Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, May 12, 2020

Official Report 852KB pdf

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Topical Question Time

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Covid-19 (Guidance)

To ask the Scottish Government what discussions it had with the United Kingdom Government regarding the change of guidance being issued to the public in England. (S5T-02172)

The Scottish Government had no prior sight of the details in the Prime Minister’s statement, the document that was published yesterday, the proposed levels system or the change in message. Over the course of the past week, following requests by the devolved Administrations, discussions were held with Michael Gove and Boris Johnson, in which respective views were shared on changes in regulation and guidance that might take place in each nation, but at no point was the detail of the proposed levels system or the change in message shared with the Scottish Government.

We know that the R number is still uncomfortably close to 1 in Scotland at the moment. Does the cabinet secretary share my concern that the UK Government’s failure to make it absolutely clear that its announced changes to guidance applied only to England was irresponsible and could result in the virus taking off again here, if people do not adhere to Scottish Government guidance?

It is really important that people understand that the changes that the Prime Minister announced on Sunday apply only to England—not to Scotland. I have seen a number of broadcasters make that point expressly clear in their communication of the Prime Minister’s message. Our counterparts in Wales and Northern Ireland have taken a similar position to that of the Scottish Government and have all maintained the same headline message of “Stay at home”, which sums up the strategy of the Scottish Government.

It is important that members of the public in Scotland are clear that the guidance and the approach that the Scottish Government sets out are what applies here and to anybody in Scotland, whether they live here or choose to come to Scotland on any particular occasion.

Can the cabinet secretary give an indication of the preparations that the Scottish Government is making in advance of the gradual easing of restriction when our infection rate becomes low enough for it to be safe to do so?

The Government is working across all policy areas on the issues that are relevant to Rona Mackay’s question. Work is on-going throughout the areas that are reflected in the framework for decision making, which we will debate this afternoon.

Some issues are relevant to the non-Covid-19 health harms that exist in our society today and to the social and economic harms that are arising out of Covid-19. How the Government collectively sets out a path will reflect the consideration that we give to all issues that are raised in those areas of policy.

My colleagues in the Cabinet, as well as the ministerial team, are engaging with all our different sectors—the Cabinet Secretary for Economy, Fair Work and Culture with the business community, the Cabinet Secretary for Health and Sport with the health community and the relevant trade unions, the Cabinet Secretary for Transport, Infrastructure and Connectivity with our transport providers, the Cabinet Secretary for Justice with the justice community, and I with the education community—to ensure that we understand all the issues that we will have to carefully consider as we ease the constraints under which we are operating. I stress that that easing can come only when we are in a safer position to do it.

The cabinet secretary says that the guidance applies only in England. That will have a massive impact on my constituents in South Scotland, many thousands of whom work in Cumbria and Northumberland. What will the impacts be, particularly for those who have children?

Is the cabinet secretary considering a review of the current criteria for key workers, so that those who work in the south of Scotland but are now told to get back to work in Cumbria can be added to that list in order to access childcare? If the position of the Scottish Government is still that that matter should be left to local authorities, will consideration be given to the provision of additional resources to those authorities in the Scottish Borders and Dumfries and Galloway, to ensure that they can cater for an increase in demand for childcare?

On the resourcing point, as I am sure Mr Smyth is aware, there is greater capacity in the provision of early learning and childcare and educational support for children and young people across the country than has been utilised by those who have come forward to access that support, so there is surplus capacity.

Mr Smyth’s question raises some of the sensitivities there are inevitable in the decisions that have been taken by the UK Government as those decisions apply to England. A consequence of those decisions is that members of the public who are employed in England may be put in the rather invidious position of being more obliged to go back to work than they feel is appropriate at this time. In those circumstances, individuals should discuss the situation with their employers. Education and childcare support for the children of key workers is available in the Borders and in Dumfries and Galloway. However, I maintain my fundamental point, which is that people in Scotland should take the Scottish Government’s guidance as their reference point.

As I understand it, the Government does not know what the R number is in Scotland, because not enough testing is being done throughout Scotland. We have an increased capacity, but we are not using it—Mr Swinney should correct me if I am wrong. When will we be using the capacity to the full and then increasing it so that we can find out what the R number is?

