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Chamber and committees

Meeting date: Wednesday, May 27, 2020

Meeting of the Parliament (Hybrid) 27 May 2020

Agenda: First Minister’s Question Time, Manufacturing (Support for NHS Scotland), Children (Scotland) Bill: Stage 1, Children (Scotland) Bill: Financial Resolution, Business Motions, Parliamentary Bureau Motion, Decision Time


First Minister’s Question Time

Good afternoon. Before we begin, I remind members that social distancing measures are in place in the chamber and across the campus. I ask that members take care to observe those measures over the course of business, including when entering and exiting the chamber.

The first item of business is First Minister’s questions. I will be taking no supplementary questions until after question 7. Members can press their request-to-speak buttons from the start of the session if they wish to ask a supplementary question later.

Before we move to questions, I invite the First Minister to make a brief statement.

I will start with an update on the key statistics. As of 9 o’clock this morning, 15,240 positive cases of Covid-19 have been confirmed, which is an increase of 55 since yesterday. A total of 1,247 patients who are either suspected or confirmed as having Covid-19 are in hospital, which is an increase of 47 since yesterday. However, the number of confirmed cases has decreased by 23. As of last night, 38 people were in intensive care with confirmed or suspected Covid-19, which is an increase of three since yesterday. I point out that yesterday’s figure of 36 has been revised to 35.

I am afraid that, in the past 24 hours, 13 deaths of patients who had been confirmed as having the virus have been registered. That takes the total number of deaths in Scotland under that measurement to 2,304.

National Records of Scotland has just published its more detailed weekly report. Unlike the daily figures, its figures do not just include the figures for deaths with a confirmed laboratory diagnosis; it also reports on cases in which no formal test was carried out but where the virus was entered on the death certificate as a suspected or contributory cause of death.

The latest NRS report covers the period to Sunday 24 May, which is three days ago. At that point, according to our daily figures, 2,273 deaths of people who had tested positive for the virus had been registered. However, today’s report shows that, by Sunday 24 May, the total number of registered deaths with either a confirmed or presumed link to Covid-19 was 3,779. Of those deaths, 230 were registered in the seven days up to Sunday. That is a decrease of 105 from the week before. This is the fourth week in a row in which deaths have fallen.

Deaths in care homes made up 54 per cent of all deaths linked to the virus last week. That is down from 56 per cent in the previous week. The number of Covid-19 deaths in care homes also reduced again, from 186 last week to 124 in the most recent week. That figure, of course, remains too high.

The total number of excess deaths—the number of deaths above the five-year average for the same time of year—also decreased from 357 to 178.

I have said before, and it remains true, that statistical trends will never console those who have lost loved ones to the virus. My thoughts and sympathies are with them all. However, the trends, which have now been sustained for more than four weeks, give grounds for encouragement. The weekly number of Covid-19 deaths has fallen by more than 60 per cent from its peak and excess deaths have reduced by more than three quarters. Deaths in care homes are also falling.

Tomorrow, we will take a formal decision on whether to begin to emerge cautiously from lockdown. Any early steps are likely to focus on outdoor activities. We will provide full information about what individuals and businesses should and should not do. I stress that, even if some restrictions are relaxed later this week, it will continue to be essential to follow guidance. People should stay 2m apart from those from other households and should self-isolate if they have symptoms.

The message in Scotland remains the same. Please stay at home except for essential purposes. When you leave the house, stay more than 2m from other people and do not meet up with those from other households. Please wear a face covering if you are in a shop or on public transport and remember to wash your hands thoroughly and regularly. If you or someone in your household has Covid-19 symptoms, you must stay at home and isolate completely.

What we have all done so far has made a difference, and today’s figures show that. Everyone has played a part in slowing the spread of the virus, protecting the national health service and saving lives. I will end by once again thanking everybody across Scotland for doing that, and by stressing that, as we start to emerge from lockdown, that co-operation will become more important than ever.

Patients Discharged to Care Homes

We now know that more than 900 patients were discharged from hospital to care homes in March before compulsory testing was announced on 21 April, which is far more than the Government previously suggested. Does the First Minister now know the total number of patients who were discharged from hospital to care homes without being tested and is she satisfied that, during that time, the Government did everything that it reasonably could do to protect care home staff and residents?

We have already published the figures for February and March. The figure that Jackson Carlaw gave was for March. The figure for April will be published in a few days’ time, on 2 June.

Two things have been suggested about care homes, both of which are serious and legitimate points. One is that we should not have discharged older patients from hospitals to care homes and the second is that we should have tested more before doing so. I absolutely see why, with everything that we know now, people would look at those things and ask why that was done. However, I invite people to look at the situation that we faced at the time.

On the first of those issues, older people who are what is called delayed discharges do not of course need to be in hospital—even in normal times, it is not in their interests to be there. However, at the time that we are talking about, we were waiting for a tsunami of coronavirus cases to enter our hospitals. We should remember the scenes that we were seeing from Italy at that time. It would have been unthinkable to leave older people there in the face of that, as it would have put them at huge risk. I am sure that many of them would have died in those circumstances, and I think that I would be getting asked different questions right now.

Secondly, on testing, at that time, the advice was that people who did not have symptoms were not likely to spread the virus and that testing people without symptoms was unreliable. Indeed, that latter point is still a concern to an extent.

If we apply what we know now to the situation then, of course we might now take different decisions, but when we faced those decisions, we had to act on the information that we had and, based on that information, we did everything possible to protect older people. There were risk assessments of people leaving hospitals and of course there was guidance to care homes about isolation. On that issue as on everything, we continue to adapt our response as our knowledge continues to develop.

