Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, September 14, 2021

Official Report 966KB pdf

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Covid-19

The next item of business is a statement by Nicola Sturgeon on Covid-19. The First Minister’s statement will be followed by questions, so there should be no interventions or interruptions.

I will give an update on the latest Covid situation. I confirm that the Cabinet met this morning and decided not to make any immediate changes to the regulations that are currently in place. I will give an update on certain other issues, most notably the mitigations that are in place for schools, including our approach to the vaccination of 12 to 15-year-olds, and the issue of a vaccine booster programme, on which we received final Joint Committee on Vaccination and Immunisation advice this morning.

First, I will recap the latest statistics. Yesterday, 3,375 positive cases were reported, which was 11.4 per cent of all tests. Currently, 1,064 people are in hospital with Covid, which is 16 more than yesterday, and 89 people are receiving intensive care, which is one person fewer than yesterday.

Sadly, a further 21 deaths have been reported in the past 24 hours. Under the daily definition, the total number of deaths is now 8,263. As always, I send my condolences to everyone who has lost a loved one.

Good progress continues to be made in the vaccination programme. As of this morning, 4,144,904 people have had a first dose and 3,788,551 have now had both doses. Of people aged over 40, 95 per cent are now fully vaccinated with two doses, as are 73 per cent of 30 to 39-year-olds and 60 per cent of 18 to 29-year-olds. Around 76 per cent of 18 to 29-year-olds have had a first dose, so the proportion in that age group who will become fully vaccinated will continue to increase in the weeks ahead. In addition, 65 per cent of 16 and 17-year-olds have now had their first jag, which is five percentage points higher than at this time last week.

Although the level of infection in Scotland remains too high, there are continuing signs that the recent spike in cases is slowing down. We are now seeing early signs not just that the rate of increase is slowing but that the number of cases is starting to fall slightly. That can be seen in the past three weeks of data. In the week to 28 August, there was an average of 5,651 new cases a day, which was an increase of more than 80 per cent on the previous week. In the week to 4 September, the average number of cases was 6,290 a day, which was still an increase but one of just 11 per cent. However, in the seven days to 11 September—the most recent seven-day period—the number of cases has fallen to an average of 5,506 per day, which is 12 per cent lower than last week.

It might be worth providing some detail on the age breakdown of cases. In the past week, more than 70 per cent of cases have been in the under-45 age group, which is consistent with the pattern that we have seen throughout the latest wave.

The picture varies across different age groups, but there are broadly positive signs in all of them. Two weeks ago, in the week to 4 September, the number of cases in the zero to 14-year-old band rose by 51 per cent. However, in the past week, the number of cases in that age group has fallen by 5 per cent. Among 15 to 24-year-olds, the number of cases fell by 16 per cent two weeks ago, and the number has fallen even further—by 34 per cent—in the most recent week. Two weeks ago, the number of cases in the 25 to 44-year-old age group rose by 7 per cent, but, last week, the number fell by 14 per cent. Finally, the number of cases among the over-65s has risen slightly, but, again, the rate of increase has slowed over the past week.

That most recent data underpinned the Cabinet’s decision earlier today not to reintroduce any restrictions. I am grateful to everyone—organisations, businesses and individuals—who has taken extra care in recent weeks to try to stop the spike. It seems that those efforts are making a difference. That said, our position remains challenging. Although the number of new cases has fallen, it remains five times higher than at the start of August. Universities are now returning for a new term. That is welcome, but it also creates some additional risk. I will shortly say more about how we are working to mitigate that.

The key point is that, although the recent fall in cases is welcome, we cannot take it for granted. We must continue efforts to keep cases on a downward track. The national health service is already under considerable pressure, and any further rise in cases would intensify that.

As we know, vaccination has significantly weakened 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 before the vaccination programme started, but current case numbers reflect how transmissible the delta variant is. As we can see already, even a lower percentage of a large number of cases results in a high number of hospitalisations. To illustrate that point, on 20 August there were 312 people in hospital with Covid; today, there are 1,064. The number of people in intensive care has also increased from 34 on 20 August to 89 today. Those figures do not include people who do not need hospital care but who are nevertheless suffering from long Covid.

It is also important to remember that the pressure that the NHS is experiencing falls on staff who have, in many cases, been working flat-out since the start of the pandemic and that it comes at a time when the NHS is working to catch up on a backlog and to care for everyone who needs that, not only Covid patients.

The Scottish Government is working closely with health boards to manage those pressures, but, as has been the case throughout the pandemic, everyone has a role to play. At the start of the pandemic, we constantly emphasised the need to protect our NHS. That is still necessary, and it should give all of us even more incentive to get vaccinated, test regularly and take all the basic precautions that we know can slow down transmission.

An additional reason for continued caution is that it helps to protect those who are most at risk. The United Kingdom Government announced earlier today that it will no longer use its shielding patient list. In the light of that, and to avoid any mistaken assumption, it is important to confirm that the Scottish Government is not following suit at this stage. We will continue to use our equivalent list, which is the highest risk list. We have used that throughout the pandemic to communicate with those at highest risk and to ensure they have advice and support. We will continue to keep that list under review, but, for the moment, we believe that it is important to retain it.

