Meeting of the Parliament (Hybrid)

Meeting date: Thursday, January 28, 2021

Official Report 950KB pdf

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First Minister’s Question Time

Good afternoon. We begin today’s business with First Minister’s question time, but before we turn to questions, the First Minister will update the Parliament on the Covid-19 pandemic.

I will give a brief update on today’s statistics. Yesterday, 1,201 new cases were reported, which is 5.6 per cent of all the tests that were carried out. The total number of cases now stands at 176,533. There are currently 1,938 people in hospital, which is a decrease of 33 from yesterday, and 142 people are in intensive care, which is a decrease of 3 from yesterday.

However, I regret to report that, in the past 24 hours, a further 82 deaths were registered of patients who first tested positive in the previous 28 days. The total number of people who have died under that daily measurement is 5,970. Yet again, I send my condolences to everyone who has lost a loved one.

Due to a hold-up in the processing of data from yesterday, I do not yet have the figure for the total number of people who have received their first dose of vaccine. That figure will be published as soon as possible. From the information that I have, though, I can report that around 60 per cent of people over 80 and living in the community have had the first dose of vaccine. We are on track to complete first doses for over-80s by the target of the end of next week. However, we anticipate that the vast majority will have been done by the start of next week. The over-70s will start to be vaccinated next week, and all of them, along with those who are clinically extremely vulnerable, will have had their first dose by the middle of February.

As we make good progress with vaccination, we also see signs of progress in suppressing the virus. Later today we will publish the up-to-date estimate of the R number, which suggests that it is now below 1. That is not unexpected, given the recent decline in new cases, but it is very welcome and provides further evidence that the lockdown restrictions are working.

That said, case numbers remain very high, and our national health service remains under severe pressure. For example, the number of people in hospital with Covid is still approximately 30 per cent higher than it was at the peak last spring, although we are starting to see, from the numbers that I have reported today, welcome stabilisation in those figures.

It is therefore vital that cases continue to fall, which is why we have already confirmed that lockdown restrictions will continue until at least the middle of February. As everyone is aware, we are also considering and implementing further measures to help to keep the virus under control, both now and in the longer term. Those measures include tougher travel restrictions—we will set out more proposals on that in the coming days—and further on-going improvements to our test and protect system.

However, for the moment, the single most important thing that all of us can do to protect each other and to keep the virus under control is follow the current rules. Put simply, that means that we must all stay at home as much as possible. We should leave home only for essential purposes such as caring responsibilities, essential shopping, work that genuinely cannot be done from home and essential exercise. All of us should exercise responsible judgment on what is really essential and what is not. We should not have people from other households in our houses, nor should we go into theirs, and on any occasion on which we require to be out of our homes, we should follow the FACTS advice. Face coverings should be worn when, for example, we are doing essential shopping; avoid places that are busy; clean hands and surfaces; use 2m distancing when talking to people from other households; and self-isolate and get tested if you have symptoms.

All that will help us to continue with the progress that we have made in the past couple of weeks. It will protect us, our loved ones and our communities and, of course, it will help to protect the NHS. My advice to everybody continues to be to stay at home, protect the NHS and save lives.

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Vaccination Roll-out

We all want the vaccination programme to work as quickly and efficiently as possible so that restrictions can be lifted, but there is genuine concern across Scotland about the pace of the roll-out. We know that more mass vaccination centres, which have already been set up elsewhere and are due to open in Scotland soon, will make a big difference. That is very welcome, and we all hope that it goes according to plan.

However, the First Minister has so far sought to blame the slow vaccination rate on prioritisation of care homes. We asked for care homes to be prioritised way back in November, and it is the right thing to do, but that is not an excuse for the slower roll-out across the general population. General practitioners know it, and the First Minister knows it, too.

One Edinburgh GP wrote to us this week and said:

“I helped deliver thousands of vaccines over the years and I know that different systems are used for care homes and the general public”.

Another GP confirmed that

“These jabs are sat there, but they are not getting to us.”

The argument that the focus is on care homes rather than on the over-80s is a red herring. It is not a choice between the two; those are different cohorts who are being vaccinated by different staff. Is the First Minister telling those GPs on the front line that they are wrong?

No—but I think that Ruth Davidson is, again, mischaracterising the position, to some extent. I make no apology for the fact that we prioritised care homes first—not just because that is what the Joint Committee on Vaccination and Immunisation recommended that we do, but because we know that those people are the most vulnerable. In this second wave of the virus, we again see concerns building about outbreaks and the numbers of people who are dying in care homes.

We have now almost completed vaccination in care homes—around 95 per cent have been done, and there will be efforts to get that percentage up. Given that in any cohort, particularly frail older people, it is unlikely that 100 per cent will be reached, we have effectively completed vaccination of older residents in care homes, which I think is important.

I was reading yesterday—I think in the Health Service Journal—about concerns regarding the target for care homes being missed in England. We are on track not just to meet the target but, I hope, to exceed our targets for the other cohorts that we are now vaccinating. Around 500,000 people in total have been vaccinated already. As I said, the level for the population over 80 is now around 60 per cent or perhaps slightly above 60 per cent—the total figure will be published as soon as possible. That is well on track for meeting the target at the end of next week, although, based on the current pace of progress, I anticipate that the vast majority of over-80s will have been vaccinated with the first dose by the beginning of next week.

I have been inundated—as have all members this week, I am sure—by people in the over-70s age group contacting me to say that they have received their appointments. Vaccination of over-70s will start next week. I know people in the 65-to-70 age group who have also received appointments for vaccination next week. Together with people in the clinically extremely vulnerable group, the over-70s will be vaccinated by the middle of February.

