Health, Social Care and Sport Committee (Virtual)

Meeting date: Tuesday, January 18, 2022

Official Report 701KB pdf

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Public Health Protection and Health Security (Common Framework)

Our third agenda item is evidence on a provisional common framework on public health protection and health security. I welcome to the committee Humza Yousaf, the Cabinet Secretary for Health and Social Care, who is joined by Erin McCreadie, the Scottish Government team leader on sexual health and blood-borne virus and infectious disease.

Cabinet secretary, the backdrop to my question is the response to the pandemic, when the common framework was not in place. Many of us want to know whether the framework would have made any difference to the Scottish Government’s ability to respond in the way that it did. Does this common framework still leave room for a differentiated response by the Scottish Government to public health threats in the future?

Good morning to you, convener, and to all committee members. I hope that you are all keeping safe and well.

You have come straight in with tough questions. I am not surprised that you are asking such key questions. I will take them in the order in which you asked them.

It is difficult to answer whether, if the framework had been in place at the outset of Covid, it would have significantly changed the response of the four nations. I suspect that it would not have done because the data sharing with the United Kingdom Government has been good. It has evolved as we have gone through the pandemic, but it has certainly been good in my time as Cabinet Secretary for Health and Social Care. Of course, I was in the Cabinet in a different role at the beginning of the pandemic, so I know that it was good previously.

The collaboration between the four nations in response to the pandemic has been good, although there have been times when it has been of concern. We have raised those concerns, sometimes in private and sometimes publicly. That is well understood, but, on the whole, the four nations’ collaboration and sharing of information on the pandemic has been good. That does not mean that it will always be thus. Therefore, whether for the pandemic, which still has to run its course, or for any future public health threat—goodness forbid—it is important that we have the framework underpinning the principles of that collaboration.

The second part of your question is equally important. Again, I stress that, although the framework has overarching principles, it does not prevent any of the four nations from acting in a different way if it wishes to do so. In essence, the framework is policy neutral. It does not prevent the Scottish Government, the Welsh Government, the Northern Ireland Executive or, indeed, the UK Government from taking decisions that diverge from those of the other home nations.

That is helpful. Thank you for outlining that.

We will move on to questions from Gillian Mackay on the role of Parliament and, indeed, the committee.

Cabinet secretary, will implementation of the framework impact on parliamentary scrutiny and decision making in the policy area? If so, what impact will it have?

I expect that the Parliament will have no less of a role than it had under the previous system. The Scottish Government is absolutely open to that role being enhanced where possible, but I suspect that that will become clear only as the framework is embedded in our public health infrastructure. A review period is built into the framework and might provide a good hook for Parliament to consider its operation and whether it delivers as well as we hope that it will.

Ultimately, those are questions for the Parliament, as opposed to the Government, to answer. However, if the Parliament wanted further scrutiny and thought that the review was the correct point at which to invite me, as the Cabinet Secretary for Health and Social Care, and my officials to comment, or if the committee wanted to undertake a detailed review or scrutinise work plans, I would be open to any role that the Parliament wished to have in the agenda, because it is so important.

Thank you, cabinet secretary. That is all from me, convener.

We will now have questions on international relations from Paul O’Kane.

Good morning, cabinet secretary. Is the Scottish Government comfortable that the common framework will provide sufficient opportunity for the Government to input to any future negotiations or for fulfilment of international obligations in the policy area?

The framework does not alter the devolved settlement in relation to international obligations or any future negotiations. That is important. Paul O’Kane and I probably have slightly different views on whether Scotland should have more of a role—or, indeed, its own role—in relation to international treaties and obligations. Notwithstanding those differences—we can park them for a minute—the framework does not alter the devolved settlement.

The UK’s fulfilment of international obligations relates largely, though not exclusively, to reserved matters. Where we have a distinct legitimate devolved interest in reserved matters, I believe that the framework provides us with a useful set of tools that gives us the greatest chance of influencing negotiations. The framework process thus far has been really engaging, and, in terms of engagement with the EU and the memorandum of understanding that the UK has signed with the EU, Scotland has been able to represent itself in relation to the ECDC, for example, which is positive.

Ultimately, I cannot promise you that there will always be alignment between what the Scottish Government or, indeed, the Scottish Parliament wants in relation to international obligations and what the UK Government ends up doing. The framework does not alter that significantly.

I know that I have asked the cabinet secretary about this before in relation to other areas of this work, but what about dispute resolution when there is a difference of opinion? I know that he will use his good nature and strong relationships to try to find a way through in relation to the Scottish Parliament’s position or, indeed, Scotland’s position on an issue, but is there is a robust resolution procedure that we could use? Would that be invoked more readily, or does he have concerns—I am sure that he does—about unilateral decision making? Does he have confidence that such a procedure is in place?

Paul O’Kane will know that, if there is a chance for me to put on record my concern about the approach that the UK Government is taking, I will not be shy in doing so. I will do that regularly—quite rightly, as my job is to stand up for the interests of the people of Scotland. Equally, when things are working well, I am not shy or reticent about saying that they are working well.

The common framework process has involved really good collaboration. Therefore, I do not envisage that we would get to the stage of dispute resolution in relation to this particular area of the common framework and what it seeks to address—certainly not from the evidence that I have seen thus far. Of course, this is about the future, too. Ultimately, if we could not get agreement—if every lever that we had tried through informal discussion with the UK Government, official level discussion, ministerial level discussion, correspondence and so on, had not worked—that dispute resolution mechanism would be there, and it exists for good reason. However, on the evidence thus far, I do not see that needing to be invoked—certainly not in the short or medium terms.