I will provide a brief update on some specific strands of work. First, I can confirm that cabinet secretaries are continuing to engage with representatives from business, the public sector and wider civic society to encourage maximum compliance with the mitigations that are still in place. I will take part in a round-table meeting with a range of stakeholders immediately after this statement in order to underline the importance of that work. I am, again, grateful to all businesses and organisations for the efforts that they are making to follow and promote measures such as the wearing of face coverings, good ventilation and hygiene, and, wherever possible, continued home working.

In addition, as I said, the university term is now starting, and colleges began their return a few weeks ago. We have been working closely with universities, colleges and the wider sector to make the return as safe as possible. As a precaution, colleges and universities will not be holding large, in-person lectures for now. Instead, there will be a mix of online and in-person learning, with institutions themselves deciding the level of in-person teaching that they will offer during this term. In addition, physical distancing will remain in place on campuses and face coverings will be required in indoor public spaces.

We are also encouraging students to get tested regularly. Test kits are available on campuses, and students who are moving to term-time accommodation should book a polymerase chain reaction test before making that move. Above all, we strongly encourage students to get vaccinated if they have not done so already. Mobile vaccination units are being deployed in universities and colleges during freshers weeks, and vaccination will continue to be made available throughout the term. Health board web pages will contain details of local drop-in clinics and clinics that are operating within colleges or universities.

We also continue to work with local authorities to make schools and childcare centres as safe as possible—for example, through support for the use of carbon dioxide monitors and improved ventilation.

We have received further advice from the advisory sub-group on education, and I take the opportunity to highlight two points arising from that advice. First, we indicated at the start of term that secondary school pupils would need to wear face coverings in class for the first six weeks of term, subject to a review at that point. Given the continuing high levels of infection that are still being experienced at this stage, the advisory sub-group has advised that that requirement should remain in place until the October holidays and be reviewed again then. I know how unpopular it is with many pupils and I completely understand why, but, for now, it remains a prudent and necessary precaution.

Secondly, we intend to clarify an aspect of guidance on contact tracing in schools in order to ensure fuller understanding of the process. There is no change in the advice for close contacts who are thought to be at high risk of having Covid: they will continue to be advised to self-isolate until they have returned a negative PCR test. For children and young people, a high-risk contact is most likely to be a household member or someone they have stayed overnight with.

However, we will clarify the guidance on the letters that schools send to lower-risk contacts. Those letters should be sent on a targeted basis to those who are most likely to have had low-risk contact with someone who has tested positive. The letters ensure that parents, staff and pupils are aware of those cases, and they offer advice on issues such as looking out for symptoms and using lateral flow testing. Our updated guidance may mean, for example, that it is appropriate to send letters to the classmates of a pupil who has tested positive but not necessarily to everyone in their year group. We hope that better targeting will help to reinforce the importance of the messages in the letters while minimising undue anxiety.

In addition, the advice in the letters will be strengthened in one respect. They will recommend to primary and secondary school pupils and staff who receive them that a lateral flow test be taken before they next return to school. That test should be in addition to the regular twice-weekly lateral flow testing that is recommended for all secondary school pupils and staff.

All those measures reflect our commitment to prioritising the wellbeing of children and young people and our determination to minimise disruption to education. That consideration was also, of course, central to the advice that the Scottish, Welsh and UK Governments and the Northern Ireland Executive received yesterday from our chief medical officers.

Members will recall that the JCVI concluded that the health benefit of vaccination for 12 to 15-year-olds outweighed any risks but that, because it was marginal, the JCVI could not recommend a universal offer of vaccine to that age group on health grounds alone. However, it indicated that it would be appropriate for chief medical officers to consider whether any wider issues might tip the balance in the other direction. The CMOs have now done that. They have concluded that vaccination could reduce disruption to education and that, taken together with the health benefits that were previously identified in the JCVI advice, extending the offer of vaccination to all 12 to 15-year-olds is justified.

Taking that broader view of the benefits and risks of vaccination, the CMOs are recommending that 12 to 15-year-olds should be offered one dose of the Pfizer vaccine, and that advice has been broadly endorsed by the Royal College of Paediatrics and Child Health. I am very grateful to all four chief medical officers for assessing the evidence on the issue with such pace and rigour, and I confirm to Parliament that the Scottish Government welcomes and accepts the recommendation. We believe that vaccination of 12 to 15-year-olds is important, and we will therefore move to implement the advice as quickly as possible. Our supplies of the vaccine are adequate to allow us to do that.

It is important to stress the importance of informed consent. I know that many young people and their parents will have questions. Material will be made available online later this week, and it will be appropriate to both young people and adults. It will seek to answer questions and provide balanced information to help young people and their parents to make informed choices.

I confirm that, from Monday 20 September—that is, Monday coming—drop-in clinics will be open for any 12 to 15-year-old who has read the information and, in discussion with parents and carers, decided that they wish to be vaccinated. It will, of course, be appropriate for parents or carers to accompany their children to clinics, and vaccinators will be on hand to answer any further questions or address any concerns.

Starting in the following week—that is, the week beginning 27 September—letters will be sent to all 12 to 15-year-olds, inviting them to an appointment at a drop-in centre or vaccination clinic. Again, parents and carers will be invited to accompany their children and the appointment will include an opportunity to ask questions and discuss concerns.

Finally, after the scheduled community sessions, there will be a programme of vaccination in schools to ensure that anyone who has not been vaccinated and decides that they want to be will get a further opportunity.

