Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, September 1, 2021

Official Report 1101KB pdf

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Covid-19

I remind members that social distancing measures are in place in the chamber and across the Holyrood campus. I ask that members take care to observe those measures, including when entering and exiting the chamber, and that they use the aisles and walkways only to access their seat and when moving around the chamber.

On a point of order, Presiding Officer. You will be aware that important Government announcements should be made first to the chamber before they are given to the press. At 14:40 this afternoon, in advance of the statement to the Parliament that the First Minister is about to make, key details—in particular, proposals to introduce vaccine certification—were posted on social media by the BBC. I am sure that you agree that that is a discourtesy to Parliament. Will you investigate whether that has been a breach of standing orders by the Scottish Government?

I thank Murdo Fraser for his point of order. I have not had an opportunity to view the information to which he refers, but it is certainly my expectation that any and all statements be made in the first instance to the Parliament wherever possible. That would seem to be the case on this occasion, so I will look further into the issue.

The next item of business is a Covid-19 update in the form of a statement by Nicola Sturgeon. The First Minister will take questions at the end of her statement so there should be no interventions or interruptions.

14:55  

Today, I will update Parliament on the state of the pandemic in Scotland, discuss the recent surge in cases and give our best assessment of the current situation. I will also outline the additional action that we are taking to try to slow transmission and reduce the spread of the virus.

I will start with the latest daily statistics, albeit in summary form, as they were published around an hour ago. There were 6,170 positive cases reported yesterday, which is 11.5 per cent of all tests carried out. There are 629 people in hospital with Covid, which is 44 more than yesterday, and 59 people are in intensive care, which is five more than yesterday. Sadly, a further nine deaths have been reported in the past 24 hours, taking the total number of deaths under the daily definition to 8,127. As always, my condolences are with everyone who has lost a loved one.

On vaccination, 4,108,804 people have received a first dose, and 3,691,066 have now had both doses. That includes 95 per cent of people over the age of 40 who are now fully vaccinated, as well as 71 per cent of 30 to 39-year-olds and 51 per cent of 18 to 29-year-olds. However, 74 per cent of 18 to 29-year-olds have had a first dose, so we expect the proportion becoming fully vaccinated to continue to increase in the days ahead. Finally, almost exactly half of all 16 and 17-year-olds have now had the first jag. Vaccination in that age group started relatively recently, and work to increase uptake further is on-going. All 16 and 17-year-olds who have not yet had a first dose should have received a letter yesterday inviting them to an appointment.

As members are aware, we still await advice from the Joint Committee on Vaccination and Immunisation on vaccinating all 12 to 15-year-olds, and I hope that the evidence will allow the JCVI to give a positive recommendation very soon. If that is the case, we stand ready to implement that recommendation.

I will talk more about the importance of vaccination later, but I will first address the surge in cases that we have experienced over recent weeks. Case levels are 80 per cent higher now than they were last week, and are five times higher than they were four weeks ago. Test positivity has also risen, from around 5 per cent at the start of August to 11.5 per cent today. As we indicated at the time, it was always likely that, as restrictions were lifted, we would see cases rise. The virus is highly infectious, so as people mix together more, it will take the opportunity to spread. Indeed, cases are rising across all of the United Kingdom and in many other countries.

However, in Scotland, unlike in England and Wales, schools have been back for some time, and we expected that that would create a further pressure not only as a result of increased interactions in schools, but because we know that there are certain ways—school drop-offs, for example—in which adults tend to mix more when schools are back. Despite expecting to see some increase in cases, the scale of the increase in recent weeks has been extremely concerning. There is no doubt that that underlines the fact that the delta variant is significantly more transmissible than previous strains.

Just as vaccines have changed the game for us in a very good way, delta has changed it in a very challenging way. That has been evident to us in the past few weeks. That is why we have been reminding the public in recent days that, if we are to avoid any re-imposition of restrictions—even in a limited way—as we all want to do, we must all play our part to slow transmission.

We have been urging everyone to comply with all the basic mitigations that are still in place, such as the use of face coverings, and to carefully follow all public health advice. If we all do that—later, I will again set out exactly what we are asking people to do—I am hopeful that we can turn the corner without having to re-impose any restrictions. However, I stress that the next few days will be crucial in our assessment, and it is inescapably the case that we must turn the corner and see the sharp increase in cases level off and then come down.

I will explain again why that is important, even with vaccination levels as high as they are. It absolutely remains the case that vaccination has significantly reduced the link between cases of Covid and serious health harm from Covid. The proportion of people with the virus who end up in hospital is much lower now than it was pre-vaccine. Indeed, that is why the record number of new cases that has been reported in recent days has not caused a record number of hospital admissions. That is very positive, but it must not make us complacent.

Although the link between new cases and serious health harm is now much weaker, it has not been completely broken—either here or anywhere else in the world; like us, many countries are grappling with the delta variant. We can see that clearly in the recent data. On Friday 20 August, 312 people were in hospital with Covid; today, there are 629. The number of people in intensive care has risen more slowly, but it has risen. On 20 August, it was 34; today, it is 59. Of course, hospital figures do not capture all the health harm caused by Covid. For example, they exclude people who do not require hospital treatment but still go on to suffer long Covid.

There is a matter of basic arithmetic at play. If the recent surge in cases was to continue—if, for instance, cases were to rise to 10,000 or more a day, which is something that I hope will not happen but is by no means impossible—that would have serious consequences. A lot of people would fall seriously ill and, obviously, some people would die. Also, the national health service would come under even more severe pressure.

