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Chamber and committees

Meeting date: Tuesday, January 25, 2022

Meeting of the Parliament 25 January 2022

Agenda: Time for Reflection, Business Motion, Topical Question Time, Covid-19, Junior Minister, Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill: Stage 3, Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill, Parliamentary Bureau Motion, Decision Time, Point of Order, My Breath is My Life


Contents


Covid-19

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

14:15  

Today, as usual, I will report on the current course of the pandemic. I will also set out the latest data and outline some further changes that we intend to make in the period ahead. Those will include an update to the guidance on working from home and a change to requirements for overseas travel. Finally, I will summarise what we can all continue to do in the immediate future to keep cases on a downward trend and reduce pressure on the national health service and on the economy.

First, though, today’s statistics: 8,022 positive cases were reported yesterday, either through polymerase chain reaction or lateral flow tests; 1,392 people are in hospital with Covid, which is 43 fewer than yesterday; and 49 people are in intensive care, which is four fewer than yesterday. That figure includes 15 patients who have been in intensive care units for more than 28 days. Sadly, a further 23 deaths have been reported, taking the total number of deaths under the daily definition to 10,222. Once again, my condolences go to everyone mourning a loved one.

Although cases remain high—as in many countries around the world—the data from the past week paints another broadly positive picture. In the seven days prior to last Tuesday’s statement, almost 70,000 positive cases were identified through PCR and lateral flow testing, which is just under 10,000 a day. In the most recent seven days, there have been just over 50,000 cases, which is slightly more than 7,000 a day. Therefore, reported cases have fallen by just over a quarter.

There have been significant reductions in every age group except the under-15s. In that younger age group, cases have increased by 41 per cent. That will, at least to some extent, reflect the impact of the return to school. We will continue to monitor cases in that age group closely. We will also study the data carefully in the coming days to see whether the increase in cases among younger people is followed by any uptick in older age groups.

Although it is less up to date than our case numbers, the weekly survey data from the Office for National Statistics nevertheless indicates a similar trend. According to the ONS, in the week to 15 January, the percentage of people in Scotland infected with the virus declined.

As we would have expected, the decline in new cases is now reflected in a fall in the number of people being admitted to hospital with Covid. In the week to 14 January, 1,026 patients with Covid were admitted. In the following week, that fell to 704. Hospital occupancy has also fallen. This time last week, a total of 1,546 people were in hospital with Covid; today, it is 1,392. The number of people with Covid in intensive care has also reduced—from 59 this time last week to 49 today.

The significantly improved situation gave us the confidence yesterday to lift most of the remaining protective measures that were introduced before Christmas in response to omicron. I will have a little more to say about Covid statistics before I finish. However, following the lifting of restrictions on outdoor events last week, yesterday marked a significant return to normality with the lifting of all of the following measures: limits on attendance at indoor public events, nightclub closures, the requirement for 1m physical distancing between groups in hospitality and indoor leisure premises, the requirement for table service in hospitality venues serving alcohol on the premises, and the guidance against adult indoor non-professional contact sport.

On Thursday last week, we confirmed changes to our recommendations on self-isolation for people in care homes and lifted the recommended limit on the number of households able to visit care home residents. Visits from loved ones are hugely important for the wellbeing of care home residents, and I make it clear that we expect care homes and local health protection teams to support visits other than in genuinely exceptional circumstances.

The welcome progress of the past week or so has been made possible by a combination of booster vaccination, the proportionate measures that were introduced in December and, of course, the willingness of the public to adapt behaviour to stem transmission. That has all made a difference and, I am glad to say, has helped to send omicron into reverse. That progress is real and I am hopeful that it can be sustained.

That said, we know that there are still uncertainties ahead and the virus continues to be unpredictable. That all means that, although our return to more normality can be made with confidence, we should still exercise some caution. I will return to that point in a moment.

Before that, I can confirm that, on the strength of the latest data, the Cabinet concluded this morning that some further easing of measures is possible. First, as indicated last week, the current guidance on working from home, which was strengthened in response to omicron, will now be updated. Instead of recommending home working whenever practical, the new guidance will pave the way for a phased return to the office. It will recommend that, from Monday 31 January, employers should consider implementing hybrid working, following appropriate guidance, with workers spending some time in the office and some time at home.

We do not expect a wholesale return to the office next week—indeed, given that the level of infection, though falling, remains high, a mass return at this stage is likely to be counterproductive and to set progress back. However, we know that there are many benefits to employees, employers and the economy as a whole in at least a partial return to the office. Indeed, many businesses successfully implemented hybrid working last autumn. Therefore, as part of a phased return to the office, we will again encourage employers to consider hybrid working, and we look to them to determine how best to manage the transition in consultation with workers and trade unions.

I can confirm two further changes. In December, in response to omicron, a requirement for 2m physical distancing was introduced for indoor settings where people have a specific exemption from the need to wear a face covering. Such exemptions apply, for example, to people who are leading religious services or carrying out some receptionist duties. From Friday, in the light of the improving situation, that requirement will revert to 1m.

Secondly, there will be a change to the guidance on organised activities for children, which currently states that adults who are attending such activities should wear face coverings when indoors, unless they are leading the activity. From Friday, face coverings will no longer be required for any adult who is taking part in organised activities when they are directly interacting with children under the age of 5. That change will bring the guidance for indoor activities into line with that for early learning and childcare settings, and it will be of benefit to younger children and people who work with them.

We are not, at this stage, recommending any immediate change to the guidance on reducing risks in schools and the early learning and childcare sector. However, that is being kept under close and regular review. The advisory sub-group on education and children’s issues is meeting again today. We will consider carefully any recommendations that it makes, and we will continue to seek its advice on issues such as groupings in schools and the requirement for secondary school pupils to wear face coverings.

I know that young people, like many adults, want to see the back of face coverings as soon as possible. However, I also know that many young people understand and agree that face coverings provide important protection, especially when the number of cases in the younger age group is rising. It is a matter that requires and will receive careful on-going consideration.