The R number—whether in Scotland or England—is considered within a range of numbers. It is currently estimated in Scotland to be in the range of 0.7 and 1.0. There is testing capacity available in Scotland—there has been more than a tenfold increase in capacity since the start of the Covid-19 outbreak. The health service and those delivering the tests are working extremely hard to maximise the number of people coming forward for testing. It is an essential part of our strategy and we encourage and motivate individuals who fit the criteria to come forward for testing to enable us to use that capacity to the full. That is one of the Government’s objectives.

I am grateful for the clarity from the Deputy First Minister today, because the statement from the UK Prime Minister and Government is creating confusion—it is important that we have clarity in Scotland.

This week, the Todd & Duncan mill at Loch Leven reopened, causing concern for many of the workers there. Is the Government having talks with the trade unions on developing a process that will reopen workplaces safely, over a period of time? More importantly, how do we police that to ensure that safety measures and social distancing are in place, particularly in non-unionised workplaces that are less likely to have health and safety reps present?

Mr Rowley raises a significant issue and it is timely that the Cabinet Secretary for Economy, Fair Work and Culture has just arrived, because she is involved in detailed discussions with employers and trade unions on exactly that question. The objective of the economy secretary is to put in place guidance and a framework so that, when it is reasonable and permissible within the assessment of the public health issues for employees to return to work, they can do so with the assurance that they are returning to a safe working environment in which social distancing is a characteristic of the workplace design. Such workplace design will be very different from the design of workplaces that existed before Covid-19—or it certainly should be—to enable social distancing to be undertaken.

On the question of policing that, the issue must be tackled workplace by workplace and business by business, which shows the importance of companies exercising responsibility consistent with the guidance that the economy secretary is developing with the trade unions to ensure that businesses are operating a safe working environment. I assure Mr Rowley that that is a significant priority for the Government and the economy secretary and one that is being actively pursued in dialogue with businesses and trade unions.

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Covid-19 (Attacks on Police Officers)

To ask the Scottish Government what urgent action it will take in light of reports of Covid-19-related attacks on police officers. (S5T-02152)

Our police officers are on the front line each day to protect the public and to keep us all safe from Covid-19. No police officer should be the victim of abuse or violence while at work, and I support the chief constable in describing such behaviour as totally unacceptable.

Yesterday, the Cabinet Secretary for Justice spoke to the chief constable and the chair of the Scottish Police Federation, and he had very positive discussions with both. It is clear that, when an officer has a Covid-19 interaction, Police Scotland can offer facilities for an assessment and, where appropriate, a test.

The Lord Advocate has confirmed that those who assault our officers and engage in such behaviour will be dealt with robustly by Scotland’s prosecution service. The Police and Fire Reform (Scotland) Act 2012 enables penalties of up to 12 months’ imprisonment, a £10,000 fine or both following conviction for the offences of assaulting, hindering or obstructing a police officer. Our justice system also provides for protection for all workers under our common laws of assault, threatening and abusive behaviour and breach of the peace.

Police officers are on the front line of enforcing the lockdown, and they continue to do their usual jobs of detecting crime and keeping us safe. For that, we cannot thank them enough. Unfortunately, some officers report being spat at and coughed at in a disgusting attempt to spread the coronavirus. Such behaviour is an attack on us all. The Scottish Police Federation has called for a guarantee that such individuals will not be released before appearing in court, so why has the Crown Office not directed that to happen?

As I have just said, any police officer who is concerned after having a Covid-19 interaction—as I imagine many of them would be—can speak to Police Scotland’s human resources department and access a test, even if they are not symptomatic. There is no barrier to accessing testing. As Alexander Stewart rightly says, the police are at the front line, putting themselves at risk on a daily basis in order to keep the rest of us safe. We want them to have confidence that those who are concerned can access testing, and we expect them to be able to do so.

Alexander Stewart mentioned automatic remand for those who carry out such an assault on a police officer. I point him towards the Crown Office’s recent guidelines, which were issued by the Lord Advocate at the start of the Covid-19 outbreak. He said that liberation is a decision for the police based on the circumstances of the individual incident and that the police can detain any person to protect the public from risk of harm. A person spitting at someone and saying that they have the virus would obviously meet a reasonable description of putting someone at risk of harm.

The Scottish Police Federation has also called for routine testing of officers who do not have symptoms but who might be spreading the coronavirus across communities without knowing. When the Deputy First Minister was asked about that on the radio yesterday, he did not respond by saying that that would happen. Can we get a straight answer from the minister that police officers who are putting themselves at risk will receive tests?

