Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, June 8, 2021

Official Report 1013KB pdf

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Covid-19

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

14:25  

At the outset of the statement, I confirm that there will be no immediate changes to the Covid levels of protection that currently apply to different parts of Scotland. I will provide a general update on the state of the pandemic and I will, of course, address any questions that members have.

First, I will report on today’s statistics. The total number of positive cases reported yesterday was 695, which is 5 per cent of the total number of tests, and the number of confirmed cases in Scotland is now 241,864. There are currently 121 people in hospital with Covid-19, which is one fewer than was announced yesterday, and 12 people are in intensive care, which is the same number as was announced yesterday. I am pleased to report that no deaths were reported yesterday, which means that the total number of deaths registered under the daily definition remains 7,677. Once again, I send my deepest condolences to all those who have lost a loved one.

I turn now to the vaccination programme. It is exactly six months since the first Covid vaccine was administered in Scotland, and progress since then has been remarkable. As of 7.30 this morning, 3,403,866 people in Scotland had received their first dose of the vaccine. That is an increase of 17,545 since yesterday’s announcement and, most important, it means that almost exactly three quarters of Scotland’s adult population has now received a first dose.

In addition, 30,944 people received a second dose yesterday, which brings the total number of second doses administered to 2,282,203. That means that more than half of the adult population is now fully vaccinated with two doses. Those are significant and heartening milestones, and, as ever, I want to thank everyone involved in delivering the vaccination programme across the country.

Last week, the Medicines and Healthcare products Regulatory Agency approved the Pfizer-BioNTech vaccine for use among 12 to 15-year-olds. That is good news, as it indicates that that particular vaccine is safe for use in children of that age. The Scottish Government is now awaiting advice from the Joint Committee on Vaccination and Immunisation on the vaccination of children in that age group. I am sure that everybody agrees that it is vital that we continue to rely on expert advice in all our vaccination decisions. Vaccination may well be an important way of giving children greater protection, minimising any further disruption to schooling and further reducing community transmission of Covid. So, I confirm that, if the JCVI recommends the use of the vaccine for children aged 12 and over, we will move as quickly as is practicably possible to implement its advice.

However, for the moment, we continue to focus on vaccinating all adults as quickly as possible. That remains crucial in the race that we are in between the virus and the vaccine. As today’s figures show, case numbers in Scotland continue to rise. In the past week, in fact, they have increased by approximately 50 per cent. Over the past seven days, there has been a net increase of 5,475 new cases, which is a rise from 3,728 over the seven days prior to that.

That will partly be a consequence of restrictions easing—it is always the case, as we have always made clear, that, as we start interacting more, the virus has more opportunities to spread—but the recent rise is also being driven by the more transmissible delta variant, which now accounts for the majority of all new reported cases. Although case numbers are rising, the key question is the extent to which vaccination is weakening the link between an increase in new cases and an increase in serious health harms. We continue to assess that data closely, and, at this stage, it is important to be clear that we remain optimistic that vaccination will allow us to move progressively to a less restrictive way of dealing with Covid.

We have evidence that having two doses of vaccine gives protection against serious illness, even with the new delta variant. As I confirmed earlier, more than half of the adult population in Scotland has had two doses, including more than 90 per cent of people aged over 60 and more than 80 per cent of those who are over 50. They are the age groups in which people are most at risk of falling seriously ill if they get the virus.

As I said last week, vaccination appears to be reducing the proportion of people who require hospital treatment as a result of Covid. At the start of the year, about 10 per cent of new Covid cases were admitted to hospital; in May, that figure was 5 per cent. However, it is important that we continue to monitor the data so that the full impact of the delta variant can be properly assessed.

There is also encouraging evidence that the time that people spend in hospital is reducing. When we take all of that into account, as we all hoped, vaccination might well be giving us more scope to ease restrictions and therefore reduce the social, economic and wider health harms that the response to the virus so far has caused.

All those signs are positive, but continued caution is needed—especially while a significant proportion of the population has not yet had both doses and so remains more vulnerable to becoming ill and needing hospital treatment. The number of people in hospital might not be rising as quickly as the number of new cases, but, even so, it has roughly doubled in the past month. If case numbers continue to rise, that trend will continue.

On average, people might be spending less time in hospital, but it is still the case that, if someone ends up in hospital because of Covid, the virus has made them seriously unwell. Some people, such as those who suffer from long Covid, can be seriously ill without ever having to go to hospital.

In summary, our position is still fragile. Case numbers are higher than we would like. The virus still causes serious health harm, and it still has the potential to put pressure on our health service. That is why we must continue to assess the data carefully as we make decisions about whether and when to ease restrictions further.

On the upside—I stress that it is a significant upside—the vaccines appear to be doing their job, which should give us all firm grounds for optimism. That is why our top priority, and a key consideration in our future decisions, remains the speed at which we can vaccinate people, so that as many as possible get the added protection against serious illness as quickly as possible.

