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Chamber and committees

Meeting date: Tuesday, April 21, 2020

Meeting of the Parliament 21 April 2020

Agenda: Time for Reflection, Business Motion, Covid-19 (Health), Covid-19 (Justice), Covid-19 (Economy), Topical Question Time, First Minister’s Question Time, Business Motion, Parliamentary Bureau Motions, Decision Time


First Minister’s Question Time

National Health Service (Non-Covid-19 Treatment)

I begin by congratulating everyone concerned with the remarkable achievement of constructing and making ready NHS Louisa Jordan—our armed forces, contractors and our dedicated national health service staff. As the First Minister said, we hope that its use proves to be unnecessary, but what a superb achievement, resource and reassurance it is to us all. [Applause.]

Constituents have contacted me, in some distress, wondering whether they should attend hospital with what sometimes sound like quite serious conditions unrelated to coronavirus. Does the First Minister agree that, although we all work to save the NHS, people should not sacrifice their health and must make continued use of the NHS, when appropriate? Can she indicate what estimate the Scottish Government has made of the number of people who it might have been anticipated would make continued use of NHS facilities but have not? Will she emphasise again, on behalf of us all, that if people need medical assistance, they should not hesitate to seek it?

I thank Jackson Carlaw for that question, which I will come to directly. First, I will echo his comments about NHS Louisa Jordan. Everybody involved has been absolutely outstanding in their efforts, dedication and commitment. The Army’s help in planning the hospital was invaluable and I thank it. All the construction workers, the clinical staff and everybody else who was involved has performed a miracle, and I am deeply grateful to each and every one of them. We fervently hope that we will not need to use the hospital but—I am sure that I speak for the health secretary, too—I certainly feel more reassured knowing that that additional capacity is there.

I could not agree more with Jackson Carlaw’s substantive point. Clearly, we have had to make some very difficult decisions, including, of course, the postponement of non-urgent, elective treatment on the health service, in order to focus the health service on doing what it needs to do to deal with increased demand from Covid-19 cases. That relates to general hospital capacity and intensive care capacity, but also to what we have done to create the assessment hubs that free up general practitioners for other things.

That focus is really important, but it is vital that we all get the message across that the NHS is open for other things. Anybody out there who is experiencing symptoms—perhaps they have found a lump or have unusual bleeding—and particularly people who are worried about symptoms that their children might have as a result of conditions that they are already aware of, or anything that they are worried about developing, should contact the health service, the GP out-of-hours service or NHS24 on the 111 number, or they should attend accident and emergency departments if that is needed.

Yesterday, the chief medical officer gave some of the figures for the reduction in the number of people who are seeking urgent referral for cancer. We will monitor that information for a range of conditions and we will make it available as appropriate in order to encourage people to come forward.

We want to get the message across that the NHS is there if people need it; they should not hold back. People should come forward for the help that the NHS is there to give them.

I thank the First Minister. That is an important message and I hope that everyone hears it.

We have been discussing personal protective equipment for some time. A few weeks ago, the Scottish Government conceded that there were difficulties and it set up an email address for any medical or care staff to get in touch about problems. Jeane Freeman said that those emails are monitored by ministers so that the Government can act on them straight away. This weekend, an intensive care doctor in Glasgow said that, nine days after emailing, he still had not had a response. He said:

“We have no visors in the largest ICU in Scotland. Staff are reusing single-use ... visors”

that are potentially contaminated with Covid-19. Does that sound like a process that is working?

We have been talking about PPE since the pandemic started, and I predict that we will continue to talk about it for the duration of the pandemic. The very nature of the issue means that staff will feel anxious and we will be anxious and constantly monitoring supplies to ensure that they get to the front line where they are needed. That is not something about which we will ever say, “Job done,” such is the importance of ensuring that we are on it every single day.

The Cabinet Secretary for Health and Sport answered the question about the Greater Glasgow and Clyde clinician in her daily update on Sunday. The issue had been dealt with but, unfortunately, the clinician had not been replied to. We apologise for that. However, issues are dealt with as quickly as possible when they come in.

We have undertaken to provide more information about the data and analytics for the email address, but I think that more than 1,400 emails were received in the mailbox up until 16 April. A team of around 20 people are working on that. The mailbox is monitored from 8 am to 10 pm from Monday to Friday and from 8 am until 6 pm at the weekends. We have asked the Minister for Parliamentary Business and Veterans to give particular ministerial oversight to that, and we will continue to respond to issues as they arise.