Yes. I am happy to go on the record as saying that there is no barrier to accessing testing for police officers or staff. Any police officer or member of staff who is concerned about their health or wellbeing following an assault of any kind relating to Covid-19 should contact Police Scotland’s HR department to be risk assessed. Following that, a decision will be made about whether testing is appropriate for that individual.

Since 6 April, we have been working with Police Scotland to ensure that officers and staff can access testing at a number of sites, so that those who can be tested are being tested. Police Scotland’s HR department is now able to risk assess any officer or member of staff who believes that they are at a heightened risk, and they will be able to access testing if that is judged to be appropriate. I emphasise that people do not have to be symptomatic to access testing. If someone has had an interaction that has given them concern, they can contact Police Scotland’s HR department to access testing.

We are ensuring that Police Scotland continues to have priority access to testing. The testing of police officers and staff is important and will continue for as long as is necessary.

Police officers have performed a crucial role during the first phase of the Covid-19 emergency, and it was right for the minister to clearly state that no police officer should be the victim of abuse or violence while they are at work. Can she outline the extent to which the public has confidence in policing in Scotland during the coronavirus pandemic?

Last week, the Scottish Police Authority published the initial results from its new public opinion survey. Those results indicated a strong level of public confidence in and consent for Police Scotland during the first phase of the Covid-19 emergency. The SPA reported that

“Public confidence in policing in Scotland was higher in April 2020 than when compared to the last Scottish Crime and Justice Survey”.

The last survey was carried out in 2017-18. The SPA also reported that

“Public support for the approach taken by policing in Scotland to the Covid-19 emergency is higher than a recent YouGov survey finding for Great Britain.”

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Covid-19 (Testing on Discharge to Care Homes)

To ask the Scottish Government whether it will provide clarification on the current Covid-19 testing policy for people being discharged from hospital to care homes, and what clinical guidance is currently in place for care homes. (S5T-02171)

The current Covid-19 testing policy for people who are being discharged from hospital to care homes is twofold. First, if a patient has been in hospital because of the virus, they should give two negative tests before discharge. Tests should be taken at least 24 hours apart, and preferably within 48 hours of discharge.

Secondly, if a patient was not in hospital because of the virus, a single test is required to be taken 48 hours before discharge. Those patients should be isolated for 14 days from the date of discharge. All other admissions from the community should have one test performed before or on admission to a care home, and should be isolated for 14 days. That is the most recent Health Protection Scotland guidance, from 1 May.

In addition, the chief medical officer for Scotland, Dr Gregor Smith, and the chief nursing officer for Scotland, Professor Fiona McQueen, have published clinical and practice guidance that provides additional practice-based information on preventing and managing Covid in care homes. That was first published on 13 March and has been updated since. The guidance is being updated again to take account of new requirements. The draft updated guidance was published in error on 8 May, before it had been agreed by the CMO and me.

The guidance that was published on Friday 8 May watered down the earlier guidance from HPS by stating that patients should “ideally” give two negative tests before discharge. The chief nursing officer tweeted about that guidance on Saturday, only for the cabinet secretary to tell the media the following day that the guidance had been issued in error. It was subsequently withdrawn from the Government website, on Sunday.

However, two days later, an error message remains in place on the website. Does the cabinet secretary understand that that looks chaotic and confusing to people on the outside? What steps has she taken during the past few days to provide clarity to clinicians, front-line workers and, importantly, families who received a letter on Friday with that guidance in it?

Let me repeat: the guidance that was published on 8 May was draft guidance, and what was said is not currently the policy of the Government. The policy of Government is what I have just provided from Health Protection Scotland. That is the policy position that has been turned into guidance for care homes, care home staff, residents, relatives, care home owners and our clinicians in hospital settings, about what testing approach should be undertaken for patients who are being discharged from hospital to a care home, and for community admissions to care homes.

The guidance that appeared on the website on 8 May was draft guidance; it was an error that it was published. It has—as Monica Lennon said—been withdrawn. I am grateful to Ms Lennon for giving me another opportunity to make clear, in the chamber, what the testing policy is.

Officials have been in touch with care homes and others to ensure that they understand that the current guidance is the guidance that was published on 13 March and updated in some measure on 26 March, and to ensure that they are aware—they are—of changes in testing policy for admissions to care homes from 1 May, be they from hospital or the community.

The revised and updated guidance will be published as soon as it meets my requirements and those of the chief medical officer, and as soon as it reflects all the changes that we have instituted to ensure that we are focusing on Covid-19 in our care homes.