Because the numbers that we are talking about are considerable, we sometimes forget that we are talking about individuals, so let me mention just one. This week, we were contacted by a lady in Glasgow called Sandra O’Neill. Sadly, her mother, Mary, died from Covid-19 on 8 April at the Almond Court care home in Drumchapel. Sandra has nothing but good words to say about the front-line care staff who looked after her mother during the three years of her stay, but she now has a series of questions about how her mother caught the disease. She says that, in March, as in other care homes, there were examples of people who were in hospital and who were returned to the home despite clearly being ill. She says that there are those in the home who believe that in at least one case residents had symptoms consistent with Covid-19 when they were returned.

The First Minister has just confirmed that elderly people were taken out of hospital and put into care homes without being tested, but can she confirm whether it is the case that even people who were ill and displaying symptoms of the disease were removed from hospital and returned to care homes?

I never forget that, when we cite the statistics, we are talking about real people and real individuals—each day when I read out the grim statistics that I am required to read out, I take the time to remember, as I always will do, that behind each and every one of those statistics is a human being who is being grieved by their loved ones.

On the issue at hand, obviously, it is not possible for me to comment on individual cases when I do not know the full circumstances, but anybody who has lost a loved one to the virus will understandably have questions and, in the fullness of time, we will want to try to answer all those questions as far as we can.

However, I point Jackson Carlaw to the guidance that was issued at the time, which made clear that clinical risk assessments should be carried out of the patients who were being discharged from hospital. Nobody who had symptoms of coronavirus, and certainly nobody for whom the clinical assessment was that they should continue to be in hospital, should have been discharged in that way. The risk assessments are required to be done by clinicians and professionals, but the guidance that was in place was clear and should have been followed very carefully, as all guidance should be followed, whether it is to hospitals or to care homes.

I thank the First Minister, but it is not quite clear from that answer whether people with symptoms may have been discharged into the care home. Even though a clinical assessment had been made, where they had symptoms, were they discharged into care homes? Sandra’s view is clearly that unwell elderly people, in her words,

“should never have been sent back to care homes”.

We read press reports in April that five residents had died in that home, although Mrs O’Neill has said that she believes that it is now more than that, and that little or no attempt was made to isolate residents who were then returned from hospital. She maintains that the front-line care staff did everything that they could for her mother and were not to blame for what happened. However, there is a growing feeling that residents such as Sandra’s mother were treated like second-class citizens. Can the First Minister give a clear commitment that the situation at Almond Court will be examined in full and that other residents and their families who remain worried about their relatives will be better treated?

The Care Inspectorate has an on-going duty to make sure that concerns about any care home are properly considered and that standards at care homes are as residents and their families have a right to expect.

On the two specific issues that Jackson Carlaw has raised, I think that I was clear. The guidance that is in place is very clear that patients should have been clinically risk assessed, and therefore patients with symptoms should not have been discharged to care homes. Clearly, I did not see every patient who was discharged to a care home; I cannot stand here and give a categoric assurance that no patient with symptoms was discharged—it would be wrong for me to do that—but the guidance that was in place was very clear.

Similarly with isolation, the guidance that was issued to care homes in March made clear that there should not be communal dining or communal activities, and that people coming to care homes should be isolated, in a way that has been hard for others and particularly hard for older people living in care homes. Clearly, although all parts of the system have to work together, and are working together, the primary responsibility is for care home providers to make sure that the guidance is being followed. I continue to expect that to be the case.

This is the issue that I take exception to: we have learned about this virus all along, and have had to adapt our approaches as we do, but at no point were older people treated like second-class citizens. At no point was anything other than the greatest care and attention and thought given to the decisions that were taken and the guidance that was put in place. That will continue to be the case every single step of the way.

With or without hindsight, it is now clear that what happened in our care homes in March and April was a national scandal. On Monday, the First Minister said:

“Undoubtedly there will be an inquiry or inquiries into all aspects of this pandemic, and I think that’s right and proper. Care homes will be part of that review.”

The scale of what has happened—what we know to be 1,749 deaths so far—and the tragic stories of people such as Sandra and her mother underline the need not just for a review but for a formal public inquiry into what has happened specifically in our care homes. Will the First Minister agree to confirm today that she will in due course instruct that formal public inquiry into the care home sector?

Of course there will be a public inquiry into this whole crisis and every aspect of the crisis, and that will undoubtedly include what has happened in care homes. Decisions were taken for the best of reasons based on the best evidence. The decisions that were taken in Scotland were similar to those that were taken on care homes in England, Wales and, as far as I am aware, Northern Ireland. Those decisions, particularly on discharge, were communicated very clearly to Parliament by the health secretary. They were not done without proper transparency and notification in the normal way. We will look back on all of that and learn a lot. There are few people who want more than I do to make sure that we learn all appropriate lessons.

Throughout this crisis, I have taken the best decisions that I can at every step of the way, based on the best information and evidence that I had at the time. All of those decisions have been tough—some have been really tough—but I have not shied away from taking them, nor will I ever shy away from being candid about mistakes or instances where, had I known then what I know now, I might have come to different conclusion. Presiding Officer, that is what leadership means—you have to make the tough calls when they fall to be made and you cannot hide away with your head down and hope that it all goes away. I hope that Jackson Carlaw and others will reflect on that.

Patients Discharged to Care Homes

Back on 5 March, I asked the First Minister about the challenge of delayed discharge in the light of Covid-19. We now know that the Government rushed to discharge almost 1,000 vulnerable patients from hospital in the month of March alone, and we have seen the devastating consequences of that in Scotland’s care homes.