More generally on PPE, we have sufficient stocks right now, but we are never complacent about that. Through NHS National Services Scotland, we are always looking to see how we can replenish stocks as they are used. Obviously, demand depends on use, which, in turn, depends on admissions to hospitals and the situation in care homes. I think that gowns and goggles are the two PPE items about which we have most on-going concern, but steps are being taken to ensure that stocks are replenished.

As long as the pandemic lasts, the issue will continue to be under active and on-going consideration by ministers and those who work with us.

The issue is inevitably complex, and it does not help that specific numbers can seem hard to come by. The First Minister talked about sufficient stock. When she was asked yesterday, she said that she did not have the exact number of hospital gowns to hand. Last week, Jeane Freeman said the same thing about supplies to care homes in response to my colleague Miles Briggs.

Earlier today, we heard that 80 million PPE items in total have been delivered so far. However, more detail would help us to understand what that means for front-line staff. Can the First Minister confirm how many of the PPE items that have already been delivered came from each of the procurement routes, how many PPE items have been ordered for the weeks ahead—I understand that there are three procurement routes that they come from—and how many weeks of supply are now in place for hospitals, general practitioners and social care?

Before I answer that question, there is an aspect of Jackson Carlaw’s previous question that I meant to touch on. I assure clinicians and those who work in social care that no PPE item that is intended for single use should be reused. That is an important part of the guidance that we give.

We are not trying to avoid giving the numbers of PPE items. I hope that people will understand that any numbers that I give right now for the aprons, gowns or gloves that we have available will be out of date almost as soon as I give them because of the nature of the issue. We are constantly supplying and updating stocks.

We have different supply routes, and we will use them appropriately. We also have different distribution routes to get equipment to the front line. We have one to two weeks’ supply of aprons in stock and action is being taken to make sure that that is replenished. We have 12 weeks’ stock of gloves. Those things are under constant monitoring. The figures, by definition, change all the time as items are used and as stocks are replenished.

We give as much information as we can about that. I ask people to take the main assurance that NHS National Services Scotland, which is our procurement agency, is working every minute of the day to make sure that we are able to give confidence about supplies of those items of equipment, not just now, but also in the future.

Sometimes the confusion comes from understanding whether the available stock is there for each of hospitals, GPs and social care. On some occasions, the answer may be relevant to hospitals, but not to the other two. Then we get emails from people saying, “We don’t have X, Y or Z.” There is a complexity in trying to understand the supply that is available in each of those three chains.

PPE is not just for hospitals but for care at home and for residential care. The First Minister has said that councils are responsible for the procurement of PPE for care homes. At the weekend, the Chancellor of the Exchequer announced new funding for councils that provided an additional £155 million for Scotland. The key question is how that money will be allocated.

To help not just with PPE, but the broad range of areas in which local government is leading the response to Covid-19, how will the Scottish Government decide to allocate the additional £155 million and will the Scottish Government publish this week how much cash each council will receive?

I give an assurance, as I have on other elements of consequential funding, that every penny that comes to us will be passed on for the intended purposes. All of the money that comes to us for local authorities will go to support local authority services. We will discuss with local authorities exactly how that is used and allocated and we will update the Parliament as soon as possible.

I will return to PPE. I know that the issues are complex, but we must be careful to think about supply and distribution differently. NSS procures supplies and it supplies the national health service. It also provides top-up supplies to care homes, which have their own supplies in place. For example, at the moment NSS is distributing top-up supplies directly to care homes to make sure that they have what they need, and it is prioritising those homes that already have outbreaks. We have taken steps to make sure that the distribution routes are as streamlined, efficient and effective as possible and that we are always listening to feedback so that we can make further improvements to that.

Although it is important that we understand those differences, the most important thing to me and to the health secretary is that everybody has what they need, when they need it. We are taking steps and we are not being too bothered at the moment about who is normally responsible for those things. We are taking the steps that we need to take to make sure that those supplies are there.

Covid-19 (Personal Protective Equipment)

I express our condolences to all those who have lost loved ones to Covid-19 over the past few days, and our support to all the care and national health service workers who are saving lives and going way beyond the call of duty.