The vaccines offer us hope for the future, but it remains the case that we all have a role to play in getting us back to normal, so I will finish by reiterating the three key requests that are being made of all of us. First, please get tested regularly. Free lateral flow tests are available through the NHS Inform website so that you can take a test twice a week, which I strongly encourage everyone to do. Taking a test tells us whether we might have the virus, even if we do not have the symptoms. If you test positive, please self-isolate and get the lateral flow result confirmed through a polymerase chain reaction test—that is vital. The more we all do tests, the more cases we will find and the more we will break chains of transmission.

Secondly, get vaccinated when you are invited to do so, and please attend for both doses. If you need to rearrange an appointment, if you think that you should have had an invitation by now and want to check that, or if you are aged 18 to 29 and have not yet registered for your appointment to make sure that all your details are up to date, please go to the vaccinations section of the NHS Inform website.

Getting vaccinated is in our own best interests—whatever age we are, vaccination makes it less likely that we will become seriously ill from Covid. Getting vaccinated also helps us to protect one another. It is likely to be the single most important thing that most of us will do this year to protect our family, friends and neighbours, so please, when it is your turn, roll up your sleeve and get the jags.

Finally, please continue to stick to the rules where you live and follow all the public health advice. I know that that becomes more and more difficult as time goes on and that, as restrictions ease—bit by bit—and we try to get back to normal, any apparent anomalies in the rules and advice can be frustrating. We are trying to strike the best and most appropriate balance overall, but I readily concede that it is not perfect.

However, there are some principles that we can and should all follow. People should meet outdoors as much as possible. No environment is ever entirely risk free in any sense, but, in relation to Covid, meeting people outdoors poses less risk than meeting indoors. If you are meeting others indoors, please stick to the limits and make sure the room is as well ventilated as possible. Please continue to follow advice on physical distancing, hand washing and face coverings. We all long to see the back of those mitigations, but, for now, basic measures to prevent transmission are really important and effective against all variants of the virus.

In summary, please get tested regularly, get vaccinated when you are asked to do so and continue to follow the public health guidance. If we all do that, we will help to keep the virus under control while the vaccination programme continues to do its work. That will help to keep us and others safe, and it will maximise the opportunity for a summer of fewer restrictions and much greater freedom.

The First Minister will now take questions on the issues raised in her statement. I intend to allow around 40 minutes for questions, after which we will move to the next item of business. Members who wish to ask a question should press their request-to-speak buttons now.

Today is exactly six months since the first person in Scotland and others across the United Kingdom were vaccinated against Covid-19. This is a moment for us all to pause and reflect on the huge success of the vaccination programme, and to express our thanks to the NHS, the volunteers and the members of the British armed forces who have ensured that 75 per cent of adults in Scotland are protected with the first dose and 50 per cent are protected with both doses of the vaccine.

It is also encouraging that younger people may soon be able to get the Covid vaccine safely, too. The vaccination scheme is our route out of both the restrictions and the pandemic. Once the JCVI makes its recommendations on the safety of the use of the vaccine for 12 to 15-year-olds, I hope that we will be able to make swift progress so that young people’s education will not be disrupted any further.

Just last week in her statement to Parliament, the First Minister announced that many areas of Scotland would remain in level 2, rather than moving to level 1 as they had expected. She said:

“we could still see a significant burden of illness and death, and severe pressure on our national health service.”—[Official Report, 1 June 2021; c 4.]

However, a week on, we have heard nothing from the First Minister or her Government to back up that claim.

We are at a difficult point in the pandemic: we need the public onside in relation to the restrictions that we continue to live with and yet we are not hearing evidence from the Government to support such strong statements as there being

“a significant burden of illness and death, and severe pressure”

on the NHS.

As a whole, that statement is telling for what it misses out and whom it ignores. There was nothing in the statement about the people who are currently protesting outside the Parliament about the restrictions on soft play centres. There was nothing for venues that are confused that the numbers for christenings are more limited than those for comedy shows, and nothing for couples who are frustrated that their wedding numbers had to be limited to just 50 at the last minute. There was nothing for parents who want to be there in person with their young children as they graduate from nursery to primary school. The First Minister referenced apparent anomalies in the rules, but did not say anything about what—if anything—she will do about those anomalies.

Will the First Minister explain to people and businesses, which have been left wondering, why 6,000 people can attend a fanzone without mandatory testing while the limits on weddings, christenings and hospitality in general remain so strict? Will she re-examine the limits on weddings and funerals in areas in level 2? What are the specific reasons for the on-going restrictions on soft play centres? Owners of soft play centres are currently protesting outside and they will be listening closely to her answer. Finally, will she agree to find a solution so that parents can see their young children graduate from nursery to primary school?

I will do my best to address all those points. In an overarching sense, none of this is easy. Such decisions require good-quality clinical advice, but they also require judgment. Sometimes we need to make decisions that people do not want to hear, because this is really difficult, and to navigate our way through the pandemic in a way that shows as much leadership as possible. That is what I will continue to do. I will continue to be accountable and to do my best to explain decisions to people across the country.

We are already doing the planning to extend the vaccination programme to children over 12, should the JCVI recommend that. It is the MHRA that opines on the safety, on balance, of vaccination. The JCVI has to look at the clinical implications of vaccination and the priorities in terms of the order in which the population is vaccinated versus supply and other such matters. All four nations of the UK follow the JCVI advice, and it is right and proper that we do so.