We are building a vaccination programme that has pace, but a sustainable pace, such that we are using the supplies that we have in a way that ensures that we can meet and, if possible, exceed the targets, while focusing first on those whom the experts say are most vulnerable to getting seriously ill and dying from the virus. That is the approach that we will continue to take.

Let me take the opportunity to thank those, including GPs, who are working so hard to deliver the programme.

The GPs are right, however. Vaccinating in care homes and vaccinating in the community are two different systems, and we are able to do both quickly and at the same time, so there is no excuse for falling behind. The Scottish National Party has fallen behind, however much the First Minister protests. We have shifted targets, we are behind the rest of the United Kingdom and, on Sunday, vaccinations hit the lowest number yet.

If the problem is not prioritisation of care homes, let us look at what it really is. GPs have been shouting about it for weeks: they need the vaccine to be delivered to their surgeries more quickly. The Scottish Government can call up deliveries overnight from the distribution centres, but it is only sending out weekly deliveries to GPs. The head of GPs at the British Medical Association in Scotland has asked whether family doctors can be allowed to order stocks directly in order to help to speed up the process. Will the First Minister let them?

We will continue to discuss with those on the front line how we can better streamline and increase the pace of the programme. Governments across the UK will sensibly do that.

On the health board ordering system, although the structure of our national health service is different in terms of the population size that is covered by the entities that order the vaccine, it is not particularly different from that of the clinical commissioning groups that are doing that in England. Andrew Buist, the head of GPs, who has, understandably, raised concerns in recent weeks about the speed of getting supplies to GPs, said at the end of last week that he thought that great progress had been made last week on vaccinators and supply. He also said that he thought that the Scottish approach was the right one, and that we were now all cracking on with getting it done. That is the view that is being reflected.

We will continue to liaise daily with those who are on the front line to see whether there are problems that we need to overcome to ensure that the programme continues at pace. To be clear, I say that we have pretty much finished vaccinations of older residents in care homes. That achievement is important, because we hope that it will, as we go through the rest of the second wave over the next few weeks, reduce the number of people in care homes who might otherwise have died from the virus.

Almost finishing the vaccination of older residents in care homes has not been achieved in England—I am not sure about the up-to-date position in Wales and Northern Ireland. It is not about the choice of one category over another anymore, because we have done that cohort. There will be efforts made to get from 95 per cent to as close to 100 per cent as possible. We are going through the over-80s. I think that we will exceed the target that we have set for them, with the vast majority of those vaccinations being done by the start rather than the end of the week.

One of my family members, who is in the over-70s group, has an appointment in the middle of next week. I know somebody else who is under 70 and has an appointment later next week. We are able to go through that process now because of the efforts of those who are planning the system, and of those on the front line who deliver it. Progress is good, and we will continue to work every day to ensure that it carries on that way.

Without further action, supplies that get to GPs too slowly will continue to be an issue, but we have not heard an answer to the question whether they will be allowed to order themselves. One north-east GP has told us that they

“have the ability to vaccinate about 500 patients a day. Other GPs in the area share our frustration.”

In Fife, a practice told its patients that it expects

“to receive further supplies to administer the second doses to the over-80s, but at the moment none beyond that.”

Those delays have a real effect on patients.

An older lady in Ayr contacted me yesterday; she is delighted that both she and her son-in-law had been called to the mass vaccination centre at the Citadel leisure centre. Her concern, however, was that her equally elderly and clinically vulnerable husband had not been called for vaccination. She phoned her GP, who told her that people who have been receiving shielding letters would be vaccinated at the practice, but that the practice had no doses and did not know when it would get any, but would be in touch when it received supplies.

The woman completely understands why clinically vulnerable people are asked to go to their local doctor and not to a mass vaccination centre, but asks why younger healthier patients are getting jabs before doctors who help more vulnerable people are even being given supplies. I had no good answer to give her. Does the First Minister have one?

Clinically extremely vulnerable people are in the same category as the over-70s, as the Joint Committee on Vaccination and Immunisation recommended, and they have been given appointments for vaccination, starting next week.

I cannot—nor should I try to—guarantee that somebody over 70 in one part of the country who is not clinically vulnerable will not get the vaccine a day before somebody in another part of the country who is clinically vulnerable. That is what happens when there is a two-week window, as we have now, in which to do everybody in those groups, based on clinical vulnerability, as experts recommended.

If it is the case that we are not getting supplies quickly enough to do the over-80s, why are we confident that we will exceed the target and complete their vaccinations well within the target date of 5 February that we set? We are not doing the vaccination programme exclusively through GPs—rightly so, because if we did, GPs would be diverted too much from caring for people with other needs.

GPs are vaccinating patients when there is a good case for it, and others are being done through mass community vaccination centres. My parents will be done at a vaccination centre that is actually closer to their home than their GP practice is. This is the mixed approach that we are taking—and rightly so.

I come back to the key point. We have completed vaccination in care homes and we are ahead of other parts of the UK in that achievement. We are now 60 per cent through the over-80s and on track to exceed the target that we have set for that group. Vaccination of the next cohorts will start next week, and we are well on track also to meet those targets. Every day, we seek to overcome and address issues that people on the front line might be experiencing. The programme is going well, thanks to the efforts of the people across the country who work hard to ensure that it does.

The problem for the First Minister is that those examples are not isolated incidents. She insists that everything is going well, but let as look at what GPs on the ground are telling us.

Earlier this week, a family doctor in Glasgow bluntly said:

“The bottleneck is not people, it is vaccine supply.”