To reiterate, that is a matter of basic arithmetic. At the start of the year, daily reported cases peaked at around 2,600, and, at that time, which was pre-vaccine, around 13 per cent of cases were ending up in hospital. Today—this is good news—around only 2 to 3 per cent end up in hospital. However, 2 to 3 per cent of 10,000 cases a day will cause similar pressure on our NHS as 13 per cent of 2,600.

This pressure is building at a time when many staff have been flat out for more than 18 months and when the NHS is working hard to deal with the backlog of other cases that has been caused by the earlier waves of the pandemic.

The situation that we face is fragile and serious. We must stem the rise in cases. Obviously, it would not be responsible for any Government in the face of the virus and the harm that it can still do to rule out reintroducing any restrictions. Indeed, in my view, that would be grossly irresponsible. However, we do not want to reimpose restrictions, even in a limited way. We know only too well how much harm restrictions cause to businesses, young people’s education and to our overall wellbeing. If that is to be avoided—as I very much hope that it can be—it will take all of us again making a conscious and concerted effort to comply with all the basic mitigations that we know from experience can slow down transmission. Of course, that applies to individuals as well as businesses.

I will set out some of the work that the Government is doing, including on one particularly significant issue, and what we are asking everyone to do.

Over the past two weeks, cabinet secretaries have been engaging closely with business and sectoral organisations across the country to encourage significantly increased compliance with existing baseline measures. That, of course, includes the wearing of face coverings, encouraging stringent hygiene and support for continued home working where possible.

I am very grateful to businesses for the efforts being made to keep staff and customers safe, and I am particularly grateful to those businesses that are continuing to support home working. It is vital that those efforts continue. I know that they are not easy for business, but they are much less onerous to them than any further restrictions would be.

We are continuing to support urgent measures to improve ventilation in schools—for example, the purchase and use of CO₂ monitors. We are also looking urgently at options to support better ventilation in priority workplaces.

We continue to do everything possible to drive up the already high uptake of vaccine. Getting vaccinated remains the single most important step that any of us can take to keep ourselves and others safe. Therefore, ensuring that as many people as possible get vaccinated remains an absolutely key priority.

As I have mentioned, we expect updated advice from the Joint Committee on Vaccination and Immunisation soon on vaccination of 12 to 15-year-olds and on booster jabs for vulnerable groups such as older people and those with compromised immune systems.

We will, and stand ready to move to implement any such extensions to the vaccine programme as soon as we get the JCVI recommendations to do so, which I hope very much will be soon.

We are also taking targeted steps to increase uptake among groups who are already eligible for vaccination. I mentioned earlier that an invitation letter has recently been sent to all 16-year-olds and 17-year-olds who have not yet had a first dose. Mobile vaccination units will be used during university and college freshers weeks to encourage students who have not already done so to get vaccinated.

We will also concentrate further effort in the days ahead on encouraging anyone in the under-40 age group who has not yet had the vaccine, or has not had the second dose, to do so now.

It really is impossible to overstate the importance of vaccination in getting us safely through this phase and the winter months ahead. By getting vaccinated, we help to keep ourselves and others safe. The reverse of that is equally true: not getting vaccinated, if you are eligible, puts you and others at greater risk, and it makes it less likely that we can make it through the winter without having to reintroduce some restrictions. To everyone out there who has not already had their jags, I say, “Please do your civic duty—please get vaccinated now, for your own sake and for all of us.”

The final issue that I want to address is vaccine certification, for when entry to venues is dependent on people being able to show that they have been fully vaccinated. In recent months there has been a lot of discussion about vaccine certification. As I have indicated before, the Government has been considering very carefully whether—notwithstanding the understandable equity and ethical concerns—vaccine certification could, in some settings, help to protect public health, reduce the necessity for any further restrictions and, of course, boost vaccine take-up.

The Scottish Government has made it clear that we do not believe that vaccination certification should ever be a requirement for receipt of any key services or in settings where people have no choice over attendance—for example, public transport, education and access to medical services or shops. We continue to hold very firmly to that position. However, we consider that limited use of vaccine certification could help to control spread of the virus as we head into the autumn and winter.

For any decision of that nature to have an impact before winter, we would have to take and implement it quickly. However, I recognise that it is a significant decision so, in my view, it should be expressly authorised by Parliament. I therefore propose that, subject to the Presiding Officer’s agreement, we have a full debate and vote on the matter next week. To help to prepare for that, I will set out now what the Government, after much consideration, has concluded would be appropriate.

We propose that, subject to Parliament’s agreement, vaccination certification should be introduced later this month—once all adults have had the opportunity to be fully vaccinated—for the following events and venues: first, nightclubs and adult entertainment venues; secondly, unseated indoor live events with more than 500 people in the audience; thirdly, unseated outdoor live events with more than 4,000 people in the audience; and lastly, any event of any nature that has more than 10,000 people in attendance. We do not currently consider that it would be appropriate to introduce certification for the hospitality industry as a whole, and we hope that it will not be necessary to do so. However, we will keep that position under review.

We are also very aware of the need to take account of people who, for good reason, cannot get fully vaccinated with both doses of the vaccine. For example, we envisage that children and people with particular medical conditions would be exempt from certification requirements. However, we consider that in order to help to protect individuals and the country as a whole, and to reduce the risk of further restrictions becoming necessary, people over 18 years old who are eligible for vaccination should be required to show that they have received both doses before entry to premises and events such as I have mentioned.