Finally, further changes to international travel requirements were agreed yesterday by all four United Kingdom Governments. As a result, from Friday 11 February, fully vaccinated travellers will no longer need to take a test after they arrive in Scotland, although they will still be required to complete a passenger locator form. Travellers to Scotland who are not fully vaccinated will still be required to take a pre-departure test no more than two days before they board their plane and to take a PCR test on or before day 2 of their arrival here.

For international travel purposes, people are deemed to be fully vaccinated if they have completed at least a primary course of vaccination, which, for most people, means at least two doses. That international definition, which does not currently require booster or third vaccinations, will be kept under review.

The four UK Governments have agreed to work on a new surveillance system to identify any future variants of concern.

The Scottish Government would have preferred that system to be in place before the removal of the need for vaccinated people to take tests. However, and as we have done in the past, we recognise the wider benefits of adopting a common approach where possible.

Although those changes will be very welcome to travellers and the travel industry, it is important and responsible to point out that no Government can completely rule out having to tighten travel requirements again if certain circumstances—most obviously another new variant—were to arise. For now, and hopefully for the long term, it is really positive that those measures can be lifted. It opens the way for family reunions and the prospect again of holidays overseas and, of course, of much-needed support for the travel sector.

I am hugely grateful to everyone who has complied with the tighter protective measures that have been in force over the past month or so. Our collective efforts have made a huge difference. I know that many people will now rightly be looking forward to getting back to concerts, shows, sporting occasions and other events. Many others will be looking forward to meeting up with larger groups of friends or having a pint at a bar without the need for table service. Whatever it is that you are looking forward to doing again, enjoy it, knowing that, by doing so, you will be supporting businesses and organisations that have been through the mill.

However, to ensure that we sustain our progress, please continue to exercise appropriate care and caution. The level of infection, although declining overall, is still high, with around 7,000 cases still being confirmed each day. Indeed, the decline may be starting to plateau, and, as I reported earlier, cases among the under-15s are actually rising. Hundreds of people with Covid are still being admitted to hospital each week, which means that the national health service is still under immense pressure. We can say without fear of contradiction that this is the toughest winter the NHS has ever faced. We also know that any lifting of the protective measures that have helped to stem transmission, however welcome, can lead to an uptick of cases in the weeks that follow.

All of that demands a degree of continued caution, even as we enjoy a return to pre-omicron normality. So, for the rest of the month, and even though there are no longer any recommended upper limits, try to keep indoor social gatherings as small as circumstances allow, and please continue to comply with all the baseline protective measures. For example, continuing to wear face coverings indoors and on public transport can help all of us to stay safe while we travel and meet up more, and so will taking lateral flow tests before meeting up with others. Please continue to do that.

All those basic measures help us to protect each other as we get on with our daily lives, and they are especially important for the protection of those who are at highest clinical risk from Covid.

This week marks the introduction of a further initiative that is designed to help people who need extra support to get out and about with more confidence. The distance aware scheme is intended to help people who might be worried about going out. Badges and lanyards with the distance aware logo will be available to anyone who wants one, and they will indicate to other people that the person wearing the logo would like a bit of extra space and to have a bit more care taken around them.

The badges and lanyards are available free at mobile and community libraries across Scotland this week, and badges are also available in most Asda supermarkets. They are also available online from some participating charities. If you are, or anyone you know is, worried about being out and about and would feel safer with a bit more space, please get a distance aware badge. For everyone else, if you see someone wearing the badge or lanyard, give them the space and consideration that they are asking for. That is another small but important way of helping each other through a situation that remains difficult, challenging and stressful for many.

Finally, I stress again that vaccination continues to be the cornerstone of our battle against Covid. The very high vaccination rates achieved so far have helped us considerably on our path back to normality.

From this week, five to 11-year-olds with specific medical conditions are being invited for vaccination appointments. Parents and carers will receive either a letter inviting them to call the national phone line or a letter directly from their local health board. The types of medical conditions that make children eligible for the vaccine are set out at NHS Inform, and a leaflet with answers to questions that parents and carers might have will be made available in advance of appointments. There is also, as I indicated last week, a self-help guide on the NHS Inform website, and young people, parents and carers can use the guide to check eligibility for the vaccine.

In addition, reminder letters have been sent to 12 to 17-year-olds who are yet to complete their primary course of two doses of vaccine, and we are preparing to send scheduled appointments for February to any remaining 18 to 59-year-olds who are yet to be boosted. All 16 and 17-year-olds can also book boosters as soon as they approach 12 weeks from a second dose.

I take this opportunity to again urge anyone who is eligible for a primary dose or a booster but has not yet had it to please get it as soon as possible. Hospital data continues to show, even when it is adjusted for age, that someone who is not fully vaccinated is considerably more likely to require hospital treatment than someone who has had a booster or third dose. Being fully vaccinated is the single most important thing that any of us can do to protect ourselves, others and the national health service.

As I set out last week, we are continuing to consider the adaptations that might be necessary in the future to help us to manage the virus more sustainably and less restrictively. We will consult on and publish the updated strategic framework in the coming weeks. In doing so, we will take careful account of the developing international evidence as well as the data here. I was struck by the remarks that the head of the World Health Organization made yesterday. He said:

“learning to live with Covid cannot mean that we give this virus a free ride”.

He also warned that,

“globally, the conditions are ideal for more variants to emerge”.

It is clear, therefore, that we must continue to learn from experience and be prepared to adapt to a range of different circumstances.

On that point, I want to address directly a claim that was made in recent weeks by some Opposition members to the effect that the protective measures that were introduced here in response to omicron were unnecessary and that data shows that Scotland’s more cautious approach achieved no more than England’s less protective approach. In response, I told Parliament last week:

“The Office for National Statistics figures this week show that infection levels in England are over 20 per cent higher than those in Scotland.”—[Official Report, 20 January 2022; c 13.]