In anticipation of the JCVI giving the go-ahead to vaccination of over-12s, we have already started that planning. As I said in my statement, we will implement any such advice as quickly as possible. It is important that we continue to follow clinical prioritisation. That is why we started with the frailest, oldest people and have worked our way down the age cohorts, while ensuring that people of whatever age with underlying health conditions get vaccinated as quickly as possible.

I have to say that I struggle to understand Douglas Ross’s second point, but I will do my best to address it. As I said last week—I do not think that there is a leader of a Government anywhere in the UK or the rest of the world who would say anything different from this—while we are still learning about the efficacy of vaccination, rising case numbers, particularly when a significant proportion of the population is not fully vaccinated, could lead to a significant burden of illness, hospitalisation and death. The operative word is “could”. Clearly, I do not ever want to be standing here, that statement having been borne out—I really hope that that does not happen.

Douglas Ross said that he has not heard anything from the Government since I made my statement last week. That is factually wrong. Every day, we publish the number of people who are in hospital, the number who are in intensive care and the number who are losing their life to the virus, so people can see what is happening daily in terms of the burden of hospitalisation, the number of people needing intensive care and the number of people who are dying from this illness.

In my view, one person losing their life is one too many, but we can see, at this early stage, a weakening of the link between rising case numbers and the burden of illness. We need to be cautious, because it is too early to be definitive that the new variant will not change that dynamic. Even if that link continues to break, for as long as a proportion of the population is not fully vaccinated, a proportion of those people ending up in hospital would place a significant burden on our health service.

We have to look at the situation carefully. All the evidence so far is positive, but it would be utterly irresponsible to deny the reality that the current rise in case numbers could cause that increased burden. We monitor the situation and publish data daily. If Douglas Ross wants to listen to the Prime Minister and the Prime Minister’s clinical advisers south of the border—I suspect that he is more likely to listen to them than he is to me—he will hear that pretty much the same calculations and considerations are under way, as they have to make a decision next week on whether to go ahead with the next round of easing in England, which is planned for 21 June. We are all grappling with the situation. Doing that to the best of our ability requires that recognition and an attempt to show people strong and clear leadership. That is incumbent on all leaders, not just those of us in government.

The Government’s clinical advice is that the indoor environment of soft play centres—there is a big difference between indoor and outdoor environments—coupled with their particular characteristics, means that soft play centres continue to pose a risk. Of course, soft play centres in level 1 areas can reopen, and we hope that more parts of the country will go to level 1 over the next few weeks. The Cabinet Secretary for Finance and the Economy set out our intention to continue to provide financial support in the meantime.

I wish that everywhere could open immediately, but I have a duty to open up in a way that keeps people as safe as possible, which means continuing to consider things in the round. There will always be apparent anomalies—I wish that there were not—but we try to avoid them. As we try, bit by bit and step by step, to get the country back to normal, we have to ensure that we strike the right overall balance. I am afraid that that is not easy, but it is necessary, and it is the job that I am determined to continue to do.

Six months on from the first vaccine, I thank our vaccinators and volunteers for giving our country hope.

Although there are definite signs of progress, the rise in cases and the increase in hospitalisations shows that we cannot be complacent and that we must accelerate our response. Does the First Minister still intend to review the next stage of the easing of restrictions on 28 July? If so, will she commit to an ambitious target of double dosing everyone aged over 40 and of providing at least one dose for everyone aged over 18 by that date? Our target was 400,000 vaccinations a week. I want us to hit that target and go beyond it to make that a reality. In areas where there is a high turnover of residents and a low rate of attendance for vaccination, can we ramp up the opening of walk-in vaccination centres so that people can access vaccinations without requiring an invitation letter? That would mean we could continue to go forwards, not backwards.

It is important that we maintain public trust in the response to the pandemic. We can do that by maintaining strong communication and by being consistent in decision making. Does the First Minister recognise why the soft play industry believes that there is an inconsistency in decision making, given what has happened south of the border and what is happening in Scotland? Will she agree to meet and work with those in that industry so that they can safely re-open premises in level 2 areas, as is happening in other parts of the UK, and we can save jobs, protect Scotland’s economy and get our country’s mental health and wellbeing back on track?

I will address most of those points.

I make this point sincerely. At First Minister’s questions last week Anas Sarwar—as he is entitled to—posed a series of questions in which he criticised me for a characterisation that I would not necessarily accept: he said that I was simply following what had happened south of the border during an earlier stage of the pandemic. Now he asks why I am not doing exactly the same as is happening south of the border.

We must take the decisions that we think are right, based on our own clinical advice. I recognise that people see perceived inconsistencies. Sometimes they will be right. We have amended things in the past, particularly where there seemed to be genuine inconsistencies for some premises. Sometimes the inconsistency will be perceived—for example, there is a good reason why soft play cannot open in level 2 areas while other things can. I absolutely accept that there is a need to communicate such things as clearly as possible but I also understand that running a business that has to remain closed will always be very difficult to accept. I appreciate that, but it is important that we try to navigate our way through this as safely as possible.