At the time, the First Minister told me that there would be

“an intensive focus on ensuring that we can discharge people appropriately”—[Official Report, 5 March 2020; c 15.]

but right up until 22 April, the Scottish Government’s guidance on the discharge of patients from hospital into care homes stated:

“individuals being discharged from hospital do not routinely need confirmation of a negative Covid-19 test.”

Just yesterday, a nurse who works at a care home in Lanarkshire told me:

“We had several residents who came from hospital. None of them knew they were going to a nursing home, so when they arrived, we contacted their next of kin, who didn’t know they were going to a nursing home either. It was all one big mess.”

Does the First Minister now accept that her intention that people would be discharged appropriately was not met? Why did she allow the policy to remain in place for so long?

We have adapted our approach as the evidence and the information that we have had have developed. Richard Leonard mentioned what the guidance said previously about tests. It is true that we now have different advice on the testing of asymptomatic or pre-symptomatic people but, at that time, two things were different. First, there was a view that it was not likely that people without symptoms would spread the virus. Secondly, there was concern about the lack of reliability of testing people without symptoms; to an extent, that latter concern still exists. We have developed our approach to testing and to other things as the evidence and the advice have changed.

Richard Leonard said that he raised the issue of delayed discharge in the chamber in early March. The fact that he did not ask the specific questions then that he has asked today shows that we cannot apply hindsight and change what we knew at the time. We could operate only on the basis of what we knew and with absolutely the best of intentions.

I challenge Richard Leonard’s assertion that we

“rushed to discharge ... patients from hospital”.

I make two points that I have made previously. First, in normal times, Richard Leonard and others—rightly—usually criticise the Scottish Government for not reducing delayed discharge, because we are talking about older people who have no medical need to be in hospital, and being in hospital is not in their interest.

Secondly, I regret, more than Richard Leonard might ever be able to know, every single person who has lost their life in a care home as a result of the virus. Again, however, this is where the point about hindsight comes in. If we had not tried to get older people out of hospital, they would potentially have been exposed to the virus in hospital and many of them would have died. In those circumstances, Richard Leonard and others would undoubtedly have asked me, “With the benefit of hindsight, why didn’t we try to get older people out of hospital?”

The point that I am making is that there are no easy choices when we face such decisions. What we have to do is make the decisions based on the best evidence and information that we have. That is what we did. We put in place the guidance that I have mentioned, and we have continued to adapt our approach as our knowledge has developed. We will continue to do that every step of the way, and we will continue to be—as we have been all along—open and transparent with the Parliament about the decisions that we are taking and the reasons for those decisions.

I have said and we have said repeatedly, “You should listen to the World Health Organization, which said, ‘Test, test, test.’” It has been saying that since March. Sadly, the result is the consequences that we see in our residential care homes.

The crisis in our care homes might be linked to the release of those hospital patients who had not been screened, but it has not stopped there. Every day, the Government’s data shows that there are more new Covid-19 infections in even more care homes. The number now stands at over 5,500. That is as many as one in six residents, with over 60 per cent of all care homes in Scotland reporting at least one case. Let us be absolutely clear that the crisis is not yet under control.

Last week, the Scottish Government announced regular testing for care home staff, but the Royal College of Nursing is warning today that Scotland is lagging behind. I ask the First Minister once again how many care home staff and residents have now been tested and when all those staff will finally have access to regular testing.

Testing of care home staff will be an on-going process, because it is not enough to do it once; we have to do it regularly. We will publish data, as we have done, on testing as we go along when we are certain that that data is robust and is able to be published.

I caution against making comparisons between Scotland’s testing and figures that are being published UK-wide. It is not for me to go into detail about those statistics, but I am certain about the validity and the robustness of the data that is being published in Scotland.

This is not political in any way, shape or form. I talk about these issues regularly with Richard Leonard’s colleague the First Minister of Wales. We are all grappling with the issues and basing our decisions on the best evidence that is available.

I would not yet describe the crisis, either generally or specifically in relation to care homes, as being under control. We have a long way to go. However, in point of fact, we are seeing the number of care homes with an active case, the percentage of care homes with an active case and the number of new cases that we see reported every day, as well as the number of deaths, decline. Today’s figures, which will be published at 2 o’clock, show that the increase in cumulative cases in care homes from the previous day was 60, which is a much lower number than we have seen previously.

We will continue for as long as the virus is a threat to take the right decisions based on the evidence and the knowledge that we have. These are all horrendously difficult decisions, because we all understand—and I absolutely understand—their consequences, which is why the decisions have to be taken with such care, thought and attention. As far as I am concerned, they absolutely always will be taken in that way with a complete focus on doing the right thing as best we can at every stage.

The situation is urgent. It is not a question of whether this is politics; it is about the urgency of the situation. As we start to see an easing of the lockdown, the human rights and dignity of care home residents must be paramount. A Government has a basic duty of care to its most vulnerable citizens, and those residents will need continued protection, which means widespread and regular testing of staff, adequate personal protective equipment and true transparency.

We know that flawed Government guidance led to the discharge of untested patients into care homes, and we know that flawed Government guidance meant that care home residents were not transferred into hospitals when they were ill. We must not make the same mistakes again. This time, the guidance must be right. Will the First Minister commit today to holding an urgent review of her Government’s approach to care homes so that lessons can be learned and action can be taken quickly as we begin to ease the lockdown?

As I said previously, I not only expect but absolutely want there to be a review or inquiry—people can call it what they want—into every aspect of the crisis. That is vital for accountability, but also to learn lessons for the future, and it will undoubtedly include what the situation was in care homes.

However, if Richard Leonard will forgive me, my focus right now is on continuing to do everything that we need to do for the remainder of the crisis. We are not through the crisis yet. We are not even through this phase of the crisis yet, and my responsibility as First Minister—and the responsibility of every one of my ministers—is therefore to make sure that we focus on the decisions that still fall to be taken, learning the lessons and applying the knowledge that we have at the time.