Thank you. We will move on. We have questions on information sharing from Sue Webber.

Thank you, cabinet secretary, for coming along today, albeit virtually. We hear at length from everyone about how much pressure everyone is under with their workloads, so I am hoping that you might be able to help. Do you get a sense that the framework will reduce duplication in the likes of the scientific advisory and expert groups that we have across the four nations? Also, are there any plans to develop greater consistency in how data is collected, analysed and presented across the UK?

That is a really good question. In time, it might well do that in terms of reduction of duplication. However, it is also important—I think that Sue Webber would ultimately agree with this—that each of the Governments across the UK nations has bespoke advice, because, although there will absolutely be some common themes that affect Scotland, England, Northern Ireland and Wales, there are also distinct issues that affect us uniquely. Therefore, having that scientific advisory group for the Scottish Government is really important for us, given the unique pressures that we might face, which might be different from those faced in parts of England and Wales—or, indeed, in Northern Ireland where it shares a land border with a member of the EU, which is perhaps the most obvious example.

On the question about reducing duplication, I would say that—yes, absolutely—that will probably happen more as the framework is embedded. However, I would always reserve our right to make sure that we have that bespoke advice where appropriate.

Thank you.

11:30  

Good morning, cabinet secretary. Do you have any concerns about cross-border co-operation with the EU? It says in our papers that access to the EU’s early warning and response system will be on an ad hoc basis, which pretty much means that, if there is a potential health issue, it will be up to the United Kingdom to write to the EU and ask whether the UK can be part of the process.

I will not labour the point. I think that everybody here understands that the Scottish Government would have preferred by far that we had retained our EU membership. That would have given us greater access and we would have been part of the European Centre for Disease Control, for example. We would not have had to have memorandums of understanding, which, although they can be positive, are suboptimal compared with EU membership. There is no point in labouring that point, but it is important to put on record that any arrangements that we put in place for cross-border co-operation with the EU are suboptimal in comparison with EU membership.

On co-operation, we expect there to be a strong system of intelligence and data sharing. As we know, the UK Health Security Agency has entered into an MOU with the ECDC. We are pleased that the MOU has been signed, but we will not have the parity of access that we had previously.

Emma Harper asked an important question about the Scottish Government’s involvement. Again, if I was to go by the process of the framework, I would definitely be encouraged. There was certainly a role for Scottish representatives in influencing those discussions with the European Union. Ultimately, though, if we were ignored, there would not necessarily be adequate recourse for us to ensure that our desires in relation to cross-border co-operation were being satisfactorily met.

We are talking about cross-border co-operation with the EU, but there is also cross-border co-operation with our neighbours south of the border. I am thinking about zoonotic diseases such as severe acute respiratory syndrome, middle east respiratory syndrome, swine flu and avian influenza—even Creutzfeldt–Jakob disease, in the past. We need to make sure that all the scientists are working together. Will the framework improve co-operation within the UK, so that everybody shares their scientific knowledge and we are better prepared for any future pandemics that we need to worry about?

The danger with our exit from the EU was that we would lose the co-operation that we were duty bound to have. The framework ensures that we do not have any less co-operation, which is important. Looking forward, the framework and the MOU that sits alongside it ensure that there will be good collaboration not only within the UK but with our European Union partners. That, too, is important.

On the framework, members will be aware—I am sure that it will be in their briefing—that there is the oversight group, which will be really important. Scotland will have representation on that group to ensure that co-operation is being maximised wherever possible. I think that the framework will evolve as it embeds, but the early signs are encouraging.

Good morning, cabinet secretary. Do you have any plans to increase the health protection resource in Scotland in areas where Scotland has been identified as the lead—for example, in review of disease notifications, analysis of four nations working groups and the evolving science of genomics?

The framework does not necessarily impose costs on any of the Governments that are taking the lead in certain areas. That is not to say that we would not bolster resources, because we would, particularly in the area of genomics. The pandemic has taught us a lot of things—among them, the importance of genomic sequencing. The Government has put on record our desire to further increase our resources around genomics—the First Minister has spoken about that on a number of occasions—so, although the framework does not necessarily do that, we want to ensure that the areas where we lead are well resourced.

It is good to hear you talk about the positive aspects of the common framework. Does what you are saying also mean that there will be increased sharing in other areas of health research?

The framework might not go into detail on that point, but that is a vital issue. Where we can share further research and intelligence, that helps us to build up our knowledge, particularly in relation to the pandemic, which is the current issue that we are facing. Research studies from across the UK have helped to inform our thinking and decision making.

You and I have different opinions on the constitutional future of Scotland—that is fine. However, ultimately, whether we are independent or part of the union, the sharing of information across borders—on these islands and with the European Union—is hugely beneficial, and I would not want to lose that, regardless of what our constitutional set-up might be.

The answer to your question about whether we will continue to share information is yes. The framework might not determine all of that, but I know from my discussions with the UK Government that it is in the same place as I am in that regard, and I know that my Welsh and Northern Irish counterparts feel the same way. The more that we can share research on health, the better for all of our citizens.

I thank the cabinet secretary and his officials for their answers to our questions today and for joining us this morning. We will now move to the next item on our agenda.