It has been the case at every stage that if we had simply opened everything up we would have overwhelmed our ability to cope. We sometimes have to limit what we do, recognising that we must work with people and compensate them, as Anas Sarwar said. I accept that, and we will continue to do it.

We are vaccinating people as quickly as our supplies allow. I would love us to do more, but supply is the constraining factor. The latest seven-day rolling total number of new first and second doses is 343,548. We will get above that number if supplies allow. Supply is what limits the speed of vaccination, but that speed is fast. If we look at first doses, we can see that people aged over 60 are pretty much 100 per cent done; those aged 50 to 54 are 93 per cent done; those aged 40 to 49 are at 86 per cent; and those who are 30 to 39 are at 58 per cent. Even in the 18 to 29-year-old group, 27 per cent have had their first dose. Among the over-50s, 50 per cent have had a second dose and are fully vaccinated. In the younger age groups, 29 per cent of those aged 40 to 49 have already had a second dose, as have 20 per cent of 30 to 39-year-olds and 14 per cent of 18 to 29-year-olds. We will speed that up as quickly as supplies allow us to.

The next review of easing will be on 28 June. I know that Anas Sarwar simply made a slip but, to be clear, the date is 28 June. On 21 June, I will set out in Parliament our expectations in relation to going ahead or not, or the extent to which we will go ahead. That will be informed by the latest data. Between now and then, as far and as quickly as supplies allow, we will get as many people as possible vaccinated, with not just one but two doses.

The First Minister referred again, as she has done in the past, to the race between the vaccine and the virus. It should be clear to us all by now that a global pandemic is the kind of race that we win only when everybody wins—we are safe only when everybody is safe.

Does the First Minister therefore support the open letter written by UNICEF and supporters to the leaders of the G7 about the global vaccination programme for developing countries? The letter points out that the Covid-19 vaccines global access—COVAX—initiative is 190 million doses short of where it needs to be and that developing countries with a more limited health infrastructure are getting a large number of vaccine doses late. That will not lead to mass vaccination; it will lead to mass wastage.

What response does the First Minister hope will come from the G7 leaders to that call for earlier, larger-scale and more predictable donations of vaccine from rich countries to developing countries? How can Scotland’s voice be added to the call for greater ambition on the global aspects of the pandemic?

Yes, I broadly support the terms of the UNICEF letter and I hope to see coming out of the G7 an agreement that there is a responsibility on the part of the G7 to help speed up vaccination, not just in the G7 countries but globally. I will continue to add Scotland’s voice to that as loudly as I can.

In summary, we need to seek to do two things. First, we need to make sure that the supplies of the vaccine that are available in the world are distributed as equitably as possible. We have to avoid the risk of false choices being put before us. The supplies, through the very good procurement that the UK has done, mean that we should not see this as a choice between, for example, vaccinating children and playing our part in helping global vaccination. The second thing that we need to do is support efforts to ramp up production of vaccines in as many parts of the world as possible.

It is absolutely the case that, although we are of course really focused on vaccinating our own population as quickly as possible—because that is our first contribution to ending the global pandemic—we will not end the pandemic until the whole world manages to exit from it. The best chance that we have of exiting from it is through mass vaccination. We therefore all have a part to play in that, and the richest countries in the world have a real moral obligation to lead that effort.

It is carers week, but 72 per cent of unpaid carers have not had a break since the pandemic began. Last week, I asked the First Minister to reopen day services for adults with special needs. In response, the relevant minister issued a new letter today, but with a link to the old guidance, so nothing has really changed in the past week. It makes no difference what level someone lives in—the barriers to reopening are just the same. People are getting desperate, so will the Government issue new guidance to give local authorities the clarity that they need to get those services open again?

I understand the desire for that; I share the desire for it. I would simply ask Willie Rennie to accept, as I have done on previous occasions, that there is no minister in the Government who is somehow standing in the way of that for any reason other than that the clinical position is still that we need to be cautious and take precautions. Yes, we will get to a position of issuing new and more permissive guidance as quickly as possible. I have said very clearly—and I repeat it today—that we need to prioritise things like that.

Nobody is trying to hold up moves like that for any reason other than trying to keep the most vulnerable in our society as safe as possible. However, I will make sure that the health ministers look again at the issue, given that it has been raised again, to see whether it is possible to speed up that process—to go more quickly and to have more distinction between the different levels of protection that apply.

Of all the jobs created in the UK last year through foreign direct investment, 16.1 per cent—some 4,500—were generated in Scotland. That is remarkable in a pandemic year. Given that, across the 12 nations and regions of the UK, Scotland has attracted the second-highest number of overseas-backed investments after London in every year since 2014, does the First Minister agree that it is time for unionist politicians to dispense with the scare stories about this Government’s commitment to independence deterring investment, desist from talking down Scotland and back the outward-looking creative and innovative nation that Scotland is as we recover from Covid-19? [Interruption.]

