Strategy: For a fairer future”, in addition to specific proposals for the NHS, justice and education, was developed in recognition of the huge impact that the pandemic has had on services, workers and the people who use the services.

Obviously, I am not familiar with the evidence that the committee took this morning, but from my experience as education secretary, I am familiar with the volume of data that was available prior to the pandemic. I should point out that a lot of it was resisted by the Labour Party when it was first put in place; the Labour Party was completely hostile to the level of reporting on such measures that I put in place. That was before the pandemic.

We have taken a proportionate response in the education system to ensure that teachers are not being asked to provide information on the capacity of pupils when they have not had adequate opportunity to engage with pupils because of the disruption to learning.

One thing of which I am absolutely 100 per cent certain is that every teacher in the country is focused on ensuring that the learning needs of children are being met. That is something that the Parliament should applaud.

By the end of this year, the Scottish Government will establish, under the Inquiries Act 2005, an independent Scottish public inquiry to scrutinise decisions that were taken in the course of the pandemic and to learn lessons for the future. That will include a statement to the Scottish Parliament on the appointment of the chair and on the terms of reference for the inquiry, in accordance with the requirements of the 2005 act. The Scottish Government remains committed to working with the United Kingdom Government to develop the approach to the UK-wide inquiry, avoiding—where possible—duplication and overlap.