It is already possible to request that a paper copy of your vaccination record be posted to you to allow you to travel. From this Friday onwards, well in advance of any certification scheme coming into operation, we will also provide a QR code. That means that you will be able to download a copy of your vaccination record to keep on your phone or to print.

The introduction of Covid vaccine certificates, even in the limited circumstances that I have set out, is a significant move and not one that we would ever take lightly. That is why I believe that it should have parliamentary approval in advance. However, it is worth stressing that although we have had to weigh the decision carefully, we would be in no way unique in taking the step. The UK Government has announced its intention to introduce certification for England, and several European countries—including France, Italy and Ireland—have already introduced certification. In fact, the certification rules in several other countries cover a far wider range of venues than those that we are currently considering for Scotland.

Many of the events and venues that will be covered by a certification scheme are important—they matter to our economy and to our cultural and social life, which is why we want to enable them to stay open safely. However, they are not essential services, and their nature, which involves bringing together many people in relatively small areas, means that despite their very best efforts—I know that they make their best efforts—they can contribute significantly to spread of the virus. By ensuring that people who enter those settings are fully vaccinated, we would be taking a proportionate step to help to make those settings safer for everyone attending and, by extension, for all of us.

As I said, I fervently hope—vaccine certification aside—that we will not have to impose any further legal restrictions. Of course, that depends on all of us making a concerted effort now, through our own behaviours, to stem transmission. We know that we cannot let cases continue to rise at the pace of recent weeks. We must slow down the pace. That is important for all of us as individuals, but especially for those who are most vulnerable to Covid.

We know that many of the people who are at highest risk, including many of those who were advised to shield at the start of the pandemic, are particularly anxious about the current situation. They worry that if they go out of their homes, especially with the number of cases being so high, they could be put at risk by people not wearing face coverings, not washing their hands or not trying to keep a safe distance. That should be a reminder for us all. When we take basic precautions, we are not simply protecting ourselves—although we are doing that, and it is important—we are making life easier and safer and helping to reduce anxiety for many others, too.

I will close by once again stressing the actions that each and every one of us needs to take in order to do that and to help to get cases down without further restrictions. First, as I stressed earlier, if you are eligible and have not yet done so, please get vaccinated. That remains the single most important thing that we can all do to keep everybody safe. There are drop-in vaccination centres in every mainland health board area. If you have not been vaccinated yet, or if you had your first dose eight or more weeks ago and have not had a second dose, you can just turn up at your nearest centre and get the jag.

Secondly, please test yourself regularly with lateral flow devices. If you do that and if you have the virus but do not have symptoms, you still have a chance of finding that out before inadvertently passing on the virus to others. You can get free lateral flow tests through the NHS Inform website. They will be sent to you in the post or you can collect them from local pharmacies or test sites.

If you test positive through a lateral flow device or if you have symptoms of the virus, make sure that you self-isolate and book a PCR—polymerase chain reaction—test. If you are a contact of someone who has tested positive, you might also be told to self-isolate pending a PCR test, as I was at the start of the week. In any of those situations, please make sure that you self-isolate. That remains a really important way in which we can all slow down the spread of the virus.

Thirdly and finally, please follow all the guidance that is still in place. Please remember that it is still a legal requirement to wear face coverings in indoor public places such as shops, on public transport and when entering and moving about in hospitality settings. That is a simple but important way in which we can all protect one another.

More generally, please meet outdoors as much as possible. I know that that gets harder as the weather moves into autumn. If you are indoors, open the windows—good ventilation makes a big difference—and avoid crowded places. Indeed, for the next couple of weeks, perhaps all of us should think carefully about the number of contacts that we are having and, perhaps, reduce the number of those that are unnecessary. Even though it is not the law any more, keep a safe distance from people in other households if you can, especially indoors. Minimise direct physical contact such as handshaking, and keep washing your hands and surfaces thoroughly.

Having to take those steps is frustrating for us and for people across the world, but it really does make a difference—we know that from experience. It helps to limit the spread of the virus, and we must do that. We must do it to keep ourselves and our loved ones safer, and to help to ensure that we can avoid the need for any further restrictions.

The next few days are crucial. The Government is doing everything it can, and will continue to do so, but as has been the case throughout, we need your help, too. So, please, get vaccinated, get tested and tighten up again on following all the rules and guidelines. I again thank everyone across the country who is doing that.

The First Minister will now take questions on the issues that were raised in her statement. I intend to allow around 40 minutes for questions, after which we will move on to the next item of business.

Covid rates are very high, which is a reminder that the virus has not gone away. We have to learn to live with Covid-19—[Inaudible.]—a better place because of the success of the vaccination programme across the country. We have to focus on the vaccine and on test and protect, because we cannot force more restrictions on the people of Scotland. We know that that would risk their mental health and result in job losses.

Appearing before a Scottish Parliament committee this morning, Barry McCulloch from the Federation of Small Businesses said that many small business owners are naturally concerned about the prospect of further restrictions and lockdowns, and that businesses are in survival mode. He is right. We need the Scottish Government to listen to our businesses and respond to their concerns.

Our NHS is also nearing breaking point. People cannot see their general practitioner in person, they are waiting hours on end for ambulances and they are being told to stay away from accident and emergency departments. Even if they get in, they are facing horrendously long waits. Let us be clear. Covid is not overwhelming our NHS, as the First Minister said in her statement; her health secretary’s failures are overwhelming the NHS. He has shown poor leadership and inaction, causing delays that have overwhelmed the health service.