I had seriously hoped that the issue of personal protective equipment would be resolved by now. However, when I hear regularly from council leaders and from NHS and care workers alike that PPE is still a big issue, I need to raise it again with the First Minister.

The First Minister and the cabinet secretary insist that we have sufficient stocks of PPE, but that is no comfort to carers and to vulnerable people if supplies are still not reaching the front line. We know that many lives are being lost in our care homes, and that many care homes still face a shortage of PPE. I ask again: what is the First Minister’s advice to those care workers who find themselves on shift in Scotland’s care homes tonight without the PPE that they need?

Care home providers will not be fulfilling their responsibilities to staff if staff are in that position. We have put in place the email address that I have spoken about. We are doing everything we can to make sure that there are ways in which staff can bring those issues directly to ministers if they cannot resolve them through their employers or their managers. We will continue to do that.

I say genuinely to Richard Leonard that if he—or anybody else—ever sees me stand up in this chamber and say that we have resolved the issue of PPE during this pandemic, he should really have a go at me then, because that would demonstrate a level of complacency that I will never want to have in handling this.

We know that there is a global pressure on supply, such that NHS National Services Scotland has to work literally around the clock, every day, to make sure that it is sourcing and securing supplies.

We have already made significant changes to distribution. For example, we put in place two routes for care homes in particular: the PPE triage helpline, and deliveries of PPE to local hubs, from which PPE can be distributed onwards or collected by social care providers. In the past few days, we have put an additional distribution route in place, whereby NSS is delivering top-up, one-week supplies to care homes directly. We are trying, as far as possible, to take a belt-and-braces approach, while putting a safety net in place so that any care home worker who feels that they do not have what they need will have somewhere to go.

I am not trying to pass responsibility to anybody. This is a national endeavour that I, as First Minister, have a responsibility to ensure that I am leading. However, care home providers have a responsibility to their staff to ensure that they have those supplies. I hope and expect that all of them are doing that.

We will continue to discharge our responsibilities to make sure that the supplies are there and that they are distributed to where they need to be. However, I will never, ever stand up here and say that PPE is not an issue that we need to continue to look at on a day-to-day basis.

The employer has a duty of care, but we have a duty of care to those workers as well. It is one that we need to take seriously, and we need to make sure that we understand that even one worker without PPE when they need it is one too many.

We are hearing concerning reports about the choices facing care home residents and their families. Yesterday I spoke to Margaret. Her husband is 70, he has Alzheimer’s and last autumn he moved into residential care. Margaret’s husband is still physically fit, which is why she was so distressed last week to receive a call from a general practitioner—who, incidentally, has never personally treated her husband—recommending that she give consent for a “Do not attempt cardiopulmonary resuscitation” notice and that she agree that her husband should not be admitted to hospital in the event that he contracts Covid-19.

Margaret does not want to sign such an order, yet she has been told that the final decision on whether to administer treatment or to send her husband to hospital will be the GP’s and not her own. Of course, every single patient’s case needs clinical judgment on an individual level, but why, when there is capacity on NHS wards and in intensive care units, are our care home residents being treated differently from other Covid-19 patients?

I have addressed that issue before, and I am keen to do so again and to do so clearly. This morning, or possibly last night, I signed a letter to Richard Leonard on that very issue, so I hope that what I am about to say to him will be available in that form as well.

I will first take the issue of hospital admission. Any person who has Covid—whether they are in a care home, their own home or wherever—should be treated as an individual. The decision about the treatment that they have, and whether that treatment is delivered in their own home—which, in the case of a care home resident, is a care home—or in hospital, should be clinically driven. There should be no set, predetermined approach. That is absolutely clear, and that is how GPs in the health service should be dealing with it.

On the issue of “Do not resuscitate” orders, I would be happy if Richard Leonard wants to pass Margaret’s details to us so that we can give her reassurance directly that she should not feel forced to sign such a document. Nobody should feel forced to sign such a document. We have been very clear that those forms should not be issued in that way, without the proper, sensitive discussions that go along with such decisions.

Aside from Covid-19, we encourage GPs to have anticipatory care conversations with their patients. All of us, at some point, have to think about what we would want at the end of our lives, but those discussions should be sensitive and holistic. If it is appropriate, and an individual wants it, a DNR discussion can be part of that. However nobody should be forced to contemplate signing such a form in isolation, without that discussion. We have been very clear about that and will continue to be clear about that to GPs and others.