Willie Rennie issued a furious press release on the back of that, saying that I had “twisted” the data. He also reported me to the impartial chair of the UK Statistics Authority. I am pleased to say that he has now written back to Mr Rennie. Oddly, as far as I am aware, Mr Rennie has not press released the reply. Sir David Norgrove, the chair of the UK Statistics Authority, says in his reply that I

“correctly stated that the figure for England was more than 20 per cent higher than the figure for Scotland.”

However, he goes further than that. While acknowledging that there are other, equally accurate ways to cite the statistics, he concludes as follows:

“the data does suggest that the rate of infection is lower in Scotland than in England”.

To me, what matters is that Scotland is doing better now than we were doing before Christmas, and better than we might have been doing had we not taken action to stem transmission. That is what is important. How we are faring relative to England or anywhere else is not, in my view, the key comparison. However, given that others have sought to draw that comparison—inaccurately—in an attempt to undermine confidence in the Scottish Government’s decisions, I hope that all members will now accept the conclusion of the chair of the UK Statistics Authority that the data that I cited was, indeed, accurate. [Interruption.]

Members!

At this stage, as protective measures ease and as we head into spring, there are very good grounds for being optimistic that we are again on the cusp of a calmer phase of the pandemic. We can all help to ensure that the waters remain calm by taking the sensible steps that we know help to stem transmission.

First, please get fully vaccinated as soon as you can. Secondly, continue to take care when socialising. We are no longer suggesting a limit for the number of households who meet indoors, but, for the rest of this month, try to limit as far as you can the size of indoor gatherings that you have, and please take a lateral flow test before you go, every time.

Finally, please take the other precautions that we know make a difference. Keep windows open when meeting indoors. Continue to work from home for now, but talk to your employer about a return to hybrid working from the start of next month. Wear a face covering on public transport, in shops and when moving about in hospitality. Please follow all advice on hygiene. Those measures are making a difference, so please stick with them to protect yourself, others and the national health service.

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. I would be grateful if members who wish to ask a question were to press their request-to-speak button now or enter R in the chat function.

I apologise for missing the very beginning of the statement.

The latest data on Covid is very positive. Going forward, it is vital that we trust people across Scotland to judge what is best for them and their families, yet the First Minister said in her statement that, from the end of January, guidance on working from home will still advise against a wholesale return to the office.

Although some people will still want to work from home, why does the First Minister not leave that decision up to employers and to workers themselves? What does she think that it means for the businesses that rely on workers being back in the office and back in our communities, our city centres and our town centres?

Those businesses have another issue to deal with, which is caused solely by the Scottish National Party Government. Six weeks on from the announcement of more Covid funds, and weeks after restrictions were introduced that have now been removed, businesses are still waiting. A document that I have seen from SNP-run Moray Council says this about the Government’s record:

“Throughout the pandemic, there has been a considerable gap between announcements & providing details, guidance & grant-offer letters”

to local authorities.

Yesterday, businesses told the First Minister directly to stop ramping up plans to split up our country and instead to fully focus on Scotland’s economic recovery. Is it not about time that the First Minister listened and got on with delivering for Scotland, instead of dividing Scotland? Just when will those businesses that are crying out for support get the cash that they need?

Finally, throughout the pandemic, there has been agreement that children’s education must come first. However, right now, adults can sit in workplaces and pubs without face masks, but pupils in classrooms are still required to wear them.

The First Minister is not even following public health advice on that. This week, University of Edinburgh expert, Christine Tait-Burkard, said:

“I would expect for schools that removal of face masks to be relatively soon, as in early to mid-February”,

and the national clinical director, Jason Leitch, said:

“I think that day is coming”

when masks in schools will be removed.

I therefore ask the First Minister what she is waiting for. Why has the Government not set a date for the removal of face masks in our classrooms?

First, the latest data is very encouraging, but I think that anybody who has a modicum of common sense and who looked at that data would say that it calls for continued good sense and caution. That balanced approach has brought us to where we are today—in a much stronger position, and able to look forward with much more optimism.

From long experience in politics, I know that opinion polls are not everything, but sometimes they give us a useful insight into the state of public opinion. Just at the end of last week, a poll showed that two thirds, or thereabouts, of people in Scotland support the proportionate and balanced approach that the Scottish Government took before Christmas in response to omicron. I suggest that it is Douglas Ross who is out of touch with public opinion, rather than the Scottish Government.

I will take the points in turn. The first was on working from home, and why we do not just leave it to the good sense of employers and workers. I know that Douglas Ross, through no fault of his, was late, as we started a bit early. I think that he was in the chamber before I got to this point in my statement but, just in case he was not, or in case he was not listening, I will read it again:

“as part of a phased return to the office, we will again encourage employers to consider hybrid working, and we look to them to determine how best to manage the transition in consultation with workers and trade unions.”

Anyone looking at the data right now would say that a mass return to the office, from next week, with all that goes with that in travel to work and people coming together, would risk setting back that progress. It would not be responsible. That is why the Scottish Government is not going to encourage it.

Financial support payments are already being made to affected businesses in every council area. All 32 local authorities are making payments to eligible hospitality and leisure businesses. Payments are also being made by Creative Scotland and VisitScotland. I remind Douglas Ross again that that funding is available in Scotland and has not been available in the rest of the UK—something that was criticised by the Night Time Industries Association and others in England.

Finally, on face coverings in schools, which is possibly one of the issues on which we need to take the greatest care, nobody wants young people—or anybody—to wear face coverings for as long as possible, and I hope that the time is coming when doing so will not be necessary.

However, in the face of the 41 per cent increase in cases in the under-15 age group that I have reported today, anyone with a degree of responsibility who says that this is the moment to say that young people no longer need to wear face coverings is—frankly—not showing that responsibility.

When? I just want to know when.