I know that these are important decisions for young people and their parents and that many will have questions. I encourage everyone to read the information that will be provided and not to hesitate to visit a drop-in clinic to ask any questions or raise any concerns. Vaccination is a vital part of our overall protection against the virus. That is why it is important to support people—perhaps, especially, young people—to make informed choices that they feel comfortable with.

In addition to the CMO advice on 12 to 15-year-olds, we have this morning received the final JCVI advice on a vaccine booster programme. That is in addition to the third doses that are already being offered to people who were severely immunosuppressed or immunocompromised at the time of their first or second vaccination. I confirm that the Scottish Government also accepts that advice and that, again, we have adequate supplies for moving ahead.

The booster programme is intended to prolong the protection that vaccines provide against severe Covid illness. It will run alongside our biggest-ever flu vaccination programme, since both programmes are important for individual and public health. Wherever possible, eligible people will be offered Covid and flu vaccines together. Booster vaccinations will be offered to all adults over 50, to front-line health and care workers, to younger adults with certain health conditions that put them at higher risk, and to adult household contacts of people who have suppressed immune systems.

The JCVI has also advised that there should be an interval of at least six months between a second dose and a booster dose.

I will now give a broad outline of the order in which we will implement the booster programme. We will set out more details shortly.

Front-line health and social care workers will be able to book their booster appointment online through NHS Inform from Monday 20 September. Also from next week, residents in care homes for older people will be offered both flu and Covid booster vaccinations. Adults aged 70 or over, and everyone aged over 16 who is on the list of those at highest risk, will be contacted shortly either by letter or by their general practitioner. Other eligible groups—all adults over 50, all those aged 16 to 49 with underlying health conditions, adult carers, unpaid and young carers, and adult household contacts of people who are immunosuppressed—will be able to book online from October.

These two announcements represent a very significant and very welcome extension of the vaccination programme and will help us considerably in our on-going efforts against the virus. I therefore say to anyone who is eligible for vaccination: please take up the opportunity.

The final point about vaccination that I want to touch on very briefly is certification for certain venues, which Parliament approved in principle last week. We are now working with businesses, events organisers and sports governing bodies to finalise both the detail of the regulations and sector-specific guidance. Covid certification has, of course, already been introduced in countries across Europe—indeed, many of those countries have already gone much further than we are proposing to do. We know that it is not a magic wand, but we believe that, as part of a package of measures, it can help to reduce transmission while keeping our economy and society open—which, of course, is what we all want to see.

Presiding Officer, I will close by emphasising again the key things that we can all do to help and to ensure that we keep infections on a downward track.

First, as I have already been talking about extensively, please get vaccinated if you are eligible and have not yet done so.

Secondly, please test yourself regularly with lateral flow devices. You can order those through NHS Inform or collect them from a local test site or pharmacy. If you test positive, are identified as a close contact or have symptoms of Covid, please self-isolate and book a PCR test.

Thirdly, and finally, please continue to comply with the mitigations that are still in place: wear face coverings in indoor public places such as shops and public transport and when moving about in hospitality settings; think carefully about the number of contacts that you have—and, perhaps, reduce any that are not strictly necessary; meet outdoors as much as possible; indoors, open windows if you can; although it is no longer required by law, try to keep a safe distance from people of other households, especially when you are indoors; and remember to continue to wash your hands and surfaces thoroughly.

As we can see from the most recent data, all of that really makes a difference, so please stick with it so that we can get cases down even further.

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. It would be helpful if members who wish to ask a question would press their request-to-speak buttons now.

It is good to hear that cases are down week on week. However, our NHS continues to face considerable pressure. We have seen long waiting times for ambulances and lengthy queues for people to see their general practitioners. Even if the First Minister will not accept it, our NHS is in crisis and our health service needs more support.

Today, on top of all the issues that face our NHS, figures on suspected drug deaths were published that are—once again—shocking and heartbreaking in equal measure. After seven consecutive years of record drug deaths here in Scotland, the problem still seems to be getting worse. When will the First Minister and her Government finally tackle that national scandal?

I turn to the announcements on vaccines for 12 to 15-year-olds and booster jags. Both those measures have the potential to be game changing in halting the spread of Covid this winter. However, we need some more answers on delivery of those schemes. The First Minister mentioned drop-in clinics for young people. Will there also be mobile vaccination units at every school to encourage uptake, particularly in areas where vaccination rates are low?

On booster jags, the First Minister said that the programme will run alongside the existing flu vaccination programme. Are there also plans to use mass vaccination centres?

On vaccination passports, the First Minister said that she is finalising the detail and is “now working with businesses”. Why did that not happen weeks ago?

Finally, the First Minister told us that the cabinet decided this morning not to make immediate changes to Covid regulations. What restrictions did her Cabinet consider reintroducing?

The Cabinet did not consider any additional restrictions this morning, because the data—as I have narrated—suggest that cases are starting to fall. We keep such things under weekly review; it would be deeply irresponsible of us not to do so. However, the decision of the Cabinet today was that it is not necessary to introduce any further restrictions at this stage.

I will quickly run through the other questions.

First, forgive me if I heard wrongly—I was struggling to hear Douglas Ross, at points—but I think that he said that I do not accept that there is pressure on the national health service. Not only do I accept that there is pressure on the national health service, but I spend a significant and considerable amount of time—as, indeed, does the Cabinet Secretary for Health and Social Care—reminding people of just how much pressure there is on the NHS.