Let us therefore look at the supply chain. Since Tuesday, the Scottish Government has had around 1 million vaccines available for use. It is up to NHS Scotland to get them to health boards. At this stage, to quote the Scottish National Party Government’s “COVID-19 Vaccine Deployment Plan 2021”,

“Next day delivery can be done”

to health boards. However, getting the vaccines from the health boards’ vaccine holding centres to GPs is “normally weekly”.

We are six weeks into the vaccine delivery plan and three weeks into community roll out. Throughout that time, GP after GP has expressed frustration about supply issues, all of which the First Minister continues to brush off. They just want that to be sorted out. When will she do that?

I do not “brush off” any of those concerns. I am answering with detail on what is happening.

Ruth Davidson might have more of a point to make if we were way off meeting the targets to get through all the population groups, but we are not. If anything, we are on track to exceed the targets for vaccine quantity and the numbers whom we are vaccinating in each category.

On supply, I will not go into the detail of what we covered last week—about the Scottish Government publishing the expected supply and the United Kingdom Government demanding that we take that information out of the public domain while being quite happy to brief about the figures through spin to the media. I have said to my officials that I think that we will, actually, regardless of what the UK Government says, just go back to publishing the supply figures from next week, so that we all have transparency around that.

On the figures that Ruth Davidson quoted, as I said to her last week, if her figures are extrapolated from the UK level, then yes—of course we have allocations of doses, but we draw those down and they go into health boards and on to GPs. Of the doses that have come into Scotland so far, way more than half are already in the arms of people, and the other doses will be going into the arms of people during the coming days.

We have to plan for how we use our allocation to allow us to vaccinate all the groups that we have prioritised in the timescales that we have set.

I come back to the key point. I know that, across the country, everyone, almost without exception, wants to get the vaccine as quickly as possible, and I know that GPs and other vaccinators want to do that as quickly as possible. We are on track to meet the targets that we have set and we will make sure that that continues as we get vaccines to as many people in the adult population as we can, as quickly as we can.

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Covid-19 Testing

I, too, send my condolences to those who have lost loved ones to Covid-19.

Since the beginning of the pandemic, the World Health Organization has told countries to “test, test, test”. Yesterday, once again, Professor Devi Sridhar, the First Minister’s adviser, could not have been clearer that the best way to stop the spread of the virus and to avoid rolling lockdowns is by testing, finding contacts and isolating them.

Scotland has a daily testing capacity of 65,000 tests. We could have done 2 million in the past month alone, but we have used only 32 per cent of that capacity. We have known for some time that the First Minister’s symptom-led approach to testing is not enough to control the virus.

South Korea, Germany and other countries have been using polymerase chain reaction tests for months to find asymptomatic carriers. Even in England now, nearly one in every 100 people is tested daily for Covid-19. What is the equivalent figure for Scotland?

I do not have that figure to hand—I will get that figure.

I say to Jackie Baillie that, if her central proposition is that England has done so much better than Scotland, why are Scotland’s virus rates so much lower than England’s right now?

I do not think that this should be some kind of competition. We are all working really hard to control the virus and get rates as low as possible. Throughout the pandemic, Scotland has consistently had rates that are too high in my opinion, but that are lower than other nations in the UK, certainly those of England and, more recently, those of Wales. The numbers of people dying are far too high and none of us should be comfortable with that. However, we are working hard to suppress the virus and we are using testing appropriately in order to do that, expanding that as we go.

The numbers that are quoted—I have tried to explain this week after week—are for people with symptoms. The reason why that quantity of tests is not used every day is that the levels of the virus are, thankfully, lower than they would be if that volume was being used up to capacity.

We are using asymptomatic testing much more widely now, through care homes and of national health service staff, and we are using community asymptomatic testing, all of which is helping us to decrease the rates of the virus, which is so crucial.

I will never stand here and say that there is not more that we can do, more things that we should learn or other advice that we should take. I do not stand here and speak for Professor Sridhar, but I speak to her often. It is true that she advises a range of things—she has been a voice of wisdom throughout the pandemic. Without wishing to speak for her, I think that she considers that many of the things that we are currently doing in Scotland are the right ones. We need to keep at them and improve as we go, which is exactly what we will do.

Let me help the First Minister out with a figure, which is that, each day in England, one person in every 100 is tested. Other countries in Europe and the rest of the world have mass testing programmes in which many more people are tested daily. In Scotland, that figure is one in every 250 people. Even in the past week, our test and protect system averaged only 20,622 tests per day out of a capacity of 65,000 per day. Nearly three-quarters of those were actually repeat tests of people who had already been seen.

Let us look at another crucial part of our current system, which is contact tracing and self-isolation. In the week ending 17 January, the test and protect system failed to reach, within 72 hours of their tests, more than 850 people who had tested positive. At the start of the month, that figure was as many as 1,625 people. When people are asked to self-isolate, there is no follow-up and little support. They get a text—that is it. In some parts of the world in which proper support is on offer, as many as 95 per cent of people are managing to follow self-isolation rules. Will the First Minister tell us the equivalent figure for Scotland?

I am happy to give equivalent figures, which I can provide later on. However, I think it is really important that we engage with the issues here, of which there are two.

Jackie Baillie said that it is terrible that only 20,000 people were tested, as opposed to 50,000. The figure is for symptomatic testing. If that figure of 20,000 had been 50,000 or 60,000, it would have meant that our rates for the virus were three times what they actually are. It is a good thing that there are fewer people with symptoms and that means that fewer people are coming forward for testing. That means that we are succeeding in starting to suppress the virus, which is the really fundamental point that has to be understood.

If England’s number of tests carried out per 100 people in the population being greater than Scotland’s was the be-all and end-all, we would expect England’s virus rates to be lower than Scotland’s. However, they are not—they are significantly higher.