My purpose in raising such cases is to bring to the First Minister’s attention what people’s experience out there is.

The Scottish Human Rights Commission raised concerns two weeks ago about the Scottish Government’s clinical guidance. Age Scotland has said that

“people ... have felt pressurised into signing Do Not Attempt CPR forms”.

Just last week, I was contacted about a standardised letter, sent by a Glasgow GP practice, to relatives of care home residents, saying that there would be no transfers to hospital. The Government has been content, up to now, to move vulnerable people out of hospitals and into care homes, so why is there still so much resistance to moving vulnerable people out of care homes and into hospitals, when they need it?

Everyone must have an equal right of access to treatment, and so to the chance of life itself. That is not only a founding principle of our national health service; it is a measure of our values as a society. What will the First Minister do to make sure that that principle is applied and that those values are upheld, even in the face of this pandemic?

Let me repeat some of what I said before, as clearly and emphatically as I can. Anybody who needs to be in hospital—if the clinical judgment about their care is that that is where they are best treated—should be in hospital. That applies to care home residents just as it applies to anybody else.

I say this on this issue, on personal protective equipment and on any other issue: if examples are being raised with members of where things appear not to be happening in line with how they should be happening, members should bring those to us directly and quickly, and we will work to resolve them.

Lots of people contact me. I cannot reply personally to everybody’s emails, but I do my best to monitor what is coming in to my inbox, so that I have a sense of the issues that are causing people concern. I ask members not to sit on those issues and wait for Parliament to be in session; I ask them please to get in touch.

Everybody deserves person-centred, individual care that is right for them. Sometimes, particularly for older people—and this would never be a judgment for someone like me; it would be a clinical judgment in all cases—the judgment will be that they are better being cared for in a home environment, whether that is their own home or the care home that they are living in. That should not be pre-determined; it should be based on what is best for that patient. I am absolutely clear and emphatic about that. If there is any example or instance where that is not happening, or where it appears that a situation has occurred contrary to that, we will take that forward, look into it and resolve it.

The human rights aspects of everything that we are doing right now are absolutely core to all our considerations. To go outwith the health and care aspect for a moment, we are placing significant restrictions on people’s freedom of movement—on the way that people live their lives—so human rights considerations have to be central to everything that we do right now. That will continue to be the case as we take decisions about the period that lies ahead.

Covid-19 (Economic Recovery)

On Friday, the First Minister said that recovery from this crisis must involve building a fairer, greener and more equal society. There is a growing recognition that business as usual was not working for most people; it was causing poverty and inequality, as well as environmental destruction. Economic recovery must surely mean that we stop undervaluing those people on whose work we all depend—carers, cleaners and those working in food supply and in public services—but also that we recognise that it is unacceptable to leave so many people with precarious incomes and precarious housing.

Will the First Minister commit to ensuring that, as we take on the challenge of planning a recovery from this crisis, public support for businesses from the Scottish Government will be directed at those clean, green industries that can build a new, more healthy economy; and to ruling out public funding for companies that are at odds with that goal, such as those in high-carbon industries, those paying poverty wages and those that are registered in tax havens?

In general terms, I agree with Patrick Harvie. I think that there will be lots of issues as we come out of the immediate part of the crisis, and beyond, that we will all want to think about afresh.

Although it is still difficult for me to lift my eyes from what is immediately in front of us, I feel that there are issues—whether we are talking about the social care sector, how our economy is structured or policies such as a universal basic income—that there was perhaps a reluctance to discuss previously but which now must be to the fore. How we make sure—of course, we try to do this anyway, and we have tried to do it before the crisis—that the support that Government can bring to bear is in line with the society and the economy that we are trying to build is central to that.

Of course, we cannot ignore the here and now, the hardship that people are suffering and the jobs that are on the line in different parts of the economy and the country, given some of the sectors that are involved. We have to help people work through the here and now, as well as making bigger judgments and decisions about the future. Government has to be in the leadership position, but it is a debate for all of us.

We would never have wished this situation to bring us to these points but, in everything that we have done—in every single element of how we do things—there will be examples of things being done differently that we will want to try to continue to do differently. These are big debates that I hope we get to engage with properly in the not-too-distant future. It is for all of us to do that; it is for us all to think long, hard and very carefully about.