Richard Leonard calls the guidance flawed. What he is doing—he is entitled to do it and it is fair enough, but it is reasonable for me to point this out—is taking knowledge that we have now, but did not have at the time, and applying it retrospectively. I wish that, when I took these decisions, I had the benefit of foresight of changing circumstances, so that I could apply that, but we have to take decisions based on what we know at the time.

Richard Leonard says that these things are urgent. Trust me, regardless of whatever else he wants to criticise—scrutiny is absolutely legitimate and important, as I have said all along—he does not have to tell me about the urgency of this. Literally, every waking of moment of mine, of the health secretary’s and of the whole Government’s—there are plenty of those waking moments right now—is spent on trying to do the best thing to deal with the crisis. That will continue to be the case for as long as we face it.

Test and Protect

From tomorrow, test and protect will be rolled out, although I deeply regret that contact tracing was abandoned in the first place.

Going into isolation for two weeks, particularly when there are no symptoms, is necessary, but it is a big ask. This week’s news has been dominated by the failure of a wealthy and powerful individual to self-isolate, but imagine the difficulties that are faced by those who are not privileged. For the self-employed and those who are in precarious work, isolation may be unaffordable. For those who share their homes with families or others, isolation may be impossible. For the sole carer of a loved one, isolation may be heartbreaking.

What support will be made available to those who need to isolate? For example, will accommodation such as hotel rooms be offered free to those who need them?

The short answer to that question is yes. Yesterday, we issued guidance to employers around our expectations on them; we are in on-going discussions with the United Kingdom Government about changes that may be needed to benefits and statutory sick pay to ensure that people do not lose income; and we have issued guidance on what people have to do to prepare for potential periods of isolation, and on the support that will be available to them.

That support will be provided largely using the kind of infrastructure that we have put in place to give support to those in the shielded group. That could be support with accessing food and medicine if there are no family members who are able to do that, or it could be, in extremis, support with alternative accommodation. It is absolutely the case that we will require to make sure that anybody who has been asked to go into a period of isolation for 14 days gets the support that they need to do that.

I will make a really important point that I fear will be lost as we move to test and protect. My biggest fear about it is that we will all think that we can stop doing all the other things that we have been doing because test and protect is some kind of system that will keep us safe from the virus regardless of what we do.

If you do not want to face a period of self-isolation, the best way to minimise that risk is not to have close contact with somebody outside your own household. If you take care not to be within 2m of somebody outside your own household, you are minimising your risk of ever getting a phone call from a contact tracer and being advised to self-isolate. If we all continue to follow that advice of staying 2m apart from others outwith our own household, collectively we will keep the virus suppressed.

Test and protect is really important, but, fundamentally, how we stop the virus spreading is down to us and our own behaviour in reducing the number of bridges that we give it to jump over. That means that physical distancing continues to be really important. Actually, as we start to ease some of the lockdown measures, it will become more important than ever.

Test and protect will have a particular impact on front-line staff and their families. Yesterday, a report linked the contracting of the virus by 24 members of medical staff at the Western general hospital with the admission of just one patient. We need to do more to suppress the spread of the virus in hospitals to protect patients, staff and their families.

It has been over a month since I started calling for regular, routine testing for national health service workers on the front line, but we have had little movement, even though too much of our capacity remains unused. Will regular testing in hospitals be introduced alongside test and protect?

That is something on which we continue to take clinical advice, and we will make decisions on that in due course.

A huge amount of work is being done not just in Scotland but across the UK and globally to better understand hospital transmission, or nosocomial infection. When a person tests positive or is confirmed as having the virus in a hospital, it cannot automatically be assumed that they got it in the hospital because of the often lengthy incubation periods.

Some weeks ago, we established a nosocomial advisory group to identify additional interventions to reduce in-hospital transmission. Health Protection Scotland is working with UK counterparts on those issues, as well. Testing will undoubtedly be a part of that work, but a whole range of things around infection prevention and control, including the cohorting of patients where appropriate, continue to be important.

Tourism Industry (Support)

We need to speak with one voice. What Dominic Cummings did was wrong, the Prime Minister was wrong to defend him and they are treating people like mugs. That is wrong, and we should condemn it. Everyone should condemn it.

I want to ask the First Minister about the legal tourism industry. The precautionary approach will mean a longer lockdown for the sector. The industry is anxious that that could obliterate its summer season, that many businesses will collapse without additional support and that that will result in thousands of lost jobs. The United Kingdom Government has extended the furlough scheme. Will the Scottish Government extend its grant scheme, too, to avoid that business collapse?

I have made my views clear on Dominic Cummings. I think that it was wrong and that the Prime Minister is wrong to defend it in the way that he has, principally because that has involved a retrospective rewriting of the rules, which undermines confidence in the rules and guidance, which remain important. However, I do not want to be standing here talking about that; my job is to ensure that I get the message across to the Scottish people that what we are asking them to do is important not just because they are being told to do it; it is important for their own protection and the protection of their loved ones. I hope that we will all speak with one voice on that in the weeks to come.

Willie Rennie is right about the tourism sector. There is not a sector in the Scottish economy that has not been hit by the virus, but some sectors have been hit harder than others. The tourism sector is one of the sectors that have been hit hardest and on which there will potentially be the longest-lasting impact.

The Scottish Government is actively considering the grant support and what will happen to it in future, and we will take decisions on that in due course. We are also looking carefully at the ways in which the tourism industry may be able to resume activities in a safe way. Fergus Ewing has been leading work on that.