That pressure is why it is so important that the Government does everything possible through resources and support for health boards, and through co-operation and collaborative working with health boards, to support those who are on the front line of the NHS. It is why it is important for all of us to behave in a way that reduces Covid cases, which helps to alleviate the pressure, and it is why, although none of us likes such things, it would be irresponsible of us not to take advantage of all the levers including, of course, Covid certification that we have at our disposal to try to push cases down.

This Government takes the issue of drug deaths extremely seriously. Although Douglas Ross might not agree with it—as is his right—a significant package of work is under way right now, backed by significant additional resource, to tackle drug deaths. The Minister for Drugs Policy, who reports directly to me, is overseeing that work daily. It includes work on new standards for treatment, including same-day access to treatment, a wider range of treatment options and more funding for community organisations and for rehabilitation, including residential rehabilitation. We will continue to take the action that is necessary to bear down on the unacceptable figures.

On vaccination, we received the chief medical officer’s advice on 12 to 15-year-olds yesterday and the JCVI’s advice on the booster programme this morning. Finer and more granular detail will be available in the coming days, but we are today giving the start date for vaccination of 12 to 15-year-olds and the start date for the booster programme, which is this Monday coming.

Drop-in clinics are already available right across the country; there are drop-in clinics in every mainland health board area. Those will be available to young people from Monday. Appointment letters with specific appointments will be issued for those who do not take advantage of the drop-in clinics, and we will use school vaccination to make sure that we reach as many young people as possible.

The judgment that has been made is that, in order to facilitate and support maximum informed consent and involvement by parents and carers, it is better in the initial stages to use clinics and appointments than to vaccinate through schools. Our aim is to reach as many people as possible and to encourage as many as possible in that age group to take up the offer of vaccination. We will use all the existing resources—mobile clinics and the other resources—to maximise uptake.

I think that Douglas Ross made a point about flu vaccination and mass clinics. The flu vaccination programme will be delivered through a combination of GPs and vaccination clinics. Health boards will not all do it exactly the same way, but the flu vaccination programme will be first, together with the Covid booster vaccine, in our older residents’ care homes. That is a massive undertaking for health boards, but given how well they have progressed the Covid vaccination programme so far, I think that we should all have great confidence in their plans to deliver the next stages of the programme with flu vaccination.

Finally, we work with businesses on an on-going basis and will continue to do that. None of us wants to be in a situation in which we are still having to deal with the virus, but it is important that we deal with it resolutely and that we continue to do all the things that we are doing now to keep downward pressure on cases.

I send my condolences to all those who have lost a loved one in the past 24 hours and throughout the pandemic.

The route to something that looks like normal for Scotland continues to be through testing, tracing and vaccination. Last week, I called for front-line NHS and social care workers to be included early in the booster programme, so I am pleased to have heard today that that will happen. However, given the high number of cases in schools, surely teachers and support staff should also be included.

I have also highlighted concerns about test and protect not functioning in our schools. I welcome the movement on that today. However, there is still work to do. I think that we will look back and think that pulling back test and protect was a catastrophic decision.

I note that there is still no detail about how vaccination passports will operate, although we are expecting businesses and individuals to implement the approach in just two weeks. We should focus instead on strengthening our existing systems. Test and protect is still failing to meet World Health Organization standards—the rate is as low as 60 per cent in some areas, and I note that last week the First Minister said that that was the rate 72 hours from when cases were logged on the system, which is a pretty heavy caveat. I note that the average number of primary contacts per case has fallen to 1.5—that is, the positive case and half a person. Just weeks ago the average number was 3.4. Will the First Minister commit to fixing test and protect and supporting staff, instead of rushing through an ineffective new system?

The Scottish Government has been saying that it has been planning for months—rightly—for roll-out of vaccinations for 12 to 15-year-olds, so it is a bit disappointing that letters will go out only from the end of this month. As we get to the harder-to-reach people, we should not be asking people to go to vaccination centres; rather, we should be asking the vaccination centres to go to people. Will the First Minister make a commitment that every child who wants vaccination will be able to get it at school and before the October holidays? We should not miss that opportunity. Surely that is the approach that should have been in planning for months.

First, on 12 to 15-year-olds—because that is probably the most important issue that we are covering today—we received the final advice yesterday. Any 12 to 15-year-old who wants to be vaccinated will be able to be vaccinated from Monday. That is less than a week away.

Why are there a few days in between? That is because we have to make sure that, taking account of the final advice, which we got only yesterday, we make available the information that young people and their parents and carers will want to consider before they make an informed choice. That is why there are a few days before vaccination will start. I think that most reasonable people—that might or might not include Anas Sarwar—will think that that is a pretty speedy start to the programme.

We have made the judgment that, in the initial stages, it is better to use drop-in clinics and vaccination appointments, because that better facilitates the involvement of parents and carers in decisions and allows them to accompany young people when they get vaccinated, so that questions can be answered and concerns addressed. Doing it that way will be quicker than trying to put in place a new programme—in effect—in schools. Doing it through the mechanisms and infrastructure that have been available for most of this year will allow us to get the programme under way more quickly.