I will never stop trying to listen and learn about how we can do those things better, but the idea that we are somehow just getting them all wrong is not actually borne out when we look at our relative position compared to those of other countries.

Jackie Baillie is just downright wrong on the question of self-isolation. When someone is contacted and told to self-isolate, if they agree to having their details passed on to the local council they will get a follow-up call to triage their situation and find out whether they have particular needs. We have given councils additional resources so that if someone needs practical help in addition to the financial help that is offered through the self-isolation support grant, up to and including accommodation, that is available. We will shortly set out further plans to extend the support that is available to people who are self-isolating, but it is simply not true to say that no support is available to them.

Those are the facts of the situation. We will continue to work hard to improve as we go.

I am always grateful when the First Minister says that she is prepared to listen and learn. The exact point that I am making is that the existing testing capacity should also be used for asymptomatic people. I do not think that she is currently doing that.

In raising such matters I am bringing into the chamber the real experience of people who are self-isolating. They tell me that they are getting little support. She herself will know that a third of those who applied for the self-isolation grant did not get it.

I did not hear an answer to my question, so I am happy to help the First Minister out again. Only 18 per cent of people in Scotland are able to follow self-isolation rules, which is fewer than one in five. It is a pity that the Scottish Government’s performance cannot be matched by the First Minister’s spin. Eleven months into the pandemic, it has been slow to test, slow to trace and slow to support people who are self-isolating.

Although the vaccine gives us hope, experts tell us that Covid will be here for some time to come. In order to lift current restrictions and not end up in a third wave and another lockdown, we need a functioning test, trace and isolate system. That is not what we have in Scotland today. Last year, community testing pilots uncovered hundreds of asymptomatic cases in just a fortnight, but instead of the promised wide-scale roll-out, the Government is still only in the planning phase.

If we are going to get the virus under control, we need mass testing in all our communities. Can the First Minister tell me when that is going to happen, or will we be back here in a few weeks, quoting the same expert advice, asking the same questions, and with more lives lost?

Listening to Jackie Baillie, people would not think that in Scotland we actually have the lowest levels of Covid in the whole of the UK—but they are too high, so we will continue to do more. We did pilots of asymptomatic testing before Christmas and we are about to roll out a number of community asymptomatic initiatives. We are about to do asymptomatic testing in more industrial settings—I am checking with the health secretary; I am not sure, but there may be one in Jackie Baillie’s constituency. There is a testing centre in Jackie Baillie’s constituency, or maybe a mobile testing unit.

We use testing appropriately; we will continue to do that and we will continue to extend that. Frankly, it does a real disservice to the people who are working so hard on test and protect to say that is not functional. It is functional—it is functioning well—and those people have my gratitude for that.

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Vaccine Roll-out

The First Minister claimed that we were slower than England at first, because we did the hard-to-do care homes first. That argument does not wash. According to a new survey, England and Scotland are now in the same place on care home vaccination but the gap is still around 140,000 for everyone else. That is the number of people who would have had the vaccine by now if Scotland had kept pace with England.

Every day that a vaccine is left in a vial is another day that a person is left exposed to the threat of this deadly virus. With 100,000 lives lost, we cannot afford such slippages any more. It is not to do with care homes and the First Minister says that it is not to do with the ordering system, so why are we so far behind England?

We are on track not just to meet the targets that we have set to vaccinate groups of the population, but we will probably exceed those targets. Sixty per cent of over-80s are already vaccinated; the vast majority, I anticipate, will be done by the start of next week; and all of that group by the end of next week. The over-70s, the clinically extremely vulnerable and some under-70s will start to be vaccinated next week. We set those targets and we are meeting those targets.

I am sorry that people do not agree that we should have prioritised care homes early; I think that we were right to do that. I do not know what survey Willie Rennie is quoting—if England has now caught up with us in relation to care home vaccinations, that is good news. However, the fact is that we were ahead in terms of care homes and now we are getting through the other groups.

If we were missing the targets, I could understand the criticisms that are being made. We are putting in place a programme that involves working through the cohorts as clinically recommended, in an appropriate and sustainable way, and we will continue to do that.

At no stage did I say that we should not prioritise care homes first; let us get that straight. What we are saying is that the First Minister should not use the care homes argument to hide the fact that the Scottish Government has not kept pace with the rest of the United Kingdom.

Yesterday, Professor Linda Bauld criticised the lack of preparation for the second wave. She went on to urge the Government to get ready now to increase polymerase chain reaction testing to catch more people with the virus.

Last week, I reported that the Government had failed to use 1 million gold standard PCR tests since Christmas. This week, it is even worse. The number is now 1.2 million tests that have not been used. The Government is sometimes only using a quarter of the capacity. Is it not time to turn that around? I know that the First Minister does not want to listen to me, but will she at least listen to Professor Bauld and use those tests? Why is the First Minister ignoring the advice of such a professor?

I am not ignoring her. I have huge respect for Linda Bauld, and I listen to her very closely, as I do to Professor Sridhar, because they not only give good advice but do not mischaracterise the position that is actually the reality.

I do not believe that Willie Rennie really misunderstands the approach to testing, but I think that he continues to pretend that he misunderstands it in order to bandy about figures such as 1 million unused tests. We use the PCR testing capacity principally for symptomatic cases, so that people can be caught and diagnosed and then put into self-isolation, and so that their contacts can be contacted and told to isolate. The reason why the symptomatic cases are not meeting the capacity that we have is that the levels of virus are, thankfully, lower than that.