Every Friday morning, I chair a Cabinet sub-committee that looks specifically at the economic issues. We are due to look at that issue in detail shortly.

Those issues are absolutely at the top of our minds. We will take careful decisions and try to ensure that, at all stages, as much support as possible is in place for businesses that have been affected.

I think that that is right, because the financial support mechanisms need to match the lockdown mechanisms.

Many students work in the tourism sector over the summer months. If the industry does not reopen, they will be without an income. Award agencies normally provide financial support only on a term-time basis. Student leaders, such as Jamie Rodney at the University of St Andrews, are leading a campaign to extend Student Awards Agency for Scotland grant payments over the summer months. The campaign has the support of sensible members across the Scottish Parliament—members such as Bob Doris, Bruce Crawford, Pauline McNeill, Andy Wightman and Keith Brown are all behind it. Will the First Minister get behind it, too, and provide financial support for students over the summer?

We will look very carefully at that, just as we are looking very carefully at all suggestions that have been made about how we can mitigate the impact of the virus on businesses and individuals. I hope that Willie Rennie will appreciate that I will not stand here and give categoric assurances on things while we are still going through the process of consideration. Many good suggestions are being made, and I would love to be able to agree to all of them, but we have to make careful decisions, bearing in mind that there is a limit on the financial resources that we are able to bring to bear. However, we will do as much as we possibly can.

I recognise that students will be affected in a range of ways, given the nature of some of the industries on which there will be the longest-lasting impact. However, I do not want to lose sight of the fact that we want to try to get businesses in all sectors operational to a greater or lesser extent as soon as possible. That has to be done safely, and there is a big focus on that in the work that Fiona Hyslop is leading overall.

We want to see as much economic activity resume as quickly as possible in a way that is consistent with continuing to suppress the virus. If we take our eye off that goal, the damage to the economy will be even deeper and longer lasting than it is currently estimated to be.

Project Birch

To ask the First Minister whether the Scottish Government has had any discussions with the Treasury regarding project birch, the plan to assist struggling companies of strategic importance. (S5F-04153)

We are in discussion with the United Kingdom Government about a range of matters right now, as members would expect, and we are very clear that more support for the economy will be required, from both the UK Government and the Scottish Government. I welcome the indication that the UK Government is prepared to provide support for large companies if failure would

“disproportionately harm the UK economy”.

To date, the Scottish Government has not been involved in specific discussions with the Treasury on project birch, although we will seek to be in the days to come. We would expect the UK Government to share more details of the project with us, particularly where the businesses that it is looking at as possible recipients of that kind of support are critical to the Scottish economy.

While the chancellor believes that the UK Government should act to save companies when their failure would, as the First Minister has just said,

“disproportionately harm the economy”,

he is thinking in UK terms, thus project birch might not apply to companies that are of vital importance to Scotland but which are not considered to be strategic at UK level.

Does the First Minister agree that the chancellor should provide both the resources and the flexibility to the Scottish Government to allow it to support the continued survival, recovery and growth of Scotland’s strategically important companies, channelled through the Scottish Investment Bank? Does she agree that the chancellor should make good on the £60 million in Barnett consequentials that were promised on 2 May to assist businesses, which, as well as £10 million that was previously pledged for charities, will, in what is a clear breach of faith, now not be forthcoming,?

It is really important that every penny of consequentials that has been promised and committed actually materialises, because we have rightly been challenged by members across the chamber to give a commitment to pass on every penny of consequentials to businesses and other interests. We have done that and it would therefore be a serious concern if all of that money does not materialise. I would absolutely say to the Treasury that it should please make good on those commitments so that we can make good on our commitments that we have made to businesses and others across Scotland.

As I indicated in my initial answer, it is vital that companies that are important to the UK and to Scotland are supported. In some cases, those companies will be the same and our enterprise agencies and the Scottish Government will work with the UK Government through project birch to support them. However, that may not always be the case, and the Scottish Government needs the resources and the flexibility to support those companies that make a critical contribution to the Scottish economy and to parts of Scotland such as Ayrshire.

Our enterprise agencies continue to work with a range of companies to provide appropriate support within the resources that we have available, but it is important that the UK-wide schemes take account of the particular considerations of the Scottish economy. We will continue to discuss that with the UK Government.

Domestic Abuse

To ask the First Minister what the Scottish Government’s response is to Police Scotland reporting that nearly 1,700 cases have been recorded under the Domestic Abuse (Scotland) Act 2018. (S5F-04162)

I point out that the figures are provisional, but I nonetheless welcome the early indication that the new domestic abuse laws are encouraging victims to come forward and report crimes, while providing officers with greater powers to target those who abuse partners or ex-partners.

Police Scotland remains committed to tackling domestic abuse; more than 14,000 officers and staff have received specialist training to spot the signs of coercive and controlling behaviour. It remains a priority that victims of domestic abuse get the support that they need, especially during these challenging times, and that they are kept safe from harm. That is why we have provided additional funding of over £1.5 million to the domestic abuse sector and have, with the Convention of Scottish Local Authorities, published guidance for local authorities on responding effectively to domestic abuse.

I thank the First Minister for her response. That indicates that, sadly, private spaces are not safe places for everyone. The “Stay at home” guidance also exposes individuals to greater harm or risk of abuse or neglect. We also know that many incidents of domestic violence go unreported. What further action can the Scottish Government take to encourage victims of domestic violence or abuse to seek the support and assistance that they require?

Those are important issues. They are important at all times but, as Alexander Stewart rightly suggests, they are particularly important when we are asking people to stay at home.