I am sure that Patrick Harvie will understand that, from a Government perspective, a lot of our focus must still be on the immediate things that we need to do to get the country from here to a point where we have something like normality back. We will not have complete normality back for quite some time, and we will have to live with the virus for some time to come. However, continuing to suppress it with a semblance of normality and getting to that kind of balance will occupy much of our thinking, certainly for the next few weeks and probably beyond.

It is undeniably true that there are huge, urgent issues that come before the question of longer-term planning for recovery. However, before we consider embarking on any recovery, we need to be ready with the public health measures that will let us to do so safely. The very strong case has been made that, when the time comes—whether in the weeks or months ahead—a strategy to test, trace and isolate will be needed. The Scottish Government now uses that term regularly, which is a welcome change, but the strategy is not in place yet.

Everybody should be pleased if the extra hospital capacity that has been built is not all needed—that would be good news. However, the same is not true of testing capacity. We have increased our capacity to test, but it has value only if we use it. Can the First Minister explain why about half of Scotland’s Covid-19 testing capacity is being unused? Why are we still testing a much lower percentage of our population than most European countries? When will a test, trace and isolate strategy be in place?

We are already undertaking the work to put that in place.

Before I come back to the detail and the specifics of those questions, I emphasise that, when we start to lift some of the most stringent restrictions that are in place right now—I do not know exactly when that will be—we should be under no illusion that we will still face a period in which we will have to suppress the virus in different ways.

Continued social distancing is likely to be part of the approach for a while, and test, trace and isolate will be a significant part of it, too. The work that we need to do to build the capacity—it is not just about testing but about contact tracing and thinking about how we then support people who are having to isolate as a result of that—is under way.

The current approach to testing is that we are building capacity. That capacity is on track for the target that we set for the end of this month, but we will require to continue to build beyond that.

We are not yet using all our capacity, and we are looking carefully at that situation. We set three objectives for testing at the outset. The first objective is to test sick people in hospital. We are now expanding that to test people in care homes.

The second objective is key workers. We are testing more key workers with every week that passes. The testing at drive-through centres at Glasgow airport and elsewhere is over and above the test numbers that we report, which are from national health service lab capacity. We are still focused on getting more care sector workers through testing, but the impact of the measure is being seen in the reduction in the health service absence rates.

The third objective is to ensure that we use surveillance testing through our assessment hubs, in particular, as part of our overall surveillance of what the virus is doing. We are looking at how we use to the full now the capacity that we are building. To go back to the point that I started with, that is important because it will become the bridge to the mass testing that will be required as part of our strategy for the future.

Those measures are all under way at pace and with a huge amount of planning around them. I look forward to keeping Parliament updated on that in the weeks ahead.


I thank the First Minister and the Cabinet Secretary for Health and Sport for responding so positively to suggestions about testing all new residents of care homes. Those steps should help to give more confidence to care home residents and their families.

I offer another suggestion. Since 2010, members of the United Kingdom military have been entitled to a daily operational allowance of £29 when they are deployed to specific operations in demanding conflicts. Would the First Minister consider the proposal of giving an extra £29 a day to front-line national health service and care staff as a reward for their service during the pandemic?

I will certainly consider any such suggestions. We will want to ensure—no doubt in a variety of ways—that we recognise and reward the contribution that health and care staff have made. I want that to be in a way that ensures that our system in Scotland properly rewards our NHS and care staff through the pay that we give them. Relative to other parts of the UK, I believe that our system currently does that.

We will want to properly reflect on this experience and, to go back to what Patrick Harvie said, ensure that what we learn from the crisis about what really matters in life and what we value most is reflected in what we as a Government spend our money on—that applies more broadly than on this particular issue.

We have listened to what has been said about care home testing and we are trying to build as much assurance on that as possible. We have said that we will test all symptomatic residents in care homes. The health secretary today talked about admissions into care homes. On the first point, we have said that that does not change the clinical management of people—it is important to stress that. We know that the test is not reliable for those who are not symptomatic so, for people who are going into care homes, it is important that we do not allow testing to offer false assurance. Infection control and isolation remain the most important things that we do in care homes.

I recognise that final point; we must ensure that everything is in place to protect individuals in care homes, including those who are just going into them. It is essential that measures are strict.