However, we are extending the use of PCR testing for asymptomatic use, just as we are using lateral flow devices, community projects, industrial projects and asymptomatic testing among care home staff, visitors to care homes and national health service staff. We are piloting approaches for asymptomatic testing using PCR testing and lateral flow devices in schools to help us as we transition to having children back in school, which I hope will be soon. We are doing all those things, and doing so in a way that makes sense and that takes account of the very good advice that we get from people such as Professor Bauld and Professor Sridhar.

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Pandemic Response

Whether or not we think that it is essential travel, the Prime Minister is visiting Scotland just days after the number of deaths from Covid in the United Kingdom reached the grim milestone of 100,000. We have one of the worst death rates in the world. Across both Governments and the whole political spectrum, we share a deep regret; we also share responsibility.

Boris Johnson claims that everything that could have been done was done, but the First Minister has acknowledged that mistakes have been made, including sticking too closely to the UK’s position on international travel. Does that regret go further? Have there been other choices where the First Minister accepts that, as seems clear to me, the desire for a four-nations approach held us back, whether it was in locking down too late or opening up too early, or in the economic response or the test, trace and isolate systems?

The milestone that was passed this week for the number of people dying in the UK is grim and should be something that lives with, haunts and is imprinted on the minds and hearts of everybody who has been a decision maker in the pandemic. I am clear that I and my Government have tried every single day to do everything that we possibly can. The death rate in Scotland is of course far too high, but it is slightly lower than the rate in other parts of the UK, or in the UK as a whole. We try to do everything every day, but nobody can look at those figures and conclude that, every day, we succeeded. That demands frankness from all of us.

I have already reflected on some of the things that I would do differently if I could turn back the clock. In part, that is about applying the benefit of hindsight, and other people can judge whether it is fair to call those things mistakes. However, in addition, mistakes will have been made.

One thing that I agonise about is whether we locked down early enough. Although we locked down at the same time as England, given the relative rates of infection, in effect we probably locked down slightly earlier than England did. But was that early enough? We of course had constraints in terms of the economic packages that required to be put in place.

I also agonise over border control. Should we have done more, even when the UK Government did not want to? We need to learn and apply that lesson in the weeks to come.

I will never stand here and pretend that we did everything that we possibly could and that we did not get anything wrong, because that is not the case. However, it is really important that we learn as we go and that we ensure that, where we got things wrong, we put that right in future, and I will try to do that.

Although I can reflect and offer thoughts on things that I wish we could have done differently, as I have just done, ultimately, it is not for me or people like me to mark our own homework. That is why, in the fullness of time, a full public inquiry into all those issues is necessary and appropriate.

Another regret that the First Minister expressed this week was in a message that she gave yesterday about transphobia within her party, in which she promised a zero-tolerance approach to such prejudice in the future. Following that statement as a party leader, does she think that the same message and the same commitment are needed from her as First Minister for the actions and inactions of the Scottish Government? Does she regret that the promises that were made to trans and non-binary people to make their lives easier, to improve their healthcare and to uphold their rights were broken, and that transphobia in Scotland has grown far worse as a result of the Government’s failure to act? What will now change?

I think that the issue is one on which all of us have a duty to speak out. I have a duty and a responsibility to tackle transphobia if it exists in my party and, as First Minister, I have a duty to make sure that the Scottish Government protects and enhances the rights of trans people. However, I do not think that anybody in the chamber, whether in relation to their organisations or to Scottish society as a whole, can sit back and rest on their laurels here.

We are talking about a really important issue. I am a lifelong feminist, and I understand the concerns that women have about abuse, misogyny and the erosion of women’s rights. As women across the chamber and across society do, I face vile misogynistic attacks every day of my life but, as a woman, I know that the threat to my safety is from abusive men, not from trans women.

I recognise the concern that abusive men will exploit trans rights to harm women, and we must address that. We must have such debates openly and honestly, but we can never allow any debate to become a cover for transphobia. Transphobia is wrong—it is as wrong as racism and homophobia. Trans people have the same rights as any of us to feel safe, secure and valued for who they are, and I, as First Minister, as leader of the Scottish National Party and as a citizen of this country, will stand against prejudice, discrimination and bigotry wherever I encounter it. That is not about political expediency or otherwise; it is a simple matter of conscience. I think that everybody should take that approach.

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Small Business Support

To ask the First Minister what consideration the Scottish Government is giving to providing funding to small businesses that are classed as essential and have no access to sector-specific support, but whose profits have been impacted by the Covid-19 pandemic and the advice to the public to stay at home. (S5F-04769)

We recognise that many businesses that are classified as essential and have therefore been able to remain open under the current and the previous restrictions will still have struggled over the past year. The £30 million local authority discretionary fund was established precisely to help to plug the gaps in financial support for businesses that exist where there are challenges inherent in implementing a national policy, and I encourage those essential businesses that are experiencing hardship as a result of reduced trade to reach out to their local authority for support through that fund.

I have been contacted by a local ironmonger whose small independent business cannot access funding from the strategic framework business fund as a result of being classed as essential and cannot access the council’s discretionary fund as the fund has already closed—it closed within a couple of days because it was heavily oversubscribed. The business is struggling to survive in the face of a huge drop in footfall, as people are rightly staying at home and following the rules. In addition, the business cannot compete with the larger businesses in the area.

What additional support can be made available to my Greenock and Inverclyde constituent and the many more people across Scotland with businesses that are deemed essential but which are struggling to survive because of the pandemic?

Obviously, I will not comment on individual cases when I do not know all the details, but I appreciate that financial support has not yet made its way to every business that is experiencing on-going disruption.

The discretionary fund was designed to get financial support to businesses where there are challenges in adopting a national approach. Some businesses will fall through gaps, for example because they are classed as essential, which means that they are not required to close, with trade severely impacted. We are working with local authorities to make sure that that money gets to businesses as quickly as possible. In addition, we are actively exploring opportunities to further widen access to the fund.