We will then use school vaccination to make sure that nobody is losing out on the ability to be vaccinated. Having spent a fair bit of time with the health secretary looking at those plans in detail, I think that that is the best and quickest way to proceed.

On the booster campaign, Anas Sarwar said that he would like teachers to be included. Teachers in the over-50 age group, and those in the under-50 age group with particular underlying health conditions will, of course, be included. I suppose that the key point of difference here between Anas Sarwar and I, perhaps it is because I have responsibility for implementing the decisions, is my belief that we have to base our decisions on expert advice—on the recommendations that come from those who have the expertise to give us such recommendations. I am a politician. It is not for me to second-guess the experts when it comes to vaccination.

Test and protect is functioning well. When cases are high, it is under significant pressure and we support it to do its work. As cases reduce—as they are doing now, thankfully—that pressure will reduce. Test and protect has never stopped functioning in schools, and it is not correct to say that it has. It is functioning on a more targeted basis in order that it can protect people from the risk of infection without undue and unnecessary disruption to young people’s education. That is an important aim.

Lastly, vaccination certification is not “instead of” doing all of the other things; it is in addition to them. One of the things that we know, and that we have learned, is that we need to use all the levers that are at our disposal to bear down on cases to maximum effect. We will continue to take proportionate targeted action to keep cases coming down and, I hope, to get through this winter without the need to impose any restrictions, but instead keep our economy and our society open.

I say for the record that Covid identification cards must be ruled out for children, because there should be no external pressure on families when deciding about the vaccine.

Last week, the First Minister leaned in to the words of Professor Stephen Reicher to justify the ID card scheme, but he is actually against it. She implied that Geoff Ellis from the events industry supported it, too. He does not. In fact, he told me today:

“I am prepared to support a drive to encourage young people to get the vaccine, but that is different to saying you are going to exclude them if they don’t.”

The First Minister is running out of experts to quote, so will she cancel Covid ID cards for all age groups today?

No, I will not, because it is really important that we do not rule out measures that many people accept. Even Steve Reicher who, yes, on balance, has decided that he does not think that vaccination certificates are a good idea, recognises—[Interruption.]—that they have advantages and that there are benefits to them. We are facing a situation right now where cases have been high—[Interruption.]

Colleagues, I am finding it difficult to hear the First Minister. I would be grateful if we could all hear the First Minister.

When we are desperately trying to keep cases under control, while keeping our economy open, it would be a foolish Government that simply ruled out anything. The scientific advisory group for emergencies recognises that vaccination certification can play a part in reducing transmission. Indeed, after a fanfare at the weekend of suggesting that it had ruled them out, the UK Government has been very clear today that it is keeping the option of vaccination certification open and, even without doing it on a mandatory basis, is encouraging venues to do it voluntarily.

It is really important that we do not limit our options here, because we want to get through this winter with everything open and with cases at a manageable level. That is what we will continue to try to do, and I make no apology for that. We will, of course, continue to involve the Parliament fully in the detail of that.

Can the First Minister provide an update on the work that is being conducted to establish an independent public inquiry into the handling of the coronavirus pandemic in Scotland?

We will continue to work across the education sector to make sure that we take all appropriate actions to support the safe return of teaching, and to ensure that physical distancing remains in place, face coverings continue to be used and vaccination continues to be encouraged. There is an opportunity over the next few weeks to really maximise the uptake of vaccination, and to use testing to full extent, too. There is a big responsibility on the part of everybody here to make sure that everything possible is being done to reduce the risk of outbreaks in the weeks to come.

As the First Minister will know, this week, NHS Ayrshire and Arran halved elective surgeries and suspended visiting unless it is essential. Accident and emergency has reached breaking point. I have been contacted by staff at Crosshouse hospital who say that cancer operations have been cancelled due to a lack of beds, and nurses are quitting the profession due to chronic understaffing.

The First Minister has boasted of how many nurses we have, but staff at NHS Ayrshire and Arran feel angry, unsupported and let down. What action will the First Minister take to improve staffing levels at Crosshouse? Can she guarantee that all cancer treatment at NHS Ayrshire and Arran will resume by the end of the month?

I want to take the opportunity again today to express my gratitude to the nurses and everyone else who is working so hard across the national health service. We have a record number of staff in our health service, including nurses, but we need to do more to support them. We have made a commitment to further increase the number of those working in our national health service over this parliamentary session.

We will continue to work closely with health boards to ensure that they are supported to minimise any need to postpone or cancel elective treatments and to ensure that the most urgent treatment—cancer treatment comes under that definition—continues as people need it to.

However, there is a fact at the heart of this: if we are to get our NHS back to normal—as everyone is working hard to do—we need to get Covid cases down further and to keep them down. This comment is particularly relevant for those on the Conservative benches: we need to be prepared to take the action that gets Covid cases down. Over the past few weeks, almost every mitigation that we have proposed to try to reduce the number of Covid cases has been opposed by the Conservatives. Covid cases will not fall of their own accord—they will only fall through the actions that we take individually and collectively. We all desperately want to reduce the pressure on our national health service, and if we are to do that, we need to keep doing all the things that we know will reduce transmission of the virus.

On cross-border vaccination between England and Scotland, the advice is that if someone lives in Scotland and they received their first, second or both vaccine doses outside Scotland but in the common travel area, which includes England, they should now be able to get proof of their vaccination status through the normal process online or by phoning the Covid helpline. However, when my constituents phone the helpline, they are told that they need to request proof of vaccination in England from NHS England. There seems to be some confusion here. Can the First Minister clarify the situation?