A survey that was conducted by the charity Inclusion Scotland has identified worrying and sometimes horrific evidence from parents of children with additional support needs. We find that their children are exhibiting behaviours such as self-harm because of the removal of the structure of their daily routine, contact with friends and access to the outdoors. For some, the only form of exercise that they could take was swimming and that option has gone, too. Will the First Minister look at what more can be done to support those families? Can they be given special consideration as we consider the strategy for the exit from the lockdown?

We will consider on an on-going basis what more we can do to support people in the situation that Willie Rennie described, as well as people with vulnerabilities more generally, although vulnerable people obviously have different vulnerabilities and cannot be treated as one homogeneous group. That will definitely be to the fore of our thinking as we look towards the next phase.

I have said this in public before and I say it now in Parliament: later this week, we will publish not a hard and fast exit strategy from the lockdown but some of the principles that will guide us in the framework in which we will take the decisions, to begin the process of opening up a discussion on that with the wider public.

Many aspects of what we are doing to deal with the virus worry me as much as the virus itself. How it is affecting young people with additional needs is one such aspect. Willie Rennie previously raised one important point of detail about the guidance on exercise—whether, for example, to help them stick to their routines, people with autism could be allowed to exercise more than once a day. We have decided to amend that guidance to give greater clarity about those things being permissible, in those exceptional and unusual circumstances, to help people to have as much structure to their day as possible. We will continue to give full consideration to all those issues.

Currently, 18 members wish to ask a question. We cannot get through that many questions, but we will make a start.

Covid-19 (Head Shield Production)

Two of my constituents in Milnathort had successfully been producing head shields for their local general practice and offered to do the same for NHS Greater Glasgow and Clyde, NHS Tayside and NHS Fife. However, their financial adviser said that they would not get any liability insurance; therefore, they have decided to stop production. What advice can the Scottish Government provide?

If Liz Smith passes details to my office or the Cabinet Secretary for Health and Sport’s office, we will see whether we can do anything to resolve that matter. With regard to personal protective equipment, we always need to make sure that there is a quality assurance process, and that what is being produced is safe and reliable for use. Where people want to help and can contribute, we encourage them to do that.

Covid-19 (Entrepreneurs)

The First Minister will agree that, following lockdown, our entrepreneurs, who often risk all to start their own businesses, will be essential to restoring the Scottish economy. Given that many thousands of self-employed people continue to fall through the gaps in the Chancellor of the Exchequer’s safety net, what more can and should be done to assist self-employed people and our innovative new companies?

The Cabinet Secretary for Economy, Fair Work and Culture has given more detail today of the additional £100 million that we announced last week and how it will help, among others, newly self-employed people, who previously would not have been eligible for United Kingdom or Scottish Government schemes.

We want to continue to find different and innovative ways of plugging the gaps. It stands to reason that financial constraints limit what we can do in totality, but I hope that we have shown that we are willing to be flexible, to listen to suggestions and to help as many people in businesses in as many different categories as possible. The economy secretary and the Cabinet Secretary for Finance will continue to be open to suggestions and dialogue on those matters.

Covid-19 (Personal Protective Equipment)

I thank the First Minister and her team for the unenviable task that they are carrying out on behalf of the country. It is a hard enough job at any normal time, but it is especially difficult at this time, when we are trying to save lives in Scotland.

In mid-March, the Cabinet Secretary for Health and Sport said that, within a few days, there would be no gaps with regard to supply of adequate personal protective equipment for those on the front line in our primary care services. Today, the cabinet secretary said that we continue to have sufficient supplies. Despite that, a British Medical Association survey that was published this week says that only 22 per cent of doctors on the front line believe that they are fully protected. There have been 1,600 emails to the PPE account; about 80 people a day say that they do not have access to adequate PPE.

We recognise that this is a global pandemic and that there is global demand for PPE. Perhaps we should be straight with the public and say that we are doing the best that we can do to get all the PPE that we can get, and that we need to do the best that we can do with what we have. That would be a much better approach to building connections and relationships with those who are on the front line and who are having to do a thankless task, rather than saying that we have the PPE despite the fact that people face challenges. Let us be straight with the public, and we can get through this together.

I thank Anas Sarwar for the sentiment and spirit of his comments. As the Cabinet Secretary for Health and Sport has, I have from the outset of this situation tried to be straight and frank with people, and I will continue to do that.