I am sure that the Cabinet Secretary for Finance—when she has got today’s budget out of the way—would be happy to have further discussions about how we can ensure that the funding that we provide helps as many businesses as possible.

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Cladding (Flat Owners)

To ask the First Minister how the Scottish Government is helping flat owners affected by dangerous cladding. (S5F-04757)

I know how much anxiety has been caused to home owners who are affected by that issue through absolutely no fault of their own. We have been working with industry bodies, home owners and others to try to resolve the situation for home owners. We established a ministerial working group on mortgages and cladding—in fact, it met most recently just this morning.

Recent consultations on guidance that was produced by the Royal Institution of Chartered Surveyors and the Scottish Government have shown that agreement is developing on the buildings that are most at risk. That will help to clarify which buildings are affected and then allow us to take action and target support accordingly, focusing on the greatest need and, of course, securing best value for taxpayers.

Last year, the United Kingdom Government set up a £1 billion building safety fund, and the Scottish Government was given £100 million as a result of that last March. People may well ask what has happened to that, and the answer is nothing. Scottish building regulations and guidance still do not ban the use of combustible materials on the outside of high-rise or other high-risk buildings, in contrast with the situation in England and Wales. Thousands of people are stuck in potentially dangerous flats for which it is a struggle to get a mortgage.

As the First Minister said, the Government set up a ministerial working group on mortgage lending and cladding. The most recent minutes that I could find were from April last year, so it is good to hear that the group met this morning.

The First Minister is well aware of the issue. She has had constituents complaining about it. When is she going to unveil her solution? When is that £100 million going to be spent?

On the question about the money, if Graham Simpson had listened to my earlier answer, he would know the process that we are going through. We need to establish where there is greatest need—the buildings that are most at risk—and then make sure that that support is targeted appropriately in a way that addresses need but which also ensures value for taxpayers. That is the process that is under way.

On the wider points, we are considering the responses to the consultation on the Scottish advice note on external wall cladding systems and we intend to publish the advice note later this year. The Minister for Local Government, Housing and Planning will keep Parliament updated, as he has done up to now.

I know through constituency experiences how anxious a situation this is for people who are affected, but that is why it is right that we do this properly to address the issue of those who are currently living in buildings that are affected by cladding, but also to make sure that, through building standards in the future, we do not repeat the situation.

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Cervical Screening Tests Backlog

To ask the First Minister what measures the Scottish Government is putting in place to catch up with the reported six-month backlog of cervical screening tests, and whether priority will be given to people who have previously had an abnormal result. (S5F-04760)

Cervical screening, which had been paused in the early stages of the pandemic, resumed on 30 June last year. During July and August, participants who receive more frequent screening because of a past result and who had not received their invitation or reminder due to the pause in screening were prioritised and were sent their invitations first. Invitations for routine screening began to be issued again in September, and appropriate infection control measures are in place so that people feel confident about attending.

The programme continues to face challenges, as many programmes do, as a direct result of the pandemic. However, diagnosing and treating cancer early remains a priority. The Government has provided just under £1 million to support capacity in sample taking, for example. That was agreed following extensive consultation with health boards and primary care.

I thank the First Minister for that response. The reason why I wanted to raise the issue is that I have had constituents get in touch with me recently who are worried because they have experienced delays in their access to cervical screening tests and, because it is already three years since their previous test, they are now deeply concerned. Does the First Minister agree that cancer tests such as cervical screening tests need to be a priority both now and when the NHS is remobilised? They are a strong preventative measure that will relieve pressure on our NHS in the long run, but also ensure that the identification of potentially life-threatening cancers is not delayed and, therefore, that my constituents are not put at risk or placed under further deep worry and strain.

I agree with all of that. Sarah Boyack is absolutely right to raise those concerns in the chamber. It is a concerning situation for anybody who is waiting for a cancer screening appointment, a diagnostic appointment or treatment. I think that we all understand that.

On the cervical screening programme in particular—although some of what I am about to say will apply to all the cancer screening programmes—people might recall that, when the very difficult decision was taken to pause the screening programmes last spring, the former chief medical officer set out that the decision was taken to pause the programme rather than continue it at a slower pace so that people would not miss appointments. If they were due an appointment, that would be rescheduled when the screening programmes started again. It is right that, since they have restarted, those most at risk have been prioritised, which I think is one of the issues that have been raised. Of course, work is on-going to get through the backlog as quickly as possible, given the on-going challenges around infection prevention and control.

It is vital that cancer symptoms and diagnostics continue to be prioritised, so that we can get people into treatment as early as possible. That remains a priority for the whole national health service, notwithstanding the pandemic conditions in which it is working.

We have a very large number of requests for supplementaries. We will not be able to take them all, but we will see how many we can take.

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Debenhams Takeover

The First Minister will be aware of the takeover of Debenhams by Boohoo. The deal does not include the shops. Hundreds of employees will lose their jobs and the Glasgow store in my constituency is closing. What support will be offered to employees, and what action can be taken to support our high streets and businesses that have been impacted negatively by the pandemic and the rise of online shopping, which has left once-lucrative retail spaces empty?

I was concerned to hear of the situation with Debenhams, and I know how distressing the situation will be for those who work for it and their families. The business minister has already spoken with the administrator for Debenhams to offer every support possible, and we are providing support, as we always will, for any individuals who are affected by redundancy through the partnership action for continuing employment initiative.

More generally, we are providing grant support for retail businesses that are required to close, and one-off top-up grant support for businesses, depending on their rateable value, has recently been announced.