Everyone recognises that it is important to have consistency in schemes that operate across the UK so that citizens can travel easily between different parts of the UK. Our app is designed to offer interoperability across not just the UK but the common travel area, including Ireland and the Crown dependencies.

That said, it is right and proper that we have designed a scheme that is right for Scotland, works first and foremost in our context and offers us the flexibility to adapt to changing circumstances. Work is well under way to ensure that, where a person has their first and second vaccinations either side of the border, that is fully recorded. I will ask the health secretary to submit further information on the detail of that to the Scottish Parliament information centre.

I have had several recent cases of people who have applied for a self-isolation grant but eight to 11 weeks later are yet to receive any support. That puts enormous pressure on household finances, especially for those on low incomes. Many people may be forced to return to work for financial reasons even though their self-isolation period has not ended.

I am told by West Dunbartonshire Council that the delay is because the local authority had not received money from the Scottish Government. Will the First Minister say whether that is true and what action she will take to ensure that self-isolation payments are made promptly?

I am not aware that that is the case. I will look into it and if there is any issue there, I will undertake to ensure that it is resolved.

Not everyone who applies for a self-isolation payment is eligible for one. If her constituents are eligible, and Jackie Baillie wants to send me the details, I would be happy to look into the circumstances. Although I am not aware of the flow of resource being a specific issue, I will undertake to investigate that.

Last week, I met the chair and directors of Ayr United Football Club, who listed their concerns about vaccine certificates. Will the First Minister provide an update on what training and support will be in place for businesses, events and sporting stadiums that need to implement vaccination certification next month?

The provision of training and support is important. As we said previously, we are working with sectors on an on-going basis on all the operational issues around certification. We are working to provide appropriate sector-specific guidance that will allow businesses to provide information and appropriate training to staff. That has to be sector specific, because the requirements in, for example, a nightclub with a relatively small number of people attending will be different from the requirements at a stadium with many people attending. That sector-specific guidance is currently being developed and finalised.

It is almost two weeks since the First Minister announced the introduction of vaccination passports. We just heard from the Cabinet Secretary for Covid Recovery that there is still no definition of what a nightclub is—and I am not talking about the Google definition. With the scheme due to start in less than three weeks’ time, can the First Minister tell businesses when a definition will be given to them and why it is taking so long?

It is taking a bit of time because we are doing what Conservative members usually ask us to do and say that we do not do enough, which is consulting with businesses in affected sectors to make sure that we get the granular detail of the issue correct. We will finalise the definition very soon; it will take account of whether, for example, settings are open between particular hours, whether they are serving alcohol between those hours, whether there is space for dancing and whether there is live or recorded music. We are taking the time to make sure that we properly consult with the Night Time Industries Association to get the detail of that right, and we will publish the definition soon, once that work has concluded.

Throughout the past year, I have been in regular contact with constituents who were vaccine trial participants. Will the First Minister provide an assurance that trial participants will be included in the forthcoming vaccination certification scheme?

That is an important issue for those who took part in vaccine trials, and I thank anybody who did so. We have been very clear that nobody who took part in a trial will be disadvantaged; the scheme will recognise their vaccination for domestic purposes. All clinical trial participants have already received a letter from their principal investigator, which can be used for proof of their trial status. That provided an interim measure to enable people to gain access to domestic venues where certification is required. Recently, we have also issued participants with a record of vaccination that contains a 1D barcode and security features consistent with all records of vaccination.

Millions of children around the world have already been vaccinated, but the UK is significantly behind other countries in its roll-out to young people. As the First Minister outlined, cases are beginning to fall, but numbers are still far too high and it is vital that we vaccinate 12 to 15-year-olds as quickly as possible. What action will the Scottish Government take to encourage take-up of the vaccine for that age group and how can we encourage looked-after children and, in particular, young carers to ensure that they get their vaccinations?

As I said earlier, we will move as quickly as possible, but we will also move in a way and at a pace that allows informed consent to be arrived at, which is particularly important for that age group. I have expressed frustration in the past that it has taken so long to get to this point, but we are where we are and it is important that we now move forward at pace.

The information that is provided will be important, because it needs to be accessible for young people themselves, not just their parents or adult carers. It is important that people in drop-in clinics and vaccination clinics are available to address concerns and answer questions. Of course, vaccinators are used to doing that with other vaccination programmes, so they are best placed to do that.

It is also important that we strike the right balance between encouraging people in that age group to engage and get vaccinated, as I will do unreservedly, and being understanding about the issues and questions that younger people will have. If we proceed on that basis, we will have every reason to be confident that we will achieve uptake levels in that age group that are as good as those in other age groups.

We know that, because of its complexity and the diversity of its symptoms, long Covid cannot be properly handled with a one-size-fits-all approach. What steps can the Scottish Government take to ensure that different health boards have flexibility to deliver the care that local people who are living with long Covid need?

James Dornan is absolutely right that we cannot have a one-size-fits-all approach to dealing with long Covid. I do not think that any country can. We are trying to recognise the need for flexibility in all the approaches that we take.