The First Minister has just announced her plans to introduce vaccine certification when, just a month ago, John Swinney, her Cabinet Secretary for Covid Recovery, said that that was the wrong way to handle the situation. What has changed between John Swinney saying what he said last month and what the First Minister said in her announcement today? When will the Scottish Government provide businesses with specific guidance on how to manage the scheme? Will they be expected to police it? If so, will the Government provide them with further support? [Interruption.]

Finally, I note that the First Minister said that she will not introduce vaccine certification to hospitality venues at the moment but will keep it under review. Will she ensure that there is meaningful dialogue with the hospitality sector during that period and that she listens to its concerns? If she believes that vaccine certification is required in hospitality venues, will that require a vote in Parliament and parliamentary approval?

I hope that the First Minister was able to catch the questions.

I did hear the questions. I am not sure what the noise in the background was, but I am sure that it was understandable.

I will try to take the questions in turn. It is important for us all to focus on the detail and the complexities of the situation. We are 18 months in and we are still not in a normal political situation in which who said what, when and whether a politician is still saying the same thing that they said a few weeks ago is as relevant as it is in other times. We are all trying to assess the evidence, learn as we go and make sure that we consider carefully all the pros and cons of every decision. I hope that all politicians will continue to do what most have done throughout the pandemic and engage with that in detail and in substance.

Nobody wants to impose greater restrictions. I absolutely understand the concerns of businesses and individuals that the virus might increase at a pace and in a way that would make them unavoidable, but I do not want that to happen. Nobody wants that to happen. Equally, I do not want people to die avoidably from Covid, and I do not want to see more people becoming seriously ill. I also do not want the pressure on our health service to build such that people who have other conditions cannot be treated timeously. It would be an irresponsible politician who ruled anything out in the face of an infectious, mutating virus, and I am not going to do that.

We all have a part to play here. The Parliament is the collective leadership of Scotland, and we all have to come together to persuade people of what we need to do to avoid further restrictions. Instead of going on about how terrible restrictions would be—we all agree with that—let us focus on saying to people, “Here is what will help us to avoid that.” That is what I tried to set out in my statement today, and I hope that we will all get behind those essential public health measures.

We have been considering the issue of vaccine certification very carefully, as members and those people who watched the two virtual meetings of Parliament over the summer will have heard me say. We have not ruled it out—we have been very clear about that—but we have made sure that we have considered carefully some of the ethical and equity issues and the practical issues that are involved. We have now come to a point where we think that a limited and careful use of vaccine certification can have a role to play.

However, given the significance of the use of vaccine certification, as I said in my statement, I think that it is right that Parliament votes on it and authorises it. If we were to decide to extend its use to other settings, I think that it would be equally important that Parliament had the ability to authorise that. I will therefore set out the details of that, and of what we will ask Parliament to vote on, more fully next week.

We are far from alone—we see this across the UK and much of the rest of the world—in being in a situation in which the delta variant has significantly changed the game. It is a different variant of the same virus, but in many respects, because of its greater transmissibility, it feels like a different virus. We must respond to that properly. As was the case with earlier strains of the virus, the same basic mitigations can help to slow it down. That is why we must continue to get those messages across and to ask people to continue to do all the important things, including getting vaccinated.

I offer my condolences to all those people who have lost a loved one. The nine deaths in the past 24 hours are a tragic reminder that lives are still at risk and are still being lost as a result of the virus. I again thank Scotland’s heroic workforce, not least our national health service and care workers, who continue to work under immense pressure.

It is clear that the virus is out of control. Case numbers are soaring and have reached record levels this week; hospitalisations continue to climb; thousands of Scots are self-isolating; and there is widespread confusion about the quarantine and testing requirements. PCR test kits are running out in some areas, and contact tracing is being carried out only in less than half of cases. Test and protect is clearly not fulfilling its function. The First Minister is right to say that we can never rule out restrictions, but the tools that the Government is responsible for are clearly not working. Restrictions cannot be a fallback for Government failure.

I look forward to seeing the proposals on vaccine certification next week. What direct engagement has there been with the sectors that are involved in order to make sure that they are part of the processes and procedures that will follow from the decisions that are taken on certification?

On the vaccination programme, I welcome the mobile clinics on university and college campuses, but can we go further and have them in schools, so that we can target 16 and 17-year-olds, at large workplaces and at large events?

We need to start planning for winter now. What specific planning is being done for the winter pressures that will arise not just because of Covid, but because of flu and the wider pressures on the NHS? When will the booster programme begin? What plans are in place to ensure that the roll-out of the flu vaccine and the booster vaccine can happen simultaneously?

The Government’s strategy—if there is one—and the tools are not working, and the virus is clearly out of control. What is the strategy? Is it virus suppression, virus elimination or herd immunity? At the moment, we are achieving none of those.

Anas Sarwar should know the answer to that last question, because it was set out in our revised strategic update. I announced it to Parliament and he asked me questions about it at the time. Our strategic objective is to reduce the virus and keep it at levels that are sufficient to reduce the harms from the virus. If that was not known to Anas Sarwar, I gently suggest that it should have been. [Interruption.]

Anas Sarwar says that our strategy is not working. Every country is grappling with a highly transmissible strain of the virus. We had a spike in cases in early July, when our case levels were the highest in the UK. We then had a period throughout the rest of July and much of August when we had the lowest case levels in the UK. Our schools have gone back ahead of those in other parts of the UK, so we are again seeing a rise. The situation that we are grappling with is not different from the one that most other parts of the world are grappling with.