The challenges are not easy, but I will never shy away from them. The PPE supplies that we have and that we are seeking to procure are intended to ensure that we can give front-line staff what they need, in terms of the guidance that has been provided. I do not want us to get into a situation, if we can avoid it, in which our direction of PPE use is driven by supplies as opposed to what is needed in order to protect staff. Given the global constraints, I cannot give an absolute guarantee that we will never run into supply difficulties, but we will work really hard to avoid that.

I am not making any criticisms of any other Government when I say that we were not required to change our guidance at the end of last week as the NHS in England had to because it had some supply issues. I am also not saying that we will never be in such a position, but we want to work as hard as we can to get the supplies that we need, so right now we are sourcing supplies from all sorts of places in order to ensure that health and care staff feel that they have what they need. That will continue to be our focus and our priority.

That said, I recognise that this is a time of high anxiety for people who are working in such jobs. For me to say, “You’ve got what you need—it’s the right kind of PPE and there are plenty of supplies,” will not necessarily take away that anxiety. This is a really stressful situation. I keep saying it, and it is true for all of us. I know that my relatives who work in the health service are very stressed and anxious about the situation. That is understandable, and just reinforces the need for us to do everything that we can to ensure that they have the supplies that they need, and for us to be frank along the way about the challenges that we are all facing.

Covid-19 (Business Support)

I have received communications from constituents who have applied for business grants but have, so far, received only an acknowledgment. Can the First Minister confirm the number of qualifying businesses that have received their grants to date, versus the number of applications that have been received?

I think that the overall number of applications is about 28,000—but correct me if I am wrong. The numbers vary among local authorities. We are encouraging and supporting local authorities to deal with applications as quickly as possible. The last figure that I saw—in fact, I have it here right now— was that local authorities have already paid out grants worth £220 million—I am sorry. I read that wrong. Local authorities have paid £120 million out of the overall £200 million.

This is an on-going process. We want local authorities to get the money out the door and into the pockets of businesses as quickly as possible, and we will continue to support that.

I have now—everybody will be glad to know—found the right figures in my brief. The figures are that 18,528 grants have been awarded so far, valued at £215 million, but that will be a moving process—[Interruption.] The Cabinet Secretary for Economy, Fair Work and Culture is telling me that those are last week’s figures, so more grants will have been awarded by now, but the principle is the right one. We want to get the money out to businesses as quickly as possible.

Covid-19 (Support for Charities)

How many charities are receiving financial support from the Scottish Government?

We have set up a specific fund for the third sector and for charities, as Bill Kidd will be aware, through which £7 million has already been committed to provide about 2,000 charities with a small grant of £2,000 each. A further £10 million has been allocated for some national priorities, with recent awards being made to Scottish Women’s Aid and Age Scotland, for example. There is another £33 million available, which was opened to expressions of interest on 13 April. On Monday, more than 1,600 third sector organisations were invited to complete an application for grants of between £5,000 and £100,000, and applications are currently being assessed.

We recognise absolutely the important work that third sector organisations do all the time, including right now, which is why it is important that we give them as much support as possible.

Covid-19 (Census)

In the light of the reported pre-action letter from the Sikh Federation UK to the Scottish Government and the impact of the Covid-19 lockdown, is the First Minister able to provide assurances that the 2021 census is on track?

The census is currently on track but, as with everything else right now, we continue to have to assess and monitor that against the realities of what we are dealing with. Any changes would be reported to Parliament in the appropriate way. Fiona Hyslop oversees that and will undertake to make sure that that is done. However, at the moment the census is on track.

Covid-19 (Oil and Gas Industry)

Can the First Minister clarify a specific issue for the oil and gas industry? United Kingdom guidance outlines how to socially distance on an offshore structure, and states that if people cannot keep 2m apart, they can take other action to keep safe while still operating. The Scottish Government guidance does not seem to have made that exemption. My understanding is that that has left companies confused and, potentially, exposed. Will the Scottish Government adopt a similar exemption in its guidance to companies so that that vital industry, which is already in the toughest of times, can keep operating?

I undertake to look into anything that is raised. However, in Scotland we have issued guidance for companies that operate in the space between businesses that have been told categorically to close, and those that are essential to keep the country going. We have talked about that in the chamber, previously.

The guidance asks whether businesses are doing something that is essential to the country’s material wellbeing, and if so, whether they can allow people to work from home or can work safely using social distancing, with 2m between staff? If they cannot, our very clear advice, which is based on health considerations, is that businesses should close. That is about prioritising public health, which is, in the longer term, in the interests of the economy.