We recognise that private spaces and people’s own homes are often not safe places, but can be among the most dangerous places that they can be in. That is why we have provided extra funding to organisations in the domestic abuse sector: for example, the national helpline can continue to be operational during the Covid-19 crisis. We have taken many opportunities to advertise and market the availability of such support so that people know that it exists. We will continue to do that as we go through and, indeed, beyond the crisis.

There is also, in relation to the Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020, a safeguarding provision for people who are fleeing domestic abuse. I am not making a political point: it is important that people understand that that provision exists and why. Another reason why we should not redefine some of the rules in the current circumstances is that it is very important that people understand what the rules are and why they are as they are.

Care Homes Review

To ask the First Minister when the Scottish Government will commence its review of care homes. (S5F-04165)

As I have said already today, I have no doubt that at an appropriate time, after we have dealt with the immediacy of the crisis, there will be inquiries and reviews of how Governments have handled it.

As I have also said, the reality is that hindsight allows people to look at decisions that were made in the past, and to apply knowledge of the virus that we have only now. We have, and always will, take the right decisions based on the best information that we have, and we will adapt those decisions as new information changes what we know.

Earlier in May, we announced new arrangements to significantly strengthen oversight of Scotland’s care homes. They involve clinical and care professionals undertaking targeted reviews of support in all care homes. Prior to Covid-19, we had started to look at ways to improve care home sustainability as part of our adult social care reform programme, which the Cabinet Secretary for Health and Sport launched with the Convention of Scottish Local Authorities last year.

We will use the learning from the Covid-19 pandemic to identify what that means for the future of care home provision—for example, how provision is organised and funded.

Transferring older people from hospitals to care homes without testing, the lack of personal protective equipment and the slow provision of testing for staff have contributed to care homes being the epicentre of the Covid-19 outbreak. Therefore, I will welcome an inquiry, but I also welcome the separate review of care homes that appeared to be announced by the health secretary a few days ago.

The Scottish Government has been here before, however. Let me refresh the First Minister’s memory. A ministerial task force on the future of residential care for older people reported in March 2014, and its report contained 34 recommendations. How many of those recommendations have been implemented, in particular the recommendations on managing risk and care home governance? I am told by social care professionals that the answer is that only a handful have been implemented. What is the point of a review if the First Minister fails to implement its recommendations?

On the first question, I will happily write to Jackie Baillie with a detailed answer because I do not have that information in front of me.

Jackie Baillie knows, as all members do, about the variety of work that has been done around social care—not the least of which has been the integration of health and social care over recent years. It is important that we learn from the crisis and that we consider afresh, based on what we know and have learned throughout it, what the longer-term future of the care home sector might be.

As I believe I said to Richard Leonard, my job right now is to focus on the crisis that is in front of us, and to continue to take the best possible decisions, based on the best evidence. We will, after that, have time for reviews and inquiries, and I will welcome them. I mean that sincerely. However, I am not going to take my eye off the ball in respect of dealing with what lies in front of us, because it is still a serious concern for people across Scotland and across the globe.

We move to supplementary questions, for which I have a lot of requests. We will run until half past one, so I ask members to be succinct.

Covid-19 (Asymptomatic Workforce Testing)

Our offshore oil and gas industry has continued to operate since lockdown began. However, Oil & Gas UK has made it clear to me this week that in order for it to return to pre-Covid manning levels, testing of asymptomatic people is essential. It also tells me that it has made a strong case for having the asymptomatic workforce tested, as long as that has no impact on national health service staff and front-line care workers.

Will the First Minister update Parliament on when we can expect testing of asymptomatic people to start, and will she say what the hold-up has been?

I am pretty sure that Liam Kerr has heard me talk many times about the issues around testing of asymptomatic people. Because we have more evidence about asymptomatic transmission, we are expanding testing, but we have focused on care home workers and residents.

All key workers who are part of the country’s critical infrastructure have access to testing when they are symptomatic, as do their wider families. We will continue to take an approach that is based on evidence and advice on the clinical benefits and efficacy of testing. We will also continue to keep Parliament updated.

Funding Consequentials

What clarity have the devolved Administrations received from the United Kingdom Government about receipt of funding consequentials following the extension to business grants?

We have the details about consequentials that the UK Government has announced publicly. Based on the strength of those public announcements, we have made commitments to pass on every single penny. However, as Kenneth Gibson said in his question, suggestions have recently been made that elements of that consequential funding will not materialise, and that if there are underspends at UK level that funding might be clawed back. We do not yet have certainty or absolute clarity on that, but the issue will be followed up assiduously and vigorously by the Cabinet Secretary for Finance.

I hope that all members will join us in making it clear to the UK Government the expectation that consequentials that have been announced will flow through in full. We have committed the funding, so if the UK Government claws the consequentials back, we will be left in the invidious position of not being able to honour the commitments that we have made. I do not think that any member wants us to be in that position.

Return Orders (1980 Hague Convention)

I have an 18-year-old constituent who has been ordered by a Scottish court to travel to Malta with her baby because of the court’s legal decisions. I am not asking the First Minister to comment on the legal case itself; I am asking whether she thinks that it is right that a vulnerable young individual and her child can be forced to travel abroad to an uncertain future, not knowing whether she and her child will be safe in the middle of a global pandemic. Will the First Minister agree to look at the case?

With the limited information that I have about the case, I share Alex Rowley’s concerns and have sympathy with those who find themselves in that position. However, I am sure that he will understand that I cannot intervene in a judicial decision, which would mean interfering with the independence of the judiciary in Scotland.

All applications for a return order under the 1980 Hague convention go to the Court of Session and are heard by one of two judges. As I understand it, evidence from both parties was heard in the case and a decision was made. Therefore, although I can sympathise with the consequences of that decision, it would be completely wrong for me to say anything that interfered with the independence of the process. I hope that Alex Rowley will understand that position.