Douglas Ross is shouting “When?” from a sedentary position in an almost childlike fashion, forgetting that we face an unpredictable virus and that it is important not to pluck dates out of mid-air, but to take those decisions responsibly. That is why the approach of this Government has such overwhelming support from the Scottish people.

I start by sending my condolences to all those who have lost a loved one.

This update confirms what we have been hoping—that the picture is improving. Covid has changed our society and our world. People accepted unprecedented restrictions and made extraordinary sacrifices. When the pandemic first hit, Governments were given the emergency powers needed to deliver a swift response to the crisis. However, things have moved on since then.

Two years on, it is clear that Covid is not going away—but there is hope. Research and innovation have given us tools such as testing to identify and help contain outbreaks, vaccines have helped reduce the severity of infections, and we have new treatments and antivirals for those who become ill. People and businesses therefore cannot be expected to live their lives subject to ad hoc and last-minute decision making from Government. We need a new approach.

Yesterday, Scottish Labour set out a strategy for living well with Covid. It seeks to learn the lessons of the past two years and looks at how we build resilience into public services, protect the most vulnerable and provide as much certainty as possible. In this new phase, any new decisions must be proportionate and clearly communicated.

Will the First Minister commit to engaging seriously with those proposals? They would mean clear triggers, the restrictions that would follow and a framework for the financial support that businesses and workers would expect. They would also mean rolling capacity for vaccination, testing and tracing, pandemic proofing our schools and—crucially—proper data sharing and parliamentary scrutiny.

Finally, does the First Minister accept that the situation that we face now is very different from that of March 2020 and that we cannot expect people to live their lives in perpetual crisis?

First, the situation is very different from March 2020, and people are not living their lives as they were asked to in March 2020. Anybody who suggests that we have not changed our response and adapted to changing circumstances is not paying attention or not wanting to recognise those changes.

We will look seriously at the proposals that Anas Sarwar has put forward, as we will look seriously at proposals that anyone puts forward. I have said before that we will consult widely as we develop the updated strategic framework over the coming weeks. It is important that we get it right. It is also important that we go beyond soundbites such as “pandemic proofing schools”. Yes, we all want to do that, but it comes down to serious investment, such as the investment that we are making in better ventilation and in other mitigation measures.

We would have to take care in relation to having a rigidity of approach around triggers, because we have learned—particularly over the past few months—that different variants do not behave in the same way as previous variants. If we have too rigid an approach, we do not adapt properly to the reality of the situation that we are facing. That is why there continues to be a need for judgment and good sense in how we try to balance things. However, we will consider any proposals that are put forward.

It is not the case that responses are ad hoc or last minute. We respond to changing circumstances—we would be failing in our obligation if we did not. I believe that the action that we took before Christmas has been shown to be worth while because of the much better position that we are in now. Yes, we need to have as much clarity as possible in our future approach, but we would be acting at our peril if we did not retain the ability to be flexible.

I go back to the comments from the head of the WHO that living with this virus does not mean simply giving it a “free ride”. We have to be smart in how we deal with it, which is what we will continue to seek to do, and we will consult as we do so.

In November, John Swinney told me and the chamber that

“Anybody who comes to Parliament and seeks to diminish Covid’s enormous impact on our national health service is not recognising the reality of the situation that we face.”—[Official Report, 11 November 2021; c 21.]

In December, we learned about the worst poverty-related attainment gap on record. The Cabinet Secretary for Education and Skills told the chamber that

“we are in a global pandemic”

and that

“that context is exceptionally important”.—[Official Report, 14 December 2021; c 64.]

Finally, earlier this month, I warned about children waiting years for mental health treatment, and the Minister for Mental Wellbeing and Social Care said:

“We are still in the midst of the pandemic, and this is the most precarious time in the pandemic”.—[Official Report, 12 January 2022; c 24.]

This country faces a litany of social problems, action on which ministers have sought to defer with reference to the pandemic. However, miraculously, we were told this weekend that the threat of the virus has abated such that, in 2023, we can hold another referendum on independence.

Those problems have not gone away. There are patients who are waiting in pain for operations, children who have missed out on life-qualifying education, and front-line staff who are on their knees and are in want of a break. Does the First Minister understand the anger and frustration at her Government as it turns its eyes away from them and back to the tired old divisions of the past?

I think that Alex Cole-Hamilton is the only one in this chamber today who is turning his eyes away from those issues. We focus on those issues each and every day, and that will continue as we come out of this pandemic and, hopefully, enter the recovery phase. However, in the interests of democracy, we will also seek to take forward the mandate that we won less than a year ago at the Scottish Parliament election to allow the people of Scotland to choose whether to complete the powers of this Parliament to better equip us to deal with the issues that Alex Cole-Hamilton has set out, because those things are, of course, very closely related.

Let me pick up on two examples. On child poverty, we are making great strides and great efforts, chiefly through the Scottish child payment, to tackle child poverty in Scotland but, as we do that, the powers that are still held at Westminster are being used to pull in the other direction. Completing the powers of this Parliament will significantly help in our task.

Secondly, in relation to staff on the front line of our national health service, who are exhausted because of Covid and the other pressures on the NHS, one of the exacerbating factors involves staffing shortages and recruitment, which are issues that are exacerbated by Brexit, which was imposed upon Scotland against our will. Again, completing the powers of this Parliament through independence would ensure that we are in charge of our own destiny.

Our ability to ensure that Scotland addresses those issues and fulfils its potential will be enhanced by Scotland becoming independent, and I think that everybody, including Alex Cole-Hamilton, should perhaps lift their eyes and their ambition.

Women’s health and wellbeing has to be an absolute priority during pregnancy, and I was pleased that pregnant women were last month added to the Joint Committee on Vaccination and Immunisation’s priority list for the vaccine and the booster.