Anas Sarwar is wrong. I also take issue with his point about winter planning in the NHS. If he is saying to me that we should be starting winter planning now, I could not disagree with that more strongly. We started winter planning a long time ago. If we were starting it only now, that would be seriously remiss of us. Last week, we set out the NHS recovery plan, which is integral not just to the medium to longer-term recovery of the NHS, but to ensuring that the NHS is equipped to deal with the variety of pressures that it will face in the winter.

Test and protect is working, and it is working extremely well. PCR test kits come via the UK Government and they have been received. There have been some pressures on them in recent weeks, but those pressures have been met by new supplies arriving. Most people are getting their PCR test result within 24 hours. Test and protect is working well and contact tracing is being targeted on the highest risk areas first. That system will always be under pressure when case numbers are high, but it is working well and I am deeply grateful to those across the system who are putting in so much effort to make sure that it is working well.

On the booster campaign—again, I have said this so many times directly to Anas Sarwar and others—we await the JCVI recommendation. If we did not take the JCVI recommendations on this, we would simply be taking decisions that many people would rightly turn around and tell us did not have the right evidential base. However, we are ready to get the booster campaign under way as soon as the JCVI gives its final recommendation. We have interim recommendations, which have been the planning basis for that.

People can hear—and will have heard before—that I am frustrated that we have not yet got updated advice on 12 to 15-year-olds. I hope that, like many other countries, we can start to vaccinate in that age group soon and that the JCVI soon feels able to say that the evidence allows it to recommend that. Again, we stand ready to do that as quickly as we are able to.

We are looking at different ways to reach 16 and 17-year-olds. Some health boards are already looking at taking vaccination directly into schools, and that process will continue. We will continue to do all those things.

However, to come back to the central point, this is an infectious virus that has got a lot more infectious. All of us need to make sure that we are playing our part, and as politicians and leaders of the country, all of us need to play our part in getting those messages across. The Government will continue to lead by example in doing that.

The First Minister will understand the real concerns of Liberal Democrats and others about the introduction of what some have described as medical identification cards. The Government has, in effect, moved to a position whereby people will be compelled both to receive medical treatment and to provide their personal data in order to access certain freedoms. That is an illiberal step.

Other information technology systems, particularly around test and protect, have proved insufficient to the challenge of big data in a Covid context. Does the First Minister have faith in the IT systems that will back this up, considering that systems are creaking everywhere else? Will she tell Parliament whether this measure will be time bound or here to stay, if we have to live with Covid? Does she understand the very real concerns of those who are worried about the impact on civil liberties?

Anybody who has heard me talk about vaccine certification will know that I understand the concerns and share some of them. This is not a move that any Government should take lightly. However, frankly, I am also deeply concerned and have been for 18 months—as I know that everybody has been—about the harm that Covid does. We therefore need to consider every possible tool at our disposal that helps us to protect people from the harm of Covid. Increasingly, after so long, we particularly have to consider any tools that can help us to reduce the harm of Covid without needing to impose wider and more blanket restrictions on people’s way of life. Using vaccine certification in a very limited way can help us to do that.

The kinds of venue that I have spoken about—large-scale events, night clubs and adult entertainment venues—are important to our economy and to many people’s cultural life. I am not underplaying the importance of night clubs to young people, for example. However, they are venues in which, despite the best efforts of those who run them, the conditions make it more likely that the virus will spread. Taking the proportionate step of asking people to make sure that they are fully vaccinated to protect themselves and others would therefore be an appropriate thing to do.

The IT systems that are supporting our efforts on Covid are not “creaking”. Everybody is under pressure from Covid, but all the systems and back-up arrangements for anything like this have to be robust. That is why we have taken such a careful approach, and it is why we are taking time, for example, to finalise and launch the app that will support some of this, which will happen later this month.

These things are really important. I think that they have a part to play, but I also think that it is important that Parliament gives its authorisation.

On the longevity of all of this, I do not think that it is either possible or sensible to be definitive about that right now. This is a global pandemic, which we are still in. For as long as any measure can help us to reduce the harm that Covid does, we should consider having it in place.

Can the First Minister say anything about the Government’s thinking on face coverings, moving forward? I am thinking particularly about schools—there was a suggestion that face coverings would be used in them for a limited period—places of worship and perhaps sports stadia, where people are sitting outside.

Face coverings play a really important part in helping to stop the spread of the virus. We will regularly review requirements to wear face coverings, and any reviews will take account of a range of factors such as the impact on transmission as well as social and economic considerations.

Face coverings continue to be worn by staff in all school communal areas and by staff and pupils in secondary school classrooms. In indoor areas of sports stadiums, such as stairwells, toilets and concourses, the wearing of masks also remains mandatory. We continue to meet stakeholders across all sectors to discuss guidance on face coverings. We know, for example, that the issue is particularly important for faith communities.

Face coverings are a measure that, like any measure, should not be kept in place for longer than we deem it necessary. For as long as it is necessary, however, I think that most people—I appreciate that it is not everybody—consider that it is a reasonably small price to pay to help keep themselves and others safe and, we hope, avoid the need for greater and more stringent restrictions.

On vaccine certification, we know that there are still adults who have difficulty in accessing vaccinations for a variety of reasons. Indeed, as of today, 17 per cent of over-18s in Scotland have not been doubly vaccinated. Given that backdrop, would the Scottish Government consider allowing evidence of a negative Covid test as an alternative to vaccine certification as a means of entry to the venues that the First Minister has outlined?