I call Mike Rumbles, to be followed by Emma Harper.

Coronavirus Regulations (Exemptions)

I have received emails from many constituents who have suffered unnecessarily because they thought that they were following the lockdown rules but have now found that the rules allowed them the exemptions that they needed. They were unaware of the detail of the legislation that, together, we passed unanimously, in this chamber, which lists more than 20 exemptions, although the list was not exhaustive.

For understandable reasons, the First Minister simplifies the regulations and the legislation during her addresses to the nation. As members of the Scottish Parliament, we know the detail of the regulations and the legislation, but the public does not. How will the First Minister address that problem?

I will try to do what I have tried to do every single day throughout this crisis and give clear and straightforward advice to the public. As Mike Rumbles said, the regulations were passed by Parliament. All MSPs are under an obligation to answer questions from their constituents and make sure that the detail of what has been passed is understood.

Given the situation that we have been facing, the most important message that I have had to get across has been the “Stay at home” message, along with the exceptions that we talk about regularly. However, I will always try, in every way that I have at my disposal, to deepen people’s understanding of what we are asking them to do. That will become more important as we start to ease the lockdown measures, because they will become more nuanced and people’s judgment will be called on much more than it perhaps has been. I will always try to do that, and I know that MSPs will always try to do likewise.

I am afraid that we do not—[Interruption.] Ms Harper is with us now—in the nick of time.

Minimum Unit Pricing

What is the Scottish Government’s response to the latest report on the impact of minimum unit pricing?

I welcome the latest report evaluating the impact of minimum unit pricing, which shows that small convenience store retailers feel that sales of drinks that are most affected by the policy have fallen. Those findings confirm a high compliance with the minimum unit pricing policy and show that those retailers have experienced little or no adverse effects from its introduction, with many reporting that they can now better compete with supermarkets on price.

A report in June last year also showed a 3 per cent decrease in the volume of pure alcohol sold per adult in the off-trade in Scotland in 2018, which is encouraging. For all that, we know that it will take longer for the impact of reduced consumption to feed through into information on alcohol-related harms. Nonetheless, the evidence that we have so far is extremely encouraging.

Examinations (Deadline for Grade Estimates)

This Friday is teachers’ deadline for the submission of grade estimates. A number of people have been in touch with me this week with concerns—specifically, those who are sitting exams externally of registered bodies, people who have been undergoing home-schooling, and people who are undergoing retakes.

One candidate has been told that the Scottish Qualifications Authority will not accept coursework unless it comes through a registered body such as a school. However, that is not always possible for every candidate. Will the First Minister press the Cabinet Secretary for Education and Skills to look into that specific cohort and issue urgent advice ahead of this Friday’s deadline, and ensure that the appeals process will be robust, transparent and fair?

On the final point, that should always be the case with an appeals process. I will raise Jamie Green’s first point with the education secretary later this afternoon. If Jamie Greene is willing to send me the details of the concerns that have been expressed to him, I will make sure that they are answered in full and that, if there is a need for further guidance to be issued, that happens quickly.

Rolls-Royce (Inchinnan Site)

Plans by Rolls-Royce to slash 9,000 jobs globally will have a severe impact on its site at Inchinnan, which employs more than 1,000 people and supports much of Scotland’s aerospace sector. If jobs go at Rolls-Royce, workers fear that they may never return.

I welcomed the update from the Minister for Business, Fair Work and Skills, but will the First Minister outline what steps the Scottish Government can take to prevent those job losses and to ensure that Inchinnan workers benefit from the economic recovery when it comes? Does she agree that there must be strategic investment in the sector to save jobs and to prevent irreparable damage to the Scottish economy?

I agree with that, and I agree and sympathise with the general sentiment of the question. As I know that Neil Bibby is aware, we are actively engaging with Rolls-Royce to try to minimise any redundancies and to do everything that we can to secure the company’s continued presence.

Rolls-Royce is important for its own sake in relation to the employment that is dependent upon it, but it is also important because of a wider strategic interest in relation to our manufacturing footprint. We therefore see the situation very much in that strategic context as well as from the perspective of the individuals who work at Rolls-Royce. We will continue to keep Neil Bibby and other members updated as those discussions continue. We will do everything that we can to secure the outcomes that I am sure he will want us to secure.

Spaces For People Fund

I welcome the Scottish Government’s support for new active travel choices through the spaces for people fund, which was expanded yesterday. Of course, it is up to local authorities to develop projects that are appropriate to their areas. However, I have a constituent in Midlothian who has been campaigning for a quiet route from Pathhead to Dalkeith, with very little support from Midlothian Council.

Does the First Minister agree that all councils should be embracing the opportunities that are provided by the fund and taking seriously proposals that come forward that meet the criteria?

I agree with that in general. Local authorities then obviously have to look at applications, apply the criteria and come to decisions, all of which I cannot second-guess. I am sure that a strong case can be made for the route that Andy Wightman has talked about—in Pathhead in Midlothian, if I heard correctly—but that is for the local council to determine.

The additional funding is important. Support for active travel is always important, but is becoming more so as we encourage fewer people to use public transport for the foreseeable future. It is really important that councils take those decisions as quickly as possible and apply those criteria as fairly as they possibly can.

Mental Health Support (Older People)

What is being done to encourage people to access mental health support, in particular older people who are shielding?

We have made significant additional funding available for mental health support and we will continue to do that. We have also run particular public awareness campaigns, such as the Clear Your Head campaign, to make people aware of where they can get that kind of support and we will continue to do that as well.