Can the First Minister confirm whether the rate of vaccine uptake among pregnant women has increased since they were added as a priority group, and will she join me in encouraging pregnant women to come forward for their first, second or booster vaccination in order to provide them and their babies with the strongest possible level of protection against the virus?

Yes, I strongly echo Natalie Don’s call to pregnant women to get vaccinated as soon as possible. Public Health Scotland will publish its next analysis of vaccinations in pregnancy on 2 February. Previously published data showed that, from the start of the vaccination programme until August last year, uptake of the vaccine among pregnant women was lower than it was among non-pregnant women, but it was increasing and, according to the most recent data that was published by Public Health Scotland in September and October, uptake among pregnant women has become more similar to uptake among the general female population. That increasing uptake is encouraging.

Vaccination is the best way to protect against the known risks of Covid in pregnancy for women and babies, including premature birth and admission of women to intensive care. Therefore, I urge all those who are pregnant and who have not already done so to book their vaccination as soon as possible. I thank Natalie Don for raising such an important issue.

Figures that were released this morning show that 47 per cent of registered patients have not seen an NHS dentist in the past two years, while oral health inequalities amongst children have widened to the worst level on record. As dentistry recovers from the pandemic, patients across the country are facing long waits for routine treatment. What steps is the First Minister’s Government taking to help restore such NHS dental treatments across Scotland, especially now, given the withdrawal of emergency funding from 1 April?

Obviously, throughout the pandemic, a range of emergency provisions were put in place, including for people who required dental care and treatment. More recently, we have been supporting dentists to recover and get back to normal so that they can do the range of procedures that they did ordinarily before the pandemic, and that support will continue to be given, including through appropriate investment.

The point about emergency funding is one that we make more widely. We are not completely out of the pandemic yet, but much of the consequential funding for Covid and Covid recovery is not continuing, which has knock-on impacts on our budget. Within that, though, we continue to support dentists and others in the national health service to the very best of our ability.

City centres such as Glasgow have been hit harder economically than most UK cities, particularly in retail and hospitality. Between them, Glasgow, Edinburgh and Aberdeen airports have lost 4,500 jobs as a result of the pandemic. In Glasgow, there are reports that passenger numbers are equivalent to what they were in 1973.

Does the First Minister agree that connectivity is vital for our economy? Can she tell me when she plans to engage with our airport industry to ensure that Scotland is not at a competitive disadvantage and we can start to see connectivity help our city economies to recover?

I agree that connectivity is vital for the prospects of our economy. It is also important for many other reasons, including family and personal reasons. However, we also have to recognise—as I am sure that Pauline McNeill does—that international travel, particularly in the face of new variants of the virus, still poses one of the biggest risks in terms of transmission. This is always going to be a difficult issue.

The pandemic has been incredibly difficult for Scotland’s airports and aviation sector, and the travel industry more widely. We continued with rates relief for the aviation sector longer than other parts of the UK. Scotland is not unique in this; many countries across the world are still managing travel restrictions as part of managing the virus.

We are in a much better place now. The changes to requirements that I have outlined today, which come into force shortly, will significantly help international travel return to a degree of normality. I think that we can look forward, at this stage, to greater normality around international travel for family connections, business and holidays, which will help the airport sector with the process of recovery. However, we will continue to engage with the sector about how we can support it more widely to recover as quickly as possible from what I absolutely accept has been a torrid time.

As restrictions and protections are eased and we begin to adapt to living with Covid-19, this will be an anxious time for some of my constituents, especially those in higher risk groups. Can the First Minister outline how the distance aware scheme might help to provide confidence and support to people who are worried about mixing with others?

That is a really important point, and one that it is vital that we do not just pass over. The majority of us are really keen to get back to as much normality as we can, as quickly as possible. We are desperate to do all of the things that we enjoyed doing before Covid. However, there are some people in our society, particularly those at highest clinical risk, and also many older people, who feel very nervous about getting back to normal and who still worry about the risk that Covid presents. In the spirit of solidarity that has served us well, we have to try to strike the right balance, so that everybody can feel confident about the path that lies ahead.

The distance aware scheme is a really important initiative in that context. It is voluntary, but it allows us to support anyone who might be a bit more worried about mixing with others or who perhaps just wants a bit more time to adjust to the transition. The badges and lanyards that can be acquired will help people in those circumstances, if all of us respect the wishes of those wearing them. That is one way of helping to ensure that we make the transition back to normality in a way that is as inclusive as possible and recognises the impact on mental health, wellbeing and anxiety levels among many people who are particularly vulnerable to the virus.

I have previously expressed concern in the chamber about the removal of PCR testing for vaccinated people travelling into Scotland. I note the First Minister’s warning that no Government can rule out having to tighten restrictions once again if a new variant were to arise. However, does she recognise that the removal of PCR testing could undermine our ability to detect and therefore prevent the spread of new variants? Can the First Minister provide any detail on the new surveillance system that is to be introduced?

I recognise that concern and, to some extent, I share it. As I said earlier, our preference would have been not to remove the testing requirement until we had a new surveillance system in place. On the other hand, we recognise the benefits and, to some extent, the practical necessity of having common travel requirements in place in all four nations of the UK. These are difficult balances that we try to strike as well as we can.

PCR tests are important because they enable genomic sequencing, which is very important in the detection of new variants. Work will be taken forward—as quickly as possible, I hope—to get a proportionate and targeted new surveillance system in place, and we will keep the Parliament up to date as that work proceeds.

Will the First Minister advise us how much it costs to treat the average patient with Covid-19 in intensive care? Does she agree that the huge financial impact on the NHS is yet another reason why people who are not yet fully vaccinated and are therefore more vulnerable should get vaccinated and boosted?

I am not able to put a precise figure on that today, but we know that intensive care is the most resource-heavy form of NHS in-patient care. It is essential for the treatment of the sickest patients, and it costs several thousand pounds per day because it uses more staff per patient than any other type of in-patient care. Our intensive care teams are among the best in the world.