I suggest that the member is perhaps straying beyond the bounds of the statement. If the First Minister has a relevant answer in line with the statement that may help Mr Gibson, she may respond.

I think that the EY Scotland attractiveness survey 2021, which was published yesterday, should be welcomed by all parties in the chamber. We should bring ourselves to come together to welcome it because it shows that, in the face of a global pandemic, Scotland has remained the top UK inward investment destination outside London, as has been the case in eight of the past 10 years. We have also managed to grow our inward investment at a time when it has shrunk across the UK as a whole. Whatever our different political viewpoints and ambitions for the country, surely, in the face of this really tough time, we can all come together to welcome some thoroughly good news for the Scottish economy.

Recent figures show that fewer than one in 20 pupils in secondary 3 to 6 have taken part in the Covid-19 testing programme and that uptake was just 6.3 per cent for younger secondary school pupils. Worryingly, despite being in the grip of an outbreak, rates of asymptomatic testing in schools in Glasgow are the lowest in the country. Given recent warnings from public health experts that school children are driving the epidemic in Scotland, what action will the First Minister take to ensure that there is an adequate testing regime in place?

An adequate testing regime is in place. All senior pupils can access tests, and many do. Although we cannot mandate and force young people to take a test, all of us—I include all members of Parliament—can, in our own constituencies or regions, encourage young people to do that.

Like many members, I have family members in the age cohort that Annie Wells mentioned. I know that taking a lateral flow test is not something that we—young people or anyone else—really want to do, but it is important because it helps to determine whether someone might have the virus even if they are not showing any symptoms, and all the other protections can flow in behind that.

As is the case in much of this situation, I do not have a magic wand. I cannot make 100 per cent of young people take the tests, but I will encourage them to do so. The tests are easily available and it really matters that people take them. I ask that Annie Wells and other members echo and add their voices to that so that we can get uptake as high as we possibly can.

I pay tribute to the work of NHS Greater Glasgow and Clyde and partners for the delivery of the vaccine programme in Glasgow. In recent days, I have been contacted by a small number of constituents who are about to approach or pass the 12-week period for their second vaccination. I appreciate that there will always be occasions when a small number of appointments do not run smoothly during any mass vaccination campaign, but I ask that the First Minister works with NHS Greater Glasgow and Clyde to ensure that that does not become a particular issue in the city that I represent and that such instances are resolved quickly. Further, what information is available as to the efficacy of a second vaccination administered beyond 12 weeks?

That is a really important issue and I give an assurance that we work closely with health boards on it. In line with the JCVI’s latest advice, where vaccine supplies allow, health boards are bringing forward the second dose of vaccine from 12 to eight weeks, and many of us will know people who have had their vaccine accelerated to within that timescale.

However, Bob Doris is right to say that, with a programme of this scale, there will always be small numbers of people who do not get what we want them to get or what we think that they should have got. We are aware that a small percentage of the overall vaccinated population has had to wait longer than 12 weeks for their second dose. For those whose dose of the second vaccine runs beyond the 12-week point, we encourage them to contact their local health board or to attend one of the drop-in clinics that a number of local authorities are running.

There will be a variety of reasons why that small number of people have not had their second dose within 12 weeks. Such people should get in touch with their local health board and check through the NHS Inform website so that the issue can be rectified.

On the final part of Bob Doris’s question, although we want people to be vaccinated within 12 weeks—and now, as far as supplies allow, within the eight-week timescale—it is important to note that receiving a second dose beyond 12 weeks does not pose any clinical risk and that, therefore, if somebody goes beyond the 12 weeks, there is no need to recommence the whole vaccination cycle.

I welcome the news that the Pfizer vaccine has been approved for use in children aged 12 to 15. The First Minister will know of the case of Katie Steel, a young girl with cerebral palsy. Katie missed all of her second year at school and has barely been in school during the current academic year, and she is not alone. Katie’s life and her family members’ lives would be transformed if she got the vaccine. Therefore, subject to the JCVI decision, will the First Minister commit to vaccinating all children in the 12 to 15 age group before schools return in August and, specifically, to prioritising vulnerable young people such as Katie?

I would absolutely love to stand here and give that commitment. I know of Katie and I know how important it is to her and her family, and the families of young people like her, to get vaccinated as quickly as possible. I also know that people would agree that it should not be for me, as someone with no clinical qualifications, to decide who gets vaccinated when. That is why expert advice is really important.

There are a couple of issues. First, we have to wait for the JCVI advice. It will advise on whether, in what order and to what extent we should commence the vaccination of children over the age of 12. The other issue that means that I cannot give a commitment right now about vaccinating before the return of schools is that the speed at which we will do it will be dependent on the supply of the vaccine. I hope that that changes towards the upside, but at this stage the MHRA advice relates only to the Pfizer vaccine. Therefore, only that one manufacturer’s vaccine would be available, and supplies are not limitless. We do not yet know exactly what the supplies would be, so we cannot set out exactly how long it would take to vaccinate that section of the population.