I ask businesses across Scotland to ensure that they pay heed to the advice and guidance that the Scottish Government gives. We will keep it all under review. As we go into the next phase of decision making, that will include looking carefully at which sectors of the economy and which businesses can—at the right time—be allowed to reopen, as long as they can do so safely.

Covid-19 (Support for the Fishing Industry)

Last week, the UK Chancellor of the Exchequer announced £10 million in cash grants to support the fishing industry in England. Fishing is the lifeblood of many coastal communities across Scotland, as the First Minister knows, and has been badly hit by the crisis. What support has the First Minister’s Government provided for the fishing industry in Scotland?

We know that the virus and the implications of dealing with it have had an immediate impact on some parts of the seafood sector, with the almost complete collapse of markets, in some cases, which is threatening businesses and livelihoods.

Therefore, we have been working hard. Fergus Ewing, the Cabinet Secretary for Rural Economy and Tourism, has been leading work to ensure that a package of support is in place for seafood, fishing and aquaculture. The package of support that we now have in place is worth nearly £23 million. More than £3.5 million of that has already been paid out to the sector, and, in total, more than 1,000 businesses—mainly in coastal and island communities—will be eligible for support. That is the right approach. One of the things that I urge the UK Government to look at is whether it can do more for fishing and for the seafood sector more generally.

Covid-19 (Lockdown)

The First Minister said that she will not hesitate to use a different approach or timescale to the rest of the UK when it comes to exiting lockdown. The national clinical director has said that Orkney is

“quite different from Oxford Street”.

Does the First Minister agree that, when it comes to the current path of Covid-19, there is little difference between Cumbria and Dumfries and Galloway, or between the Scottish Borders and Northumberland, and, that we therefore need the right exit strategy for both sides of the border? Does she also accept that two different strategies, with different timescales for communities that are next to each other, would simply add to confusion and would be almost impossible to enforce in one community, when a neighbouring community, barely a social distance apart, is doing something completely different?

We have to—and will—take such factors into account. I hope that I have been clear in what I have said. Let me be clear again. For me, that is not a predetermined and ideological constitutional or political decision. Decisions are entirely driven by the best judgements that I and the Government can make about what is right in order to protect the people whom we serve. The virus, like all viruses, does not respect borders or boundaries. People move around the different parts of the UK—that issue will be particularly acute in the border communities to which the member referred.

It is also the case that for simplicity of messaging, the more uniformity and consistency there is, the easier it is to get messages across. However, I will be driven by what the advice, with my judgement applied, tells me is the right thing to do to protect people in Scotland. We have just spoken about advice to businesses, on which we have taken a slightly different approach because I—and the Government—thought that that was necessary in order to give priority to the public health message.

Where we think that it is right to do so, we will operate on a consistent UK-wide basis. However, when we think that it is right for Scotland to do something slightly differently, we will do that. That will be driven entirely by what we think is best to meet the objectives that we are all working towards right now, which are to suppress the virus, protect the national health service and save lives.

Covid-19 (Rent Support for Social Housing)

The Scottish Government has already committed to setting up a loan fund for private landlords who suffer from lack of rental income. However, the social housing sector has already been affected—a large number of tenants pay their rent by cash and cannot physically do that at the moment. There is also a strong possibility that tenants will not be able to afford to pay rent, however that rent is paid. Can the First Minister commit to support housing associations financially through this crisis, so that they and their tenants are not left worse off at the end of it?

I will not give a categorical commitment to specific assurances of financial support before we have properly talked through matters with the various stakeholders, and have thought through the consequences and implications. From my constituency, I know the importance and value of housing associations. I assure them and the social housing sector generally, and any other sector, that we will undertake dialogue, listen and try to respond as flexibly and quickly as possible.

This virus, and what we are doing to deal with it, will continue to impact on literally every aspect of life. It has already done so. We are asking people to do extraordinary and unprecedented things, which means that the response of the Government must be equally extraordinary and unprecedented. I think that it already has been, and that the same is true of the UK Government’s interventions. We always have to be looking, listening and considering what more we can do, and we will always do that.

I am afraid that we must draw questions to a close. I am conscious that many members did not get a chance to ask questions today.

I draw members’ attention to the fact that we will have two virtual question time sessions later this week—on education on Thursday and on environment and rural affairs on Friday.