We do not and should never make admission choices based on consideration of resource in that way, but, of course, if there is something that all of us can do, in the face of the virus, to minimise our chances of needing intensive care, then we should—for all sorts of reasons—do that. Right now, vaccination is one thing that we know reduces our chances of getting seriously ill if we get the virus.

For that reason, as well as because of the unnecessary risk that you are posing to yourself and others, if you are choosing not be vaccinated right now without good reason, you are being deeply irresponsible. I urge you to change your mind and get vaccinated as soon as possible.

Yesterday, Dr Jane Morris, vice chair of the Royal College of Psychiatrists in Scotland, reminded us that, although Covid restrictions serve a physical health purpose, they have a mental health consequence. Nearly 2,000 young people in Scotland have waited more than a year for an appointment with child and adolescent mental health services. The statistics were shocking long before Covid. Many young people are desperate and, sadly, for some it is just too late. Will the First Minister commit to putting every ounce of Government focus and attention into supporting and rebuilding the nation’s mental health off the back of Covid, and will she back that up with a plan and all the resource that it needs and deserves?

Yes. We had a focus on that—particularly child and adolescent mental health services—before the pandemic, redesigning the way in which services were offered with much more focus on community services and preventative early intervention services such as counsellors in schools. That work will continue. The member is right to say that that is even more important now than it was before the pandemic struck.

I recognise that physical restrictions have a mental health impact. Everything that we have had to do in response to the pandemic, to stem transmission of a virus, has had impacts in other ways. I am not suggesting that this is what Jamie Greene is putting forward, but the fallacy that we often hear is that, if we had not introduced restrictions, there would have been no impact. Without restrictions, transmission would have got more out of hand and the mental health and wellbeing impact of that would have been considerable, too.

This has always been a difficult balance to strike, for Governments everywhere. We continue to do it as well as we can, and we absolutely recognise the work that needs to be done to recover from the impacts that our response to the pandemic has had. Mental health is one area in which that is particularly important.

The chair of the UK Statistics Authority has confirmed that the First Minister accurately described Covid infections and that the figure for England was more than 20 per cent higher than the figure for Scotland. That success was achieved because people throughout Scotland stuck with the necessary restrictions that were put in place to protect lives and the NHS. Does the First Minister agree that Willie Rennie should apologise to the Parliament for his ham-fisted bid to twist the data, to the people of Scotland for failing to acknowledge the sacrifices they have made, and, last but not least, to Sir David Norgrove, the head of the UK Statistics Authority, for wasting his time?

This is important. It is vital that people like me show integrity and accuracy when we cite statistics. Sometimes we get it wrong and make mistakes, and it is important that we recognise that. For somebody to accuse me of twisting data—when a cursory glance at what I was citing last week would have shown that it was accurate—and to report that to the chief statistician was, I think, uncalled for. There is also a more substantive point here: I do not believe that the comparison between Scotland and England is the one that we should focus on. The comparison that we should focus on is the one between how Scotland is doing now compared with how we were doing at the start of the omicron wave and how we might have been doing now had we not taken the sensible and proportionate steps that we have.

For reasons that I cannot fathom, because I cannot understand the politics of this other than its pure political opportunism, Opposition members have tried to suggest—and to say that the data suggests—that the restrictions in Scotland made no difference. It is good that we have the confirmation that the data that I cited in response to those claims last week was accurate and that the actions that the Government and, more importantly, the public have taken have got Scotland into a much stronger position than we would otherwise have been in. If we could all put party politics aside for a moment, in the midst of a global pandemic, we might all find that that is something to warmly welcome.

I understand the need to balance lifting restrictions with the need to protect people who are most at risk from the virus, and I share the First Minister’s appeal for people to show solidarity with those who are most at risk. However, I cannot help feeling a bit uncomfortable about the distance aware badges, because they appear to shift the burden of protection on to people who are most at risk. What engagement has the Government had with people who are most at risk, including those who were shielding?

We engage with different groups all the time. I will come back to the member or ask a minister to come back to the member on the detail of that consultation. I recognise and accept the member’s observation, and I stress that the distance aware scheme is voluntary. We are not asking or expecting anybody to comply with it, but I know—I have had representations—that many people say that something such as the scheme would be helpful.

If there is a better way of doing it, I am open to considering it. I am not suggesting that we have come up with the best possible way that we could ever do it. We are trying to strike a balance between the majority, who want to go back to normal and go to pubs and concerts, and the groups—it is not a homogeneous group—in our society who feel nervous about that. People in my family are expressing that nervousness, and people with particular health conditions will especially feel it.

It is about striking a balance and finding practical ways of doing it. It is being done in good faith and for the best of reasons, but, if there are better ways of doing it, I am happy to listen to them and give them full consideration.

Does the First Minister agree that, as part of the strategy for living with Covid in Scotland, we will need to learn to adapt and respond to future variants that could emerge in other parts of the world, and that we will always be vulnerable to potential sudden decisions that could affect the economy and society unless and until there is an effective strategy for global vaccination? What is the Scottish Government doing to encourage the UK to play its proper and full part in that drive?

Fiona Hyslop is right to say that the possibility of future variants remains the biggest risk that we face. As an aside, I should say that the UK Health Security Agency confirmed at the end of last week that it has designated a sub-lineage of omicron as a variant under investigation. We think that there might be a small number of cases in Scotland and we are monitoring that carefully. I say that simply to illustrate the wider point that the global nature of this is important. None of us will be completely free of the pandemic until everyone is free, which means that the importance of extending vaccination globally cannot be overstated.

In December, I wrote to the Prime Minister to urge the UK Government to end its opposition at the World Trade Organization and join more than 100 other countries who support a temporary waiver of trade-related aspects of intellectual property rights. That is important and I repeat that call.

Although Scotland is not part of the COVAX scheme, we provided international development funding to support vaccine preparedness and delivery in our partner countries. We have a responsibility and will exercise it, but we will also continue to call on other Governments to take responsible action to extend vaccination across the globe as quickly as possible.