I am prepared to be corrected, but I do not believe that the guidance said “draft” when it appeared on the website on Friday. I wonder why draft guidance would be sent to thousands of care providers and to local authorities, health boards and integration joint boards. It would be good to have some clarification.

I am certain that thousands of people across Scotland are very concerned about their loved ones who are in, or who might be admitted to, care homes. There is still a feeling that testing is too slow, that there is not enough testing and that results are taking too long.

Does the cabinet secretary believe that any care home residents have died after contracting Covid-19 from discharged patients? If so, what lessons are being learned?

I repeat: publication of that guidance on the Government’s website was an error. It was not a conspiracy; it was a mistake that was made by people in the health directorate who have been working non-stop on the matter since the turn of the year.

It was a mistake: I have apologised for that and we have made sure that all those who might be affected because they have to apply the policy know what the policy is. We will publish the revised guidance when it meets my requirements, and those of the chief medical officer and the clinicians involved.

We are working very hard on testing. As the Deputy First Minister said earlier, our capacity for testing has increased significantly. It must increase even further in order to meet our needs for the full test, trace, isolate and support strategy, which will be critical to any easing of the current measures. However, capacity has increased significantly.

Our work now is not only to continue to increase the capacity for testing, but to increase its use. That involves speeding up the turnaround time from the point when the sample is taken to the point when the result is given. At the moment, that ranges from four to 48 hours, which is not good enough; the advice that I have from clinicians is that the turnaround time should be under 24 hours. If we can bring results in in under 24 hours, that will be very helpful for the test, trace, isolate and support strategy. The process should take 24 hours at most.

Work is now under way on logistics to ensure that samples are taken quickly, that they get to the laboratories as quickly as possible, and that we have everything that is needed in the labs to process samples. Laboratories need equipment and chemical reagents, for which we are working on a solid supply line. A bit like the case of the supply line for personal protective equipment, lots of people are chasing the same global supply line. I am pleased that my colleague, Ivan McKee, is now working to source testing supplies, as he has done so helpfully for personal protective equipment. Work is under way to speed up the testing turnaround time.

We have two supplementary questions, cabinet secretary.

I do not and cannot know whether any care home residents who have contracted Covid-19 did so as a consequence of the admission of residents who already had Covid-19. I cannot know that because of the length of the incubation period and because I do not know exactly what conditions individuals might have had before we instituted the testing policy.

Care homes are reporting that only 30 per cent of staff have been able to access testing. Yesterday, the Scottish Government reported that only 3,584 tests were carried out in NHS, community, care home and mobile settings, but there is the capacity in labs for more than 8,350. Why is testing in care homes not increasing? When will all care home staff in Scotland be tested? We are now hearing reports of asymptomatic members of staff testing positive.

The latest figures that I have are that 32 per cent of all key workers who are tested are social care staff, or members of their households. There is no barrier to social care staff being tested. We are promoting that message—as are, I hope, care home owners. The message is certainly being promoted by local authority partners to their home care staff.

As Miles Briggs knows, the policy is now to test all residents and staff in care homes in which there are active cases, and to undertake sample testing in care homes where there are no active cases, so that we can keep an eye on what is happening. All that effort is designed to provide the maximum number of tests that we can in that area, and in other areas where testing is important, in order to make sure that we use our capacity to best effect.

Surely, we should always test a person before their admission to a care home, and not—as the minister indicated has happened in some cases—after their admission. Surely, the whole purpose of testing is, if it is at all possible, to stop the virus getting into care homes. Why cannot testing be done in all cases?

Testing is a really important part of preventing the virus in all settings and of ensuring that it is not transmitted, but it is not the only measure. By itself, it will not do that job for us. An individual who comes out of hospital for a community admission who has not been in hospital for a reason related to Covid-19 requires to be isolated for 14 days. That is to ensure that they are, if they develop symptoms of the virus, isolated, and to ensure that proper infection, prevention and control nursing are in place, so that transmission is not possible from one resident to another. Of course, personal protective equipment is a big part of that.

It is often the case that individuals in care homes or those who are being admitted to care homes are frail and elderly and have dementia. Taking a test sample is a distressing experience for them, and it might not be possible to do it in the ideal timeframe. Isolating individuals in care homes for the first 14 days allows the test to be taken if it was not possible to take one before their admission. The process is designed to ensure that we maximise protection not only of the resident but of staff and other residents against the virus being transmitted.