We have invested in increased capacity through the NHS 24 helpline and through other routes. We will take steps to ensure that people know where to go. People can access all the information on what services are available on the NHS Inform website, where they will find different routes to get support at what is a very difficult time with regard to not only challenges to physical health but ones that many people face with mental health and wellbeing as well. That is one of the most important issues that we are dealing with, and we will have to continue to deal with it as we recover from the crisis that we have faced in recent weeks.

Hospital Discharges (Power of Attorney)

In February, 236 patients were classified as delayed discharge patients, because they did not have a power of attorney in place. Many of them had been in that situation for months. How many patients with no power of attorney were discharged during the crisis? What legal framework has the Scottish Government used to take decisions to move individuals to care homes? What assessments of those individuals’ human rights have ministers undertaken?

Given the importance of that issue, I will give a detailed and full reply in writing to Miles Briggs. When people are in the situation that he has identified, it is really important that, generally speaking, they are not discharged without power of attorney and that the proper legal steps are taken.

Miles Briggs has asked me specific questions on which I do not have the information to hand, so I will write to him with the answers as soon as possible.

Asymptomatic Testing (Care Homes)

Care workers were not relying on hindsight at the beginning of the crisis when they spoke out about personal protective equipment and testing. Worryingly, front-line staff and families continue to raise the alarm. In response to such concerns, I have referred Whitehills care home in East Kilbride to the Care Inspectorate this week. Tragically, 23 residents have died at the care home so far as a result of Covid-19. Currently, at least a dozen residents are infected and dozens of staff have tested positive.

I am grateful to the Cabinet Secretary for Health and Sport for her speedy written response supporting my call for an urgent review, which I received this morning. Can the First Minister provide an update on the reported discrepancy that the BBC raised with her last week about NHS Lanarkshire not testing asymptomatic care home staff when the guidance changed on 1 May? Has that been an issue in any other health board?

Finally, does the First Minister agree that asymptomatic transmission is a serious risk in our care homes? Would it not be safer if the guidance were changed to ensure that anyone who works in a care home is issued with PPE or at least a face covering? The crisis in our care homes is far from over.

Everybody should have the PPE that they need. The guidance that was changed a few weeks ago across all four nations with expert and clinical input said that, ultimately, it should be down to the risk assessment of the individual staff member to determine whether they should be wearing PPE and in what circumstances. Any staff member who feels that they need PPE should have it.

Let me be clear that the principal responsibility for the provision and supply of PPE is on care home providers. However, since the start of the crisis, we have put in place top-up arrangements if any care home provider should find it difficult to get what they need through their normal supply routes, and we have developed new distribution routes to get PPE to staff as quickly as possible.

On the issue of the Care Inspectorate, it has a responsibility to look into and address any issues of concern, and it would be inappropriate for me to comment in detail about work that it is doing in relation to any individual care home. As we have seen in other contexts recently, it is important that, where steps need to be taken, the Care Inspectorate takes them and that it has the protection of residents uppermost in its mind at all times.

Construction Industry (Housing)

At the moment, we have 6,000 homes in Scotland that are nearly completed. The construction sector is waiting to start rebuilding those homes, but it does not yet know when it can do so. I have been contacted by customers—who are the important people—across the country, who are waiting to get into their homes, including one man today, who was written to by the Minister for Local Government, Housing and Planning and advised to contact the housing charity, Shelter.

All that people want to know is when builders can start working again. What is the answer to that question?

I will make three quick points. First, the important people in the context of the crisis are the entire population of Scotland, and the priority is to keep people as safe as possible from a virus that we know from the evidence—and from the discussions that we have had here even today—can have a potentially deadly impact. That must continue to be our guiding principle in all of this.

Secondly, in the route map that I set out in the chamber last Thursday, we indicated that, if and when we move into it, phase 1 will allow the construction sector to implement the first two stages of its own restart programme, which is a programme that has been developed through collaboration between Government and the industry.

The third point is that, as I said previously today, we will make the formal assessment tomorrow of whether the evidence says that it is safe for us move into phase 1. I will set that out tomorrow, when I will make clear what changes in phase 1 we are prepared to make at that stage that are consistent with trying to get back to as much normality as possible, while continuing to suppress the virus. We will give as much clarity about all that as we can, step by step, but we will not—we must not—take our eye off the priority of keeping the virus suppressed and not allowing it to get out of control again.

Hospital Discharges (Availability of Care)

For years, patients have been stuck in hospital and told that their discharge has been delayed because a care home place or a care package is not available. However, in March, 1,000 such cases were resolved almost overnight, not because new care home rooms were suddenly built, or because new staff were recruited overnight, but because money became available to purchase places.

Does the First Minister accept that all those delayed discharge patients and their families, who for years were told that they were delayed because no care home place or care package was available, were in fact misled, and that the real reason that they were stuck in hospital was because integration joint boards and councils did not have the money to purchase the care packages that they needed?

We always have to work within the resources that we have, and we do so to the best of our ability. Within that, the Government that I now lead has prioritised health and social care all along. We have lived through many years of austerity along the way, which has made it very difficult. We received additional funding through the consequentials route at the start of the crisis to help us to deal with the health and social care impacts, and we took decisions to try to mitigate the impacts as much as possible.

We continue to take the best decisions that we can, based on the best evidence, and will continue to do so. I will not shy away from doing that, even though I know that, often, whatever decision I take, somebody in the chamber will say that it is the wrong decision and that I should have taken another one. Particularly at times of crisis, the job of somebody like me is to take those decisions, based on the best evidence that we have and with the resources that we have at our disposal, and to be accountable for them. I will continue to do that every step of the way.

That concludes First Minister’s question time.

13:24 Meeting suspended.  

14:30 On resuming—