Speaking in Parliament on 9 September, the Deputy First Minister said:

“We are saying that the certification passports will be in place for a period up until the end of February 2022—but they would automatically expire at that moment”.—[Official Report, 9 September 2021; c 96.]

Is that still the case? If not, why not?

In terms of the legislation that is in place, I am sure that what the Deputy First Minister set out on the expiration is the case. If we consider that there is a need to extend that period, we will come to Parliament in the normal way and set that out.

Nobody wants any of these measures to be in place for any longer than necessary, but I think that we can safely say that it is because we have been prepared to take sensible and proportionate steps and the public have responded so magnificently that we are managing again to send Covid into reverse. We need to continue to be responsible about the matter. If asking people to show Covid certificates keeps nightclubs open and allows sporting events to go ahead, that is a much more proportionate measure than restricting or closing such venues and events again.

I go back to a point that I have made regularly. I think that the facts bear me out here. The Conservatives have opposed almost every sensible measure that we have taken in order to control the virus. To be honest, we would be in a much more difficult position if we had followed that advice. I think that the public support the cautious and proportionate approach that we are taking. We will take that approach for as long as necessary, and we will lift measures as soon as it is possible to do so.

Will the First Minister say something more about hybrid working opportunities as we slowly recover from the pandemic? Some of the surprising gains that we have experienced have been in the deployment of digital technology to enable hybrid working and home working and to help people to achieve a better work-life balance. Does the Government support that continuing? How can we guard against dropping back to the old norm of everyone piling on to our motorways and into their offices five days a week to get to and carry out their work?

On hybrid working, a lot of businesses implemented a hybrid approach quite successfully in the autumn last year, before we had to pull back again and tighten the guidance on home working in response to omicron. We are asking businesses to consider going back to that again and to talk to workers and trade unions about how workers can best do that in their own circumstances. In summary, that means people being in the office sometimes and working from home at other times, and perhaps a mix of office-based and home-based staff. The Government cannot and should not seek to mandate what that looks like in every working environment, but it is important that we are moving from heavy work-from-home-whenever-possible advice to something that is much more about enabling a phased return to the office.

Willie Coffey is right. I know that many businesses are already taking the unfortunate and unwelcome experience of the pandemic in the past two years to think afresh about the best configuration for their workforces in the future. Many people will be sick of working from home and will want to get back to the office, and many businesses will want that. That has knock-on benefits for people in the office and city centre economies, for example, but there are also many people who think that working from home is more productive and that it improves their work-life balance. That also has environmental benefits, of course. Getting the balance right in the months and years to come will not be easy, but there is an opportunity to rethink things and not simply go back to the status quo as it was before the pandemic.

There are big challenges, but I suspect that there are also big opportunities for our economy and our society.

Since 23 December, there has been a moratorium on fertility treatment for unvaccinated women, which has cross-party support. However, will the First Minister explain to my constituents why that moratorium is required and when it will be reviewed?

I think that I set out the Government’s position on that at quite some length last week, when I made a statement. I refer members and anybody else who is interested to that answer.

I go back to the question that I was asked earlier on about the vaccination of pregnant women. We know that the risks for a pregnant woman and an unborn baby are significantly increased if there is no vaccination and the pregnant woman gets Covid. The judgment was made that there should be a pause on fertility treatment for those who are unvaccinated. However, I said last week that people should discuss the situation with their clinical advisers.

We keep that under careful review. I absolutely and fully understand the stress and anxiety that any woman or couple will go through as they seek fertility treatment. It is important that we enable and facilitate that as much as possible, but we also have to understand the wider risks that exist around Covid, particularly for those without vaccination.

Many people are planning ahead and organising their summer holiday, which might include travelling abroad. In the light of Covid, what advice does the First Minister give such people?

As I said in my statement, we have agreed with the other UK nations to relax international travel requirements from 11 February, which means that fully vaccinated travellers will no longer need to take a test on arrival here. That will benefit Scottish residents who want to travel abroad, whether that is to visit loved ones whom they have not seen in some time or to have a summer holiday that they have not had the opportunity to have for a couple of years.

It is possible for people to look forward to this summer with much more confidence about booking summer holidays, but we are still in a global pandemic, and the situation in other countries is changeable, just as the situation here is still prone to change. People must recognise when they book a holiday that, although the rules might say one thing, the rules might be different in the country that they wish to travel to by the time they go. It is common sense to bear that in mind, but there is much more optimism about the prospect for summer holiday travel this year than there was in the past two years. I am sure that many people are looking forward to getting overseas and possibly even getting some sun.

Yesterday, I was contacted by a constituent who had cancer surgery cancelled with only a few days’ notice, as there were no beds in recovery or in any other ward for cancer procedures at our local hospital. Last year, the target for 95 per cent of urgent referrals with a suspicion of cancer to start treatment within 62 days was missed again.

My constituent’s family are calling for additional capacity to treat cancer patients. Will the First Minister listen to their anxious pleas and the pleas of so many and take action on waiting list numbers and delayed discharge rates, which were too high pre-pandemic? Will she introduce a robust recovery plan for cancer services?

Cancer is a core part of the NHS recovery plan. Cancer treatment and surgery are cancelled only as an absolute last resort. Cancer has remained a priority throughout the pandemic. We are focused on getting cancer services that have been disrupted back to normal for patients as quickly as possible. We are taking action to improve early diagnosis and cancer services. I think that eight out of 10 people are seen within the 62-day period, which is a whole journey waiting time. The 31-day target is being met, but we are working to improve the position on the 62-day target and to meet it.

The core of this is keeping Covid cases on the downward trend, because that reduces the Covid pressure on hospitals, whether that is in general hospital wards, in waiting times for surgery or in recovery. If Covid case numbers and the pressure on hospitals continue to come down, the need to cancel other operations diminishes. That is why the efforts to get Covid under control are so important to the national health service’s overall wider recovery.