I will come to that point directly in a moment. On the point about some people finding it difficult to get to vaccinated—I mean this quite generally; I am not making a political point—there are some people who cannot get vaccinated because of a health condition or age, and it is important that any vaccine certification scheme takes account of that, but I would seriously question whether anyone who is eligible has difficulty in getting vaccinated that prevents them from doing it right now. There may be some, in which case we will work to overcome that, but there are drop-in centres in every part of mainland Scotland and people have been offered appointments. I would say to people that, if you are eligible to get vaccinated, there is no reason not to do so. If there is some reason that I am not aware of, get in touch with NHS Inform or your local health board, and I am sure that a way will be found to overcome that.

It is really important that all of us get that message across. If you are eligible, there is no reason why you cannot or should not be getting the vaccine right now.

My segue into the next part of the question is that I do not think that we should say that we will allow a negative Covid test to effectively let people off the hook of getting vaccinated, if they are eligible. Vaccination is really important to keep the country safe. We are not proposing that we would do this initially, but in the longer term there is an argument for considering whether we would add a negative test to the certification. If someone was unable to get vaccinated, instead of a straightforward exemption, a negative test might be an alternative. We are not proposing to introduce that initially, but it is one of the things that we will keep under consideration.

Constituents of mine have had issues with accessing local services such as cafes and restaurants when visiting France, as Scotland’s paper Covid vaccination certification is not accepted. Only a valid QR code, as recognised by France’s pass sanitaire system, is permitted, so I welcome this afternoon’s announcement.

The UK Government has issues with the European Commission regarding having the UK certification and QR code accepted across Europe, although I note that some countries, including France, are the exceptions to that. Is the Scottish Government confident that, once we roll out the QR code system here in Scotland, it will be accepted internationally? Have representations been made to European countries and the European Commission to make sure that it will be accepted for Scots who are visiting Europe?

Yes. That is an important question. We have been engaging actively with the Commission to ensure that our app meets the required standards. The Scottish Government is part of the UK Government’s application to join the EU’s e-health gateway scheme, along with the other devolved nations. We have already successfully tested our QR codes with Norway, Denmark, Belgium, Ireland and Northern Ireland, and we continue to expand the list of countries that we have tested ahead of the release of the QR code on Friday.

More generally, it is the role of the Foreign, Commonwealth and Development Office to liaise with international countries on behalf of the UK. The Scottish Government has been working closely with the FCDO and Border Force to ensure that its Covid status solutions are recognised and accepted world wide.

Work is on-going, and I absolutely recognise the importance of making sure that all of that is done to a satisfactory standard.

For months, members across the Parliament have raised concerns about test and protect being overwhelmed and underresourced.

Today’s contact tracing figures from Public Health Scotland expose the difficulties at the heart of test and protect. In the past week, only 43 per cent of cases have been completed and the average number of primary contacts has dropped to an all-time low of 1.5. No wonder the virus is spreading.

As the First Minister just said, the focus is on highest-risk cases, which means that it is only on people who have tested positive. The testing of close contacts appears to have been all but abandoned. The First Minister understands the importance of test and protect in controlling the virus, so will she provide it with the necessary resources to properly track down and contain Covid-19?

Test and protect is properly resourced. We continue to keep its resourcing under review and we continue to work with it to ensure that it can meet the demands on it. The demands will always be higher when cases are higher. We often get the sense from the Opposition’s questions that the virus is circulating only in Scotland, but countries across the world are grappling with Delta.

On contact tracing through test and protect, I know from my experience this week that close contacts are being asked to get tested, and I know many other people who are in that position. People should put a lot of faith in test and protect.

People should also remember that, as I have said repeatedly throughout the pandemic, test and protect is not our first line of defence: we are our first line of defence. We must all behave in a way that tries to limit transmission. That is the key message that we all have a duty to communicate to people right now.

I noted what the First Minister said about the JCVI in her reply to Anas Sarwar, but can she share with the Parliament her preferred timetable for booster vaccines for the very vulnerable, the elderly, and health and care workers, for example, which must surely alleviate pressure on the NHS and reduce deaths?

I am tempted to say that, assuming that the evidence is that it is safe to do it, I want to get that done as quickly as possible—that is certainly true in relation to vaccinations for 12 to 15-year-olds; as soon as we get a recommendation, which I hope will be soon, we want to get on with that. I am tempted to say the same for a booster campaign. However, one of the issues that the JCVI is looking at is the optimal interval between someone’s first dose and a booster dose, so although the temptation for people like me is to get on with a campaign as soon as possible, if we would reduce a booster’s effectiveness by doing that now, as opposed to in a month’s time, that is a material consideration. That is why we need to wait on the final recommendation.

The important thing for us right now is that we are ready to go as soon as the JCVI says that that is appropriate. Some other countries are starting to schedule booster vaccines—I think that Israel is the earliest country to do that; it was also quite early with the original vaccination programme. As soon as the evidence tells us that it is right to do, we are ready to get on with it.

I am sure that the First Minister shares my concern about the high level of positive Covid-19 cases across East and West Dunbartonshire. Will she say what additional measures are being taken to tackle that worrying trend and address the challenges in areas with the highest prevalence of cases?

I have indicated our intentions, subject to parliamentary approval, on vaccine certification. Notwithstanding that, the current systems that are in place for outbreak management will continue. We continue to maintain daily watch lists, which provide information on trends to inform us about the status of the virus across the country.