As James Dornan will be aware, we recently established a £10 million long Covid support fund. That is additional resource that is designed to strengthen services throughout the country for people with long Covid. We are also working with boards and others to identify where that additional resource is most needed and where it will have the biggest impact for those affected. As he has rightly said, supporting health boards to deliver tailored responses to meet the differing needs of people with long Covid is key to that. That will allow people to access services that are appropriate to their own health needs and appropriate to the part of the country that they live in. I very much hope that that fund will, in the weeks and months to come, lead to a lot of developments that will help those who are living with the condition.

Will the First Minister provide an update on the Scottish Government’s latest engagement with the United Kingdom Government regarding international travel restrictions?

There is regular official-level dialogue on border health measures, and there is due to be a four-nations ministerial meeting this week that will address the regular review of country risk ratings and look at wider policy issues. We expect that that meeting will take place on Thursday morning, as usual. I know that there is a lot of speculation in the media about the UK Government’s intentions. That speculation is happening before those intentions have been properly discussed with counterparts in the devolved Administrations. We want to work on a four-nations basis wherever we can, and we will aim to make further announcements on any future changes on a four-nations basis after, I hope, proper consideration and discussion.

The Covid pandemic has shown us how important our front-line NHS staff are. The First Minister has stressed that point this afternoon. The pressures that our front-line NHS staff face mean that we must protect their wellbeing and provide them with high-quality leadership. However, a recent survey suggests that bullying, even during the pandemic, remains a problem in NHS Highland. Last week, the First Minister’s Cabinet Secretary for Health and Social Care reneged on the Government’s promise to bring forward a debate on that issue in the Parliament. Does she support him? Is she happy with his breaking her Government’s promise?

Bullying in the national health service is unacceptable, just as it is in any setting.

There is no hesitation. I think that the Cabinet Secretary for Health and Social Care said that our priority right now—most people would understand this—is to deal with all the various Covid-related issues, not least the extension to the vaccination programme. I am perfectly happy for a debate to be held in the Parliament in Government time, if that is the view. I think that the Tories have Opposition business tomorrow. It would have been an option for them to debate that issue in their time. That is entirely up to them. However, I am happy to repeat the commitment that, when we are able to, we will bring forward a debate on that issue in Government time.

What discussions has the Scottish Government had with the UK Government about its vaccine procurement contract with Valneva in West Lothian? The Valneva facility is a well-established vaccine production facility that was previously visited by the Prime Minister and the then UK Secretary of State for Health and Social Care on separate visits during the pandemic.

I recognise Fiona Hyslop’s constituency interest in the matter alongside that of Angela Constance. I know that she was in the chamber when the Cabinet Secretary for Health and Social Care answered a question on that issue a few moments ago.

The UK Government’s decision to terminate the contract with Valneva was taken unilaterally by the UK Government. As the health secretary has indicated, he was informed of that on Saturday by the Secretary of State for Health and Social Care. We do not have the full details of everything that lies behind that decision, but I know that the Secretary of State for Health and Social Care has indicated in the House of Commons today that the vaccine might not receive Medicines and Healthcare products Regulatory Agency approval. I repeat the call from our own health secretary that the UK Government should publish all the relevant information on that for transparency.

On the Scottish Government’s part, Scottish Enterprise is already in contact with the company. We will do everything that we can to support the company in light of the decision because, obviously, we want to see that facility not just remaining in Livingston but going from strength to strength in future. We will do everything that we can to support that.

It is important to reiterate the point that the health secretary has made that, however regrettable the decision might be, it does not affect our ability to extend the vaccination programme in the ways we have talked about today.

Figures show that just 5 per cent of senior pupils in Scotland took a Covid test last week, as Covid-related school absences soar. With test and protect virtually non-existent in schools and no tangible action yet taken on ventilation in classrooms, testing is one of the only tools of defence that the Government has made available to keep pupils and staff safe and minimise further educational disruption. What immediate action can the First Minister take to increase those testing figures?

First, lateral flow testing is not the only mitigation that is being applied in schools. The work around carbon dioxide monitors, leading to the assessment of ventilation, is under way. A range of other mitigations are in place and, of course, contact tracing has not been ended in schools; it is being done, rightly, on a more targeted and proportionate basis because, before the summer holidays, we knew that significant numbers of young people were having their education disrupted when that was not strictly necessary.

On how we get more young people to take lateral flow tests, we make the tests available free of charge and they are easily accessible. I think that it is incumbent on all of us, both in the chamber and in our own constituent networks and in every possible way, to encourage young people to take those tests. I understand that, for young people in particular, they are not pleasant and are inconvenient, but they provide us with an added layer of protection. I take the opportunity today to encourage all young people—and encourage parents and carers—to take up the opportunity of LF testing twice a week and additionally if they get a low-risk contact letter.

Covid vaccination certificates will play an important role in reducing risk while maximising the ability to keep open certain settings and events where transmission is a high risk, so it is important that staff at the venues that are affected are properly supported to implement the scheme. Can the First Minister provide an update on the work that is being conducted to prepare detailed guidance on how to use the NHS Scotland Covid check verifier app?

We should remember that 85 per cent of the adult population are now fully vaccinated, and that number is increasing daily. In Scotland, first doses for 18 to 29-year-olds increased by 11 per cent in the 12 days following our announcement of Covid certification compared with the numbers in the previous 12 days. Again, I think that we can see—although it is still early—that that is having an impact in driving up vaccination uptake.