We are working closely with stakeholders to develop a retail strategy to help the sector deal with the situation that it is facing. Considerations for the strategy will include the impact that Covid has had on retail, the response to increased online trading and how the sector may have to adapt to meet those challenges as we start to recover from the acute phase of the crisis.

There is no doubt that retail is one of the most badly affected sectors and will require our on-going support for some time to come.

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Arran Ferry (Reliability)

I was contacted last week by Arran Cancer Support Trust, which raised concerns that many of its patients have been missing vital cancer treatment from the mainland due to the unreliability of the Arran ferry. Of course, the replacement vessel is now three years late. The trust described the situation there as “critical”.

This week, a number of 80-year-olds on the island had their Covid vaccination cancelled because doses failed to arrive on the island. The situation simply is not good enough. We need reliable transportation to our island communities, and they deserve the same standard of healthcare as anyone else in Scotland. Why are they not getting it?

People living in island communities absolutely deserve the same standard of healthcare as anybody living in mainland Scotland. I am very happy to look into the particular issues relating to hospital appointments and Covid vaccinations that have been raised regarding recent disruption to the Arran ferry and get back to the member as quickly as I can.

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NHS Lothian (Covid-19 Vaccination Rate)

According to weekly Public Health Scotland figures, NHS Lothian has the lowest vaccination rate of any health board in Scotland. Just 7.3 per cent of residents have received their first dose. Within the area, Edinburgh is the worst local authority for vaccinations, with just 4.9 per cent of residents vaccinated, which is almost half the Scottish average. According to the Edinburgh Evening News, it emerged last week that NHS Lothian has given vaccinations to volunteers at a food bank, despite care home residents and staff still waiting for inoculation. The health board claims that that is because Scottish Government guidance on prioritisation is unclear. Has the Scottish Government been in touch with NHS Lothian regarding its apparent slow rate of inoculation? Does the First Minister have an explanation as to why it is lagging behind the rest of the country? Is the health board right in claiming that the guidance on prioritisation is unclear?

I thought that the Cabinet Secretary for Health and Sport was about to combust at the suggestion that she not been in touch with NHS Lothian or other national health service boards. I assure Daniel Johnson that there is daily contact with all health boards about the vaccination programme and other matters.

Any health board, council or organisation that thinks that the guidance on any aspect of our Covid response is unclear should let us know. We will look into it and, if that is the case, seek to rectify the issue. I am not aware of there being any lack of clarity in the guidance on vaccination priority, but if there is a perception that there is, we will address it.

The weekly Public Health Scotland figures, which I assume are the figures that are being quoted, are accurate as at a few days ago, so the position will have moved on. The Scottish Government is now publishing a daily breakdown and, in due course, Public Health Scotland will publish daily breakdowns as well. Therefore, I caution against putting too much store on figures that are for three or four days ago. Nevertheless, we want the vaccination programme to proceed at pace, not only across the country but in all parts of the country. If there is any suggestion that any health board is behind the pace, Daniel Johnson can be assured that the health secretary and Scottish Government officials are following the matter up very assiduously indeed.

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Covid-19 (Vaccination of Police Officers)

Will the Scottish Government address the concerns of police officers regarding vaccination timescales for their profession?

I absolutely understand the desire of police officers, teachers and other professional groups who have direct contact with members of the public to be vaccinated as quickly as possible. I absolutely sympathise with that. However, right now, we are following a clinical prioritisation list that has been recommended because following that clinical prioritisation is the best way to protect the most vulnerable and reduce the burden of the virus in terms of serious illness and death.

If, at any time, we said that a group outwith the clinical prioritisation was to be prioritised beyond where it is right now, we would, by definition, be deprioritising groups with greater clinical need. There are two important points, which I will set out as briefly as possible. First, there will be many police officers in the initial Joint Committee on Vaccination and Immunisation priority groups, such as people with underlying health conditions or those who are over 50. Therefore, many of the police officers will be included in the clinical priority groups.

Secondly, the quicker we do the first JCVI priority groups, which we are aiming to do by the start of May, the sooner we get on to the wider population. It is a whole adult population programme that will, as quickly as possible, include everybody.

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Queensferry Crossing Closure

Connections for key workers and key deliveries are vital during the pandemic but, when chaos on the roads is caused by ice-related closure of the Queensferry crossing, it has an enormous knock-on effect. The £1.3 billion bridge was opened to great fanfare as both an engineering marvel and a new icon for Scotland. However, the closures could have been avoided, as the problems with falling ice were highlighted at the design stage. What urgent action will the Scottish Government take to find a proper solution to allow this flagship bridge to be used as intended?

This flagship bridge is used as intended, and it is a huge success. Bridges of similar design in other parts of the world offer suffer occasionally from extreme icy conditions. I am not sure whether Alexander Stewart is suggesting that we stop ice accumulating on a structure in sub-zero temperatures, or just let traffic go across the bridge regardless of the risk of ice falling off it. Thankfully, such occasions are rare, but the bridge is a great success and we will continue to work with its operators to make sure that travel flows across it without disruption on as many days of the year as possible.

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Small Business Support (Glasgow)

My question is similar to Stuart McMillan’s. For reasons that the First Minister is aware of, newsagents, convenience stores and food takeaways that are based in Glasgow city centre get no financial support at all, but tier 4 restrictions have reduced the footfall in the city centre. Glasgow city centre small business alliance has written to the First Minister to say that its members have no option but to close, because they are not bringing in enough sales and that, if there is no help, many of them will go to the wall. Will the First Minister keep me and other Glasgow members informed as to how the Government will proceed on that point? I am sure that she appreciates that Glasgow city centre already has huge challenges and will likely require a specific recovery plan, given its strategic role as a driver of the Scottish economy.