In relation to the areas that the member asked about, we have provided NHS Greater Glasgow and Clyde with more than £11 million of funding as part of the targeted community testing programme. That is supported by the mobile testing fleet that the Scottish Ambulance Service runs, and we provided the Ambulance Service with additional funding, to increase its capacity. A range of things are being done to support the local response appropriately, and it will be important that that continues throughout this challenging phase.

The news that eight health boards, including NHS Greater Glasgow and Clyde, are in the top 20 Covid hotspots across Europe is concerning. Although we are all thankful that the vaccination programme has been an incredible Scottish and UK success story, it has been revealed that just four in 10 people who downloaded the app are still using it. Given the latest World Health Organization statistics on the prevalence of the virus in Scotland, does the First Minister agree that those test and protect figures are unacceptable? If so, what further measures is her Government taking to promote the app’s use at every turn?

The app is an important part of test and protect, but it has never been the whole part of it. I take every opportunity to remind people to download the app, use it and ensure that it is turned on so that it can provide the support that we want it to. I hope that every member across the chamber will do that, too, and take the opportunity to remind our constituents of that.

We also have to remind people to do all the other basic things: wear face coverings, wash hands, keep a safe distance, even though that is not the law, and ventilate rooms. Based on previous experience to a large extent, I believe that, if we do all those things, we can turn the corner and start to see case numbers level off and come down. Again, we know from experience that that will not happen by itself; it will happen only when we do the things that stem transmission.

The Government takes the lead in having responsibility for doing all the things that we have to do and for persuading the public to do likewise. However, as the collective leadership of the country, all of us across the chamber have a role in ensuring that we get such messages across.

I thank the First Minister for her statement. Some of my constituents who are due to go to university are getting mixed experiences and expectations in relation to whether they will get face-to-face teaching. Will the First Minister clarify whether face-to-face teaching can take place? What are her expectations for how universities communicate that to their students?

Given the concerningly high case numbers in Lanarkshire, what support is being provided to NHS Lanarkshire at this extremely testing time?

We continue to work closely with universities and colleges on preparing and publishing guidance for the new academic term. That work has been informed by expert advice that the Covid-19 advisory sub-group on universities and colleges has provided.

I can confirm that in-person learning can take place. However, we understand that most universities and colleges will operate a blended learning approach, which will involve some learning continuing to be online at least for the start of the academic year, and I support that. I expect institutions to clearly communicate that to students, because that is their responsibility and there will not be an entirely consistent picture across different courses, given their nature.

In relation to NHS Lanarkshire, we continue to liaise with and provide support to all NHS boards to help them to cope, both in a public heath sense in terms of local outbreak management and through the NHS recovery plan and the winter planning that is already under way. NHS Lanarkshire receives support as part of that.

I have some concerns about how the introduction of vaccine certification could affect disabled people, those with underlying health conditions and those from the global south who might not be able to access proof of vaccination from the countries in which they were vaccinated. How will the Scottish Government ensure that the introduction of vaccine certification will not negatively impact those whom I have already mentioned and those who are most at risk from the virus?

Will the Scottish Government write to the UK Government to ask for an extension of the furlough scheme to be available, should Scotland need it?

On the latter point, we will continue to argue for the extension of the furlough scheme. I thought that we had reached an agreement earlier in the pandemic that financial support that must come through the UK Government because we do not have borrowing powers would flex, depending on the public health situation in each of the four nations. I hope that that agreement will be respected. That said, I should underline the point that I made earlier: I do not want to be in the position of imposing any restrictions if we can at all avoid it. Therefore, I hope that that is a hypothetical point but, nevertheless, it is an important one that we should understand.

The points about vaccine certification are well made. I have made some of them myself as we develop the proposals further before bringing them to Parliament. For example, I have indicated today that we are already envisaging exemptions for some people who cannot get vaccinated. There are issues with people who have been vaccinated in other countries and how we recognise that here. Of course, some of the work that is being done on international travel and recognition of vaccination will have a part to play in that.

We will set out more detail when we bring those proposals to Parliament for debate next week, but I encourage any member who has practical or detailed questions right now to send those to us and we will try to make sure that we address them all as we develop the proposals.

In a similar vein, I have a question about certification decisions. We had an update that the QR code will be launched on Friday; I assume that that is an interim arrangement and that an app will be launched. A QR code might be open to abuse by being shared among people who might not be vaccinated. Can the First Minister provide any more detail about when the app might be launched and how it might work?

Gillian Martin is absolutely right: the QR code that I spoke about that goes live on Friday is not a substitute for the app. The app is currently under testing; it is important that we test it properly. It is scheduled to be released on 30 September. It has been designed to meet European Union standards for international travel, which I referred to earlier, and it will provide access to individuals’ vaccination records that are held by NHS Scotland. The app will be released later in September after all the robust testing that is required; the QR code is an interim measure until that happens.

A recent Medical and Dental Defence Union of Scotland survey shows rising levels of stress among key medical and dental staff. With the Cabinet Secretary for Health and Social Care attacking general practitioners and causing my colleagues a lot of distress, and Covid pushing my NHS colleagues to the brink through exhaustion, is it any wonder that the survey shows that 50 per cent of GPs and 70 per cent of dentists are likely to leave their profession, which would push our NHS deeper into crisis? How will the First Minister ensure that my colleagues do not leave? It would be an unmitigated disaster if they did.