We encourage everyone to get vaccinated. Some people will not have completed their full vaccination course when the certification scheme comes into place, but people can check their vaccination status through NHS Inform, and details are available of how to do that. The app will go live later this month, which will make the system even easier.

These are all things that none of us wants to have to do and I hope that the vaccination system does not have to be in place for very long. However, while it can give us an added layer of protection, particularly as we go into the winter months, it is important that we take advantage of it.

Can the First Minister provide an update as to the Scottish Government’s work to respond to the global impacts of Covid-19?

That is a very important question because, although we understandably and rightly, to some extent, focus on the domestic impact and implications of Covid, it is a global pandemic and none of us will be truly safe from it until it is well under control across the whole world. In summary—I can provide more information for those who are interested—we have provided support to our existing international partners; undertaken a review of our approach to international development at an early stage of the pandemic so that we could better target support; and authorised over £3 million of support from our international development fund, targeting Covid-specific initiatives in our partner countries, which are Malawi, Rwanda, Zambia and Pakistan. That includes £2 million to UNICEF to help prepare health systems to distribute vaccines and £0.5 million to support vaccine roll-out and online learning on healthcare. More recently, our donations of vital medical supplies include oxygen concentrators, ventilators and personal protection equipment through the NHS Scotland global citizenship programme. We also sent oxygen and ventilation equipment to India and, lastly, our humanitarian emergency fund has supported vulnerable communities in countries such as Syria, Yemen, Somalia, South Sudan and Afghanistan.

My 31-year-old constituent received a first dose of AstraZeneca before others in her age group because she was in an at-risk group. When it subsequently emerged that those in that age group were being offered the Pfizer vaccine, my constituent opted not to receive the second AstraZeneca dose, after discussing the issue with her GP. Would it be possible for those in that category to be granted a vaccination certificate in order to access certain venues?

The advice for someone in that position is to get the second dose of vaccine but, obviously, I do not want to say too much about the individual case because, clearly, the person has received input and advice from their GP. I am happy to look into the issue in more detail and come back with a considered answer rather than answering before I have had the opportunity to consider the matter properly.

The default position is that we would encourage people to complete their second doses but, if there are circumstances where, for good reason, that cannot be done, we would want to take account of that. I will ask the health secretary to write to the member once we have had an opportunity to consider the issue further.

I want to come back to the cross-border issue. The First Minister knows that, every day, thousands of my constituents travel a few miles to Cumbria and Northumberland for work. Many of them work in the NHS so, naturally, they were vaccinated by their employer in England. However, they cannot get a vaccination certificate from NHS England because they are registered with a GP in Scotland and they cannot get a vaccination certificate from NHS Scotland because it has no record of the vaccination. I am already dealing with cases involving NHS staff who cannot get a well-earned break because they cannot get vaccination certification.

The First Minister says that action is taking place at the moment to resolve the issue. Can she give a categorical assurance that, if this policy is rolled out to events and nightclubs in just two weeks’ time, none of my constituents will be denied a vaccination certificate simply because they were vaccinated in England?

Yes, I want to give that assurance. Clearly, we are working to resolve the cross-border issues. As anyone would realise, we are not in control of what happens in England, and it is not something that we can do unilaterally. That is why the discussions between Governments are important.

We hope and expect that a solution will be in place soon and we will make the details of that known. However, it is in nobody’s interests to disadvantage anybody. The whole point of vaccination certification is to allow people to go about their normal lives and not have to see places close or be unable to access them. The policy is about enabling activity in the economy, not the reverse.

We know that the detail of the Scottish Government’s plans for vaccination passports has been severely lacking. Therefore, can the First Minister say whether everyone who is eligible for vaccination will be required to have a vaccination passport for certain events and if, as is now recommended by the UK’s chief medical officers, 12 to 15-year-olds will be offered a single vaccine dose, does that mean that a 14-year-old might need to have a vaccination passport just to go and watch their local football club play if the attendance is over 10,000 people?

The requirement for vaccination certification does not apply to 12 to 15-year-olds, so that point is not relevant.

I will not repeat all the points that I have made about the on-going work to develop the finalised detail of the operation of the system on a sector-specific basis, but I can say that the detail of the vaccination certification programme in Scotland is identical to that published on page 24 of the UK Government’s document today, in which it sets out what it continues to call plan B, which concerns its continued plans to introduce vaccination certification should that be required. The only difference is that we are trying to give businesses here certainty and the UK Government appears to have removed that certainty and is just saying that maybe it will introduce vaccination certification and maybe it will not. However, the level of detail is pretty identical.

That concludes questions on the First Minister’s statement.

On a point of order, Presiding Officer. For the second time in two weeks, the First Minister read the wrong pre-scripted answer to one of her back-bench members’ pre-scripted questions. Stuart McMillan asked about the inquiry into the Scottish Government’s handling of the pandemic and the First Minister’s answer was all about schools. Presiding Officer, can you advise what options there are to ensure that we hear an answer to the question that was actually asked?

I thank Mr Kerr for his point of order. The content of members’ contributions is not a matter for me. There is a mechanism by which members can accurately reflect any change that they might wish to make via the Official Report.

That concludes the First Minister’s statement on Covid-19. There will be a short suspension before the next item of business.

15:20 Meeting suspended.  

15:22 On resuming—