It may be—I do not know, because I have to wait and see the advice—that, just as with the adult population, the JCVI recommends an order of priority for children over the age of 12, and that might take account of underlying health conditions and other factors. As soon as we have that advice and we have a clear line of sight about supplies, we will inform Parliament of our expectations and what the timescale for any such extension is likely to be.

Before I bring in the next member, I want to say that there is a lot of interest in the statement and desire to ask questions from across the chamber, so I would be grateful for shorter questions and responses.

I will certainly try to comply, Presiding Officer.

Will there be a review of the vaccination status scheme? I have constituents who were awaiting their second vaccination appointments but did not receive those, and then logged on to check their vaccination status only to find that it had been erroneously recorded that they had been vaccinated a second time. They then had to go through the helpline and all that. Will there be an assessment of the whole vaccination programme and, if so, can that issue be taken into account? Although it affects only a minority of people, it matters.

Of course it matters. It will be a small minority, but every individual cares deeply about their vaccination. NHS staff work to absolutely minimise any errors in recording and to rectify issues when they are identified. We are aware that a small number of users have faced challenges with the service, such as when the first dose has been recorded twice in error. Where such cases are identified, the NHS works to resolve them as quickly as possible. We understand that, even in cases where an individual’s first dose has been marked on their record twice, that should not prevent an appointment for a second dose being generated.

Wider work is under way to ensure that records are accurate and are amended in ways that are auditable and have clinical oversight. Our focus right now is on vaccinating people but, in due course, we will want to have a review of this first Covid vaccination programme, because I suspect that it will be a regular vaccination programme in the years ahead.

Many cultural venues and festival organisers are understandably frustrated by the perceived inconsistency in physical distancing rules. In hospitality venues, people can sit 1m from others without a face covering, but in cultural venues people must keep 2m apart and wear a face covering. Will the First Minister commit to reviewing that discrepancy urgently, especially in light of the fact that various summer festivals are about to occur across Scotland?

As, I am sure, Donald Cameron is aware—because I am pretty sure that I said it during last week’s statement—we are currently undertaking a general review of physical distancing and will set out the conclusions of it as soon as possible.

With Covid cases rising more steeply in some areas, including in parts of Tayside, what lessons have been learned from areas such as Glasgow and Moray that have recent experience of dealing with rising case numbers? Are similar public health measures being considered and implemented in my constituency in Dundee and neighbouring areas to tackle our concerning rise in case numbers?

The incident management team is actively managing the situation in Tayside. I am grateful for its hard work. That work includes deployment of a mobile testing unit, targeted engagement through schools and community outreach and, of course, the continued vaccination drive.

As I said last week, there is a massive opportunity to share learning. To support that, the Scottish Government has developed for local authorities and other partners an outbreak management toolkit that was shared last week. The toolkit includes practical material on enhanced testing and accelerated vaccination, and a communications toolkit to support local messaging. It draws on practical material that has been shared by colleagues in Glasgow.

Public Health Scotland continues to support lessons-learned activity, and the national incident management team provides regular opportunities for all 14 health boards to share experiences, too.

Given that Edinburgh’s incidence of Covid in terms of numbers per 100,000 has, over the past seven days, overtaken Glasgow’s, when will walk-in clinics be available for people who are over 18 to access vaccines urgently? What monitoring and testing are now being carried out across Edinburgh in public and private sector workplaces and in our schools so that, when Covid transmission is identified, urgent action can be taken to reduce its rapid spread throughout our city?

The toolkit that I spoke about in my previous answer is available to NHS Lothian and to local authorities across the NHS Lothian area. They have plans in preparation for walk-in vaccination clinics and are using testing as appropriate. At the height of the Glasgow outbreak, NHS Greater Glasgow and Clyde communicated very effectively with local MSPs—of whom, of course, I am one. I will ask the Cabinet Secretary for Health and Social Care to ensure that NHS Lothian does likewise with local members so that there is understanding of all the outbreak measures that are being taken to bring transmission back under control.

As a result of the fact that no food or beverages will be sold at Hampden for the upcoming Euro 2020 matches, some fans will have to wait for up to five hours between eating or drinking, which might cause an issue, especially for people with underlying health issues. Although it is understandable that the decision was taken, will fans be allowed for health reasons to take food or beverages into Hampden for the four upcoming Euro 2020 matches?

Concession stands will not be in operation for the Euro 2020 matches at Hampden because of all the mitigations that have had to be put in place. That is to ensure that physical distancing is possible on concourses when people move to and from their seats on entry and exit, and when they go to the toilet.

However, spectators will be able to bring food with them into the stadium. Discussions are on-going between the Scottish Football Association and UEFA to reach agreement on what will be in place with regard to drinks. UEFA will confirm the situation with all ticket holders, and I will make sure that Stuart McMillan is updated when that has happened.

I have written to Kate Forbes to ask for extra help for the travel industry, especially travel agents, and I hope that the First Minister will agree to look at that. However, I want to ask about another issue that is concerning the industry.

If someone travels to a green-list country from an English airport, they can book a testing package, through multiple providers, for £60. The Scottish Government says that if that traveller flies from a Scottish airport, they can use only one provider—CTM—and the same package costs £195. The situation is similar for countries that are on the amber list. What can the First Minister do to bring down the cost and stop Scots being ripped off?