I refer to my entry in the register of members’ interests as a practising doctor and member of the MDDUS.

No member of the Scottish Government, including the health secretary, has attacked GPs. It is, to be frank, disgraceful to suggest otherwise.

When I launched the NHS recovery plan at the Golden Jubilee national hospital in Clydebank last week, I made the point that GPs have been working extremely hard throughout the pandemic. At the start of the pandemic, I visited a general practice to launch the roll-out of the Near Me service, so even though face-to-face consultations have, understandably, been restricted, GPs have been seeing patients online and in other ways, including home visits.

To say that we do not want to move away from the virtual arrangements that have worked well during the pandemic and get back to a more face-to-face approach in primary care is not attacking GPs. It is incumbent on us all not to engage in such suggestions.

The point about the stress, anxiety and exhaustion of many members of the NHS workforce, though, is very well made and is one that we recognise. That is why a significant part of the NHS recovery plan talks about the support that is being put in place for the mental and physical health and wellbeing of NHS staff.

In our discussions, we often talk about hospitals and health centres—the bricks and mortar of the NHS—but the NHS is nothing without the dedicated people who work in it, so it is vital that we support them. That is one of the reasons why I am proud—much as I would love us to be able to go further—that we have this year given agenda for change staff in the NHS the highest pay rise in any part of the UK.

The United Kingdom Obstetrics Surveillance System published research last month that showed that the number of pregnant women being admitted to hospital with Covid-19 across the UK is increasing, with many experiencing acute symptoms. What message does the First Minister have for pregnant women who are unsure about getting the vaccine?

Pregnant women should come forward for vaccination. I recognise that there have been concerns, but many people working in midwifery and obstetrics, for example, have also said that pregnant women should come forward. It is safe to do so; in fact, the risks from not being vaccinated outweigh any risks from vaccination.

Vaccination uptake levels are high, which is obviously a good thing, but we know that anyone who is not vaccinated right now poses a greater risk to themselves and creates vulnerability in the population as a whole, so we want everybody who is not yet vaccinated to come forward. We will be making particular efforts with the under-40s group in the days to come. Again, I appeal to all members to ensure that they communicate the message clearly to the people in their constituencies whom they serve.

The Government has, in effect, ended test and protect in our schools. It is necessary for a student to have a negative PCR test before returning to school when their close contact with someone who has tested positive takes place in a school setting, rather than, for example, during an overnight stay, and they are not displaying symptoms. What assessment has been made of the extent to which that change in policy is contributing to the current rise in the number of cases, including in transfer between school and home?

The Educational Institute of Scotland has called for a reversal of that policy. However, given reports that people are having to travel some distance to get a PCR test, and given the delays in test and protect following up close contacts, would we have the test-and-trace capacity even if the policy was reversed?

Yes. Anybody can see from the data for the past few days that although we have had record numbers of cases being reported, we have also had record levels of testing. We have testing capacity through test and protect. I will continue to defend the people who work in test and protect, because they are doing a great job. We will continue to support them with the resourcing and capacity that they need.

It is not true, and not helpful, to say that the test and protect approach has been abandoned in schools. What we did, as we set out to Parliament, was modify the approach. We knew that, in the previous term, many young people were being asked to isolate and were therefore missing out on education when they probably did not have to do so. We are now taking a more risk-based approach, which is kept under constant review.

As with anything, if we feel that we need to go backwards—we do not want to do it—and put in place greater protections, that will be done. We are also taking a number of other steps to ensure that school settings reduce the risk of transmission. Ventilation and CO₂ monitoring are key parts of that.

Reports have been circulating about a shortage of testing kits in the walk-in PCR testing centre in Greenock, in addition to people being sent elsewhere for PCR tests. Can the First Minister provide an assurance that the facilities and kit at the centres will be replenished to help the people of Greenock and Inverclyde?

I alluded to that earlier. I am aware that last week some people experienced difficulties in accessing tests due to a shortage of kits. The UK Government supplies the test kits, and the Cabinet Secretary for Health and Social Care has raised the issue with the Secretary of State for Health and Social Care. Nevertheless, as there have been those pressures, we have been getting new supplies to ensure that testing kits continue to be available.

As we do on all aspects of testing, we continue to liaise closely. At an earlier stage of the pandemic, there were pressures on Lighthouse laboratory capacity. We worked collaboratively to resolve those; that will be the case in this situation, as well. It is vital that PCR testing is available for those who need it, as long as we are in a situation in which there are rising or high levels of cases. I know that the Greenock site was fully booked earlier last week, so we will continue to work to ensure that capacity exists there.

As I think I said earlier, most people get their PCR test results back relatively quickly. That is important, especially now that the rules on self-isolation for close contacts have changed.

My question follows on from Stuart McMillan’s question. What action is the Scottish Government taking to increase Covid-19 testing capacity in Argyll and Bute?

I thank Jenni Minto for that important question. For people with symptoms, we have extended PCR home test kit coverage and the 119 courier collection service to the islands of Bute and Mull. Local partners have the option of extending provision further, if that is required.

There is also a walk-through local test site and there are a number of mobile testing unit deployments and 10 small-scale test sites across Argyll and Bute. People with symptoms can book a test at those sites or order a home test kit through NHS Inform. People who do not have symptoms can access lateral flow tests by ordering them online, getting them from a community pharmacy or going to a community test site. Local residents can find the site locations and opening hours on their local authority website.

15:54 Meeting suspended.  

15:56 On resuming—