NHS Borders has substantial staff absences directly because of Covid, as is the case elsewhere, so it has asked the public to ease pressure on accident and emergency services and not to attend unless doing so is absolutely necessary—for example, when somebody has severe breathing difficulties or severe bleeding. Does the First Minister agree with NHS Borders about that? Does she agree that the public should access expert advice from alternatives, if that is appropriate, such as community pharmacies and opticians?

When people need care from the NHS, we want them to get it from the most appropriate part of the NHS. That was true before Covid and it will be true after Covid, but there are particular reasons why we want it to be the case during Covid. A and E is for people who need A and E treatment; many other parts of the NHS—NHS 24, primary care and community pharmacies—are sometimes better placed to give people treatment. I encourage people to access the part of the NHS that is most appropriate for their needs.

Staffing pressures on the NHS are acute now, which is partly because of Covid. Covid-related absences are starting to stabilise; I hope that they will now reduce. The hope is that that will continue, which will ease a lot of the pressure.

As we come out of Covid, part of the recovery focus will be on encouraging people to use the part of the NHS that is most appropriate for their needs, and on giving them the support and the information to allow them to know about that. It is not in the interests of any patient to end up being treated in one part of the NHS when they would get better and more responsive care somewhere else.

I listened with care to the First Minister’s announcement of a return to hybrid working from 31 January. Could she advise those of us who assist the Scottish Parliamentary Corporate Body, which must consider the decisions, whether the regulations underpinning that will permit a return to 1m social distancing here in the chamber, in our parliamentary and constituency offices, and more widely across the parliamentary campus, in order to facilitate it?

We will provide advice and guidance to the corporate body, as we will to businesses more generally. This morning, Cabinet discussed the wider position and what it means for the civil service. There will be a return to hybrid working within the civil service from next week. It is not for me to decide, but I hope that the underpinning legislative arrangements and the changes that we are making will allow the Parliament to get back, if not to complete normality, to a greater degree of normality in its operations from the start of next week, or whenever the corporate body deems is appropriate.

What are the medium-term and long-term strategic aims and objectives for take-up of vaccines by those who are still to have their first, second or booster jags?

The key message is that it is never too late to get the vaccination. People will be able to access vaccines, if they have not had their first, second, third or booster dose, well into the future. We are the most vaccinated part of the UK for all those doses, but there are still too many people in Scotland who are eligible but have not been vaccinated. The message is this: please come forward for vaccination. The facilities are there, the capacity is there and the vaccinators are there.

I set out in my statement some of the steps that we are taking, for example to send scheduled appointments to those in the 18 to 59-year-old age group who have not had boosters yet. We will not give up on trying to get vaccine to every last person in Scotland, if that is at all possible.

I listened with care to the First Minister’s answer to Paul O’Kane’s question. On top of cancer operations being cancelled, diagnoses of early-stage cancer in Scotland have, tragically, fallen to the lowest levels in a decade. When and how will the Scottish Government increase the number of diagnoses of breast, colorectal and lung cancer in the first stages of illness, especially given that it was failing to meet the targets before the pandemic?

I have been asked that question for the past two weeks at First Minister’s question time—rightly so, because it is important—and by Brian Whittle on at least one of those occasions. I have set out the various steps that we are taking to ensure the earliest possible diagnosis of the most common cancers, and we are extending that to symptoms of cancer that are perhaps not as common as the ones that we often think of.

In summary, there is continued investment in the detect cancer early programme; there is continuing work to ensure that those who are referred on the urgent suspicion of cancer referral pathway are seen as quickly as possible within the 31-day and 62-day targets; and there are the new early diagnostic centres that we are establishing to provide a rapid route to diagnosis for people with less-common cancer symptoms, which would not normally be picked up on the urgent suspicion of cancer referral pathway.

We are doing a range of things to ensure that as many people as possible are diagnosed as early as possible. That is critical for outcomes for cancer patients. Of course, diagnosis is not the only consideration: ensuring that there is rapid access to the best quality and most appropriate treatment is important, too. All aspects of the cancer journey are under focus to ensure that we make the progress that Brian Whittle rightly says is vital.

Last week, Margaret Wilson, the chairwoman of the National Parent Forum of Scotland, told the Education, Children and Young People Committee that children are under

“stricter mitigations than any other group in society.”

On face coverings in classrooms, she said:

“we do not support the continued use of masks. We ... have asked for, evidence of why face masks need to be used.”—[Official Report, Education, Children and Young People Committee, 19 January 2022; c 41.]

Will the First Minister give a straight answer to Scotland’s parents? What is the evidence for delaying the end of the requirement for children to wear face masks in classrooms?

First, there is very strong published international evidence that face coverings are one of the most effective non-pharmaceutical interventions to have been used throughout the Covid pandemic in helping to reduce transmission.

Secondly, on children and young people being under more restrictive measures in relation to face coverings, let us not forget that, because of the phasing that is in the Joint Committee on Vaccination and Immunisation’s advice—I am not criticising the JCVI—children are not as vaccinated as adults are, so there is a need to ensure that we seek to protect them in other ways.

I respect the individual whom Stephen Kerr cited and I understand that people have strong views about face coverings. However, even if I was to say today that children and young people no longer need to wear face coverings, I know from the young people to whom I speak that many would continue to do so, because it makes them feel safer.

This is about trying as hard as we can, while we are still in this pandemic situation. I point Stephen Kerr to one of the statistics that I cited in my statement. In the past week, while cases in every other age group in our country have declined, cases in the under-15 age group have increased by 41 per cent. We need to continue to take sensible measures to protect children and young people while—I hope—we get vaccination rates in that age group higher and are able to vaccinate some younger children.

As far as I can recall, the Tories have never supported face coverings in schools. On that issue, as on so many other things, they are way out of touch with the majority opinion in Scotland.