There are on-going discussions with the Scottish Cities Alliance about some of those issues, which will be important for the medium to longer term. More immediately, the Cabinet Secretary for Finance will cover issues of business support in her budget statement this afternoon, so I will not tread on that territory right now.

However, in the immediate sense, Glasgow City Council already has a share of the £30 million discretionary funding which, as I said to Stuart MacMillan, was designed to ensure that businesses that fall through the gaps of the other sector-specific or other schemes can have access to funding. I think that some of the businesses that Pauline McNeill talks about fall into that category. We will continue to work with councils and others to make sure that we are doing as much as possible to fill those gaps. That discretionary funding is already available to councils, which should be seeking to get it to businesses as quickly as possible.

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Job Retention Scheme

The job retention scheme has been extremely valuable and has been welcomed in Scotland and across the United Kingdom. However, we do not yet know whether it will continue beyond April. This afternoon, we will hear the Scottish budget. If the job retention scheme does not continue, will that have a negative impact on the Scottish budget and the Scottish economy?

If the job retention scheme is withdrawn prematurely, while we still have any degree of Covid restrictions that put constraints on the way businesses operate, that will be bad for Scottish workers and workers across the UK. If that happens, there will be a knock-on effect on the economy and the Scottish budget.

My appeal to the Chancellor of the Exchequer would be that he extend the job retention scheme for as long as it is necessary. Many other countries in other parts of Europe have already made similar decisions. It would be wrong and deeply damaging for the scheme to be withdrawn before we are out of the acute phase of the crisis. We saw unemployment figures this week. The job retention scheme is preventing unemployment from being much higher than it is, which gives us a sense of what might happen if the scheme is withdrawn. I hope that that does not happen.

Perhaps, when we are talking about learning from mistakes—and I will seek to learn from any mistakes that this Government has made—it will be acknowledged that the uncertainty that was caused by the chancellor saying that the furlough scheme was going to be stopped and then at the very last minute extending it cost jobs. Clarity now that the scheme will be extended for as long as necessary would be welcomed by businesses across the country.

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Covid-19 (Vaccination Programme)

I declare an interest as a shielded person. Further to Ruth Davidson’s questions, can the First Minister explain to the Parliament why general practitioners in my constituency, who vaccinated their over-80s and nursing home patients some weeks ago, cannot now get vaccines to vaccinate their shielded cohorts? When will they get those vaccines?

GPs and the vaccination centres that will be vaccinating the over-70s and people who are clinically vulnerable in the shielding category will have the supplies to vaccinate everybody in those categories by the middle of February. That is the target that we have set and the target that we are on track to meet.

The overall vaccination programme is being done through a mixed approach. Some vaccinations are done through GP practices and some through vaccination centres, for reasons that I think I set out earlier.

Everybody in those categories will be vaccinated with the first dose by the middle of February. That is the target that we set and the target that we are on track to meet.

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Abbeyfield House Care Home

I have been informed that Abbeyfield House care home in Springburn is consulting on potential closure, and it is possible that it will close by the end of May 2021. I understand that there are 14 residents. Families have contacted me raising understandable concerns. I am in contact with the owners of the care home, social work authorities and the Care Inspectorate. Does the First Minister agree with me that moving vulnerable residents to a new care home has inherent risks at any time, let alone during a pandemic? How can the Scottish Government work with all involved to do all that it can to prevent that from happening?

The interests of the residents must always be the paramount consideration, and their care must be delivered as safely as possible. I agree with Bob Doris that moving residents to a new care home should always be a last resort but, when it is necessary, that must include a safe and supported transition for residents to alternative care environments. I am happy to ask the Cabinet Secretary for Health and Sport to engage with the health and care partnership in Glasgow on the current position of this care home to ensure that the needs of residents are being met and, should it be necessary, to seek assurances that any transition is managed safely. I am sure that the health secretary will be happy to liaise with Bob Doris on that.

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Edinburgh Airport (Covid-19)

The First Minister’s announcement of new border arrangements and her advice against booking international travel came as a surprise to the management of Edinburgh airport, who learned about it only while watching the lunchtime briefing on television. That has effectively closed down the aviation sector, and the airport has signalled that it could well lead to further unplanned redundancies in my constituency. The airport does not oppose the restrictions but is concerned that they are being brought in without the support packages that have been offered to the sector in other countries that have gone before us. What additional support will be offered to our airports in light of this? Will she commit to working closely with them to determine a route out of these measures once conditions allow?

My comment is not directed at Edinburgh airport which, like all airports and the aviation sector generally, is having a torrid time. I said yesterday that we are specifically seeking to work with the United Kingdom Government so that, collectively, we can ensure that there is additional support for airports and the aviation sector.

I cannot honestly believe that anybody was surprised yesterday when I said that we should not be planning overseas travel for the foreseeable future. I have been seeing that repeatedly for some time. The clue is in the fact that we are living in a global pandemic and, as we suppress the virus here and continue to roll out the vaccination programme, it becomes more important that we minimise the risk of reimporting the virus, or possibly importing new, faster spreading and more dangerous strains of the virus into the country.

I remember saying last year that we thought that we had virtually eliminated the virus in Scotland during the summer, but then it was reimported. Willie Rennie criticised me for claiming that at the time, but genomic sequencing has since proved it to be true. We must learn that lesson. If we want to get back to any semblance of domestic normality during the next few months, we must make sure that we are not taking the risk of bringing the virus back into the country. I do not believe that me saying that yesterday came as a surprise to anybody who has been listening to any of this in the past weeks.

We are resuming at 2 o’clock to discuss the budget, so I will draw First Minister’s questions to a close.

13:32 Meeting suspended.  

14:00 On resuming—