I am not sure whether it was Graham Simpson who asked that question a couple of weeks ago, but my answer today is the same. We continue to look at the matter, but we want to make sure that we have assurance—and can give assurance—on the quality of the testing that is in place.

Why is there a difference? In many respects, the UK Government—this is entirely up to it—chooses to outsource more outside the NHS than we in Scotland have decided we will do. We keep such things under review, but making sure that we have assurances around quality is really important. I hope that most people understand and accept that.

Over the past year, we have at different times looked at different numbers—the reproduction number, intensive care unit capacity, hospital capacity and, sadly, the number of deaths. Can the First Minister say what figures we will focus on in the next few weeks and months?

We have always relied on a range of indicators and criteria, and we combine that information with clinical advice, local intelligence about the state of the epidemic and, of course, judgment, in order that we can construct a full, reliable and robust picture of the threat that Covid is posing across all four harms. We continue to monitor cases, obviously, but we also monitor numbers of hospital admissions, lengths of stay and deaths.

As and when we become increasingly confident, as I hope will be the case, that vaccinations are breaking the link between case numbers and serious illness, we will, although we will not ignore case numbers, be able to change the balance of factors that we take into account, and our response will perhaps, as I have said before, be driven less purely by case numbers—or, rather, it will be less driven by case numbers, because it is not driven purely by them.

However, we have to do that carefully; we have to allow the data to emerge so that we can properly assess it, and we have to not act prematurely in a way that would cause a significant burden of ill health and pressure on the NHS.

Given that there cannot be a commitment to vaccinate in schools by the end of the summer holidays, when can schools and education authorities expect amended Covid advice on safety in schools, wearing of masks, bubbles, distancing and especially school transport, given the rising infection rates that are linked to schools?

The advisory group on education, which is a sub-group of the overall Scottish Government Covid-19 advisory group, looks at those issues on an on-going basis. It is important that it does so and that it gives ministers its views. Ministers, through the education recovery group, have reached positions on the mitigations that are required.

We all want mitigations such as face coverings to be no longer necessary; I think that that is particularly true when we are talking about young people in schools. However, right now, they are an important added mitigation. We will continue to review that, as the situation overall and our understanding of the new variant and the wider impact of vaccines develop.

The Scottish Government is rightly committed to ensuring that cancer screening and diagnostic services are prioritised as we continue to remobilise the Scottish NHS as we recover from Covid. Cervical cancer self-tests are being trialled by some health boards, including NHS Dumfries and Galloway. They have the potential to be an effective way for women to screen for human papillomavirus. Self-tests have also—given that 6,000 women in the NHS Dumfries and Galloway area have missed appointments—been proved to reduce the number of women who default on their appointments.

Can the First Minister outline how cancer diagnostic services will be prioritised? In particular, can she provide an update on the cervical cancer self-test roll-out?

Self-sampling has significant potential to increase take-up of screening and to make it easier for people—there are many—who find the current process difficult. That said, the United Kingdom National Screening Committee is gathering evidence on the matter, but has not yet recommended that self-sampling be incorporated into the national cervical screening programme.

We have convened a working group to explore the feasibility and requirements of different self-sampling models, which will contribute to the evidence base. The group brings together clinical and public health expertise, including representatives from the Dumfries and Galloway study. Introducing self-sampling to the national cervical screening programme would be a not insignificant undertaking, but we are working hard to ensure that Scotland is well placed to implement the National Screening Committee’s recommendations when we have them.

I am sure that the First Minister is aware that there is a significant backlog for people waiting to sit their practical and theory driving tests. In my constituency, poor or non-existent public transport makes it imperative that young people obtain their driving licence quickly, to allow them to get to work. There are also genuine concerns for businesses this summer, particularly those in hospitality and agriculture that are struggling to find employees.

I have contacted the Driver and Vehicle Standards Agency, which states that the capacity at most theory sites in Scotland is still at 50 per cent as a result of the Scottish Government’s 2m physical distancing restriction, despite the exam conditions. Will the First Minister look to relax that rule in order that the DVSA can increase testing capacity and ease the plight of many learner drivers? Will she do what she can to address long delays in sitting theory and practical driving tests?

I know how important the matter is and I know how frustrating delays are. There is obviously an economic imperative to have people able sit driving tests, but they are also one of the rites of passage for young people that have been disrupted over the past year or more. Obviously, it is really important for them that we get things back on track.

Unfortunately, all these issues are complex and rarely straightforward. In certain environments, 2m physical distancing remains an important mitigation. However, the issue is important and we will continue to look at the situation to see how quickly we can increase capacity and get the backlogs down. I absolutely understand the importance of the issue and I will make sure that the transport minister keeps members updated.

The pandemic has had a significant impact on young people, particularly on their chances of employment. The First Minister has appointed a minister who is specifically tasked with supporting youth employment. Can the First Minister provide any further information about the steps that the Scottish Government is taking to support young people to access employment and training?

The young persons guarantee is obviously central to those efforts and will be increasingly important as we go through the next few years and, we hope, through recovery from Covid. We will also continue to work closely with local authorities and schools to minimise any on-going disruption to children’s education and their ability to go from school to further and higher education or into training and employment.

One of the key things that we are doing right now is working to get people vaccinated, including the younger groups in the population, and that is going extremely well. As we come out of the pandemic, there is no doubt that, as part of the overall recovery, we need to prioritise recovery for young people. The previous question related to driving tests, which are only one aspect, but an important aspect of this. Young people have borne so much of the brunt of what we have all gone through over the past year.

Hundreds of thousands of my constituents are living under level 2 restrictions, with no indication of when they will move to level 1. The councils currently in level 1 know that they may move to level 0, provisionally on 28 June. When will the Scottish Government set out precise revised planning for when the 14 councils affected will move to levels 1 and 0?

If Stephen Kerr took a bit more time to understand the situation, he would know that what he just said was not really accurate at all. The next review of all levels of protection happens on 21 June. Of course, there may be circumstances that require us to move more quickly than that, but I hope not. On 21 June, I will set out for every area of the country what we expect the level of protection to be from 28 June. That will cover those in level 1, which we hope will be able to go to level 0, and those in level 2, which we hope will go to level 1, but we need to assess the data nearer the time. That is the three-weekly review cycle that we have committed to, and that is what we will continue.

I wish that I could wave a magic wand and get every area of the country not just into level 0 but beyond level 0, but we have to do this carefully and in a way that protects our process and, of course, allows us to get as many people as possible vaccinated.

In the light of the recent news that Portugal has been placed on the amber list, taking effect today, it is clear that international travel for holiday purposes remains risky and subject to sudden change. What steps is the Scottish Government taking to support our local tourism industry, particularly as many people are seeking to holiday at home this year?

Before I address the question, I will make a point about international travel. We often talk about it in the context of holidays, and people who have family overseas—and for whom international travel is about family connection—often feel frustrated at that. I recognise that, for many people, the restrictions on international travel are keeping them away from their loved ones, which is why we want to get back to normal there, as in every other aspect of life, as quickly as possible.

For non-essential travel such as holidays, my advice to people continues to be that they should not go overseas if they can avoid doing so. Right now, it is safer for us not to go overseas, as it helps to mitigate against the importation of the virus. If someone is in the position of being able to go on a holiday this year, I ask that they support the local tourism industry. We discuss such matters regularly—I have reasonably regular discussions with the Scottish Tourism Alliance about how we can better support the tourism industry in the immediate term, and also as it recovers in the medium to long term.

A message that we could all helpfully convey to our constituents is that they should support their local tourism industry, the Scottish tourism industry and local businesses generally as much as they are able to.

Finally, after weeks of asking, NHS Lothian announced an hour ago that, from next week, walk-in vaccination clinics will be available to those over 40, which is very welcome. Last week, the Cabinet Secretary for Health and Social Care told me that Edinburgh is now the new Glasgow in terms of infection rates. If that is the case, why do we still not have access to the door-to-door surge testing that has been available for weeks in areas such as G41? Why are Edinburgh residents not as deserving of Covid protections as Glasgow residents?

If I may say so, that is just complete nonsense. By all means, people should rigorously hold me and my Government to account—that is absolutely essential—but I urge everybody to avoid saying that Edinburgh is the new Glasgow, or that Edinburgh is not as deserving of measures as Glasgow. Such attempts to divide and set people against one another, or to suggest that we are not taking the pandemic seriously in every part of the country, do not help anybody.

The local director of public health in Lothian, along with the local incident management team, will be working to decide what measures are appropriate, based on the nature of the outbreak across Lothian. If they consider it necessary and essential, surge testing will be a part of that, as well as door-to-door testing and walk-in vaccination clinics. It might surprise people to hear that I do not mandate to local public health directors exactly what they do in local outbreaks, because it would be wrong for me to do so. They are the ones who understand the nature of outbreaks and, from the range of tools that they have available, what works best in local circumstances.

I ask all members to engage, as I am sure that they already do, with their local health board and director of public health, in order to understand the local measures that are being put in place, which will be bespoke to the particular challenges that are being faced. I ask that we all avoid suggesting that one part of the country is being done down in favour of another part of the country. That is not true. We are all in this together, and we are trying to get through it together.

I have been asked to raise a specific issue about the European under-20 and under-23 athletics championships, which take place this year. The trials for the Great Britain team take place on 19 and 20 June in Bedford. Under the current Scottish legislation, it is illegal for Scottish athletes to travel to Bedford, which means that there will be no Scottish representation at the championships. Will the First Minister look into the matter with a degree of urgency, given that each athlete has to provide a negative test prior to competing in the trials?

I would like to have the opportunity to look into the matter before trying to answer the question in detail. I will come back to Brian Whittle as quickly as possible. When there are travel restrictions in place, there are exemptions for essential travel. I will need to check whether such travel by athletes would fall into the category of permissible travel. If that is not the case, I am happy to ask for the issue to be looked at, to ensure that the athletes can do what is required to compete, as everybody would want them to do.