Scottish Parliament, 23 December 2020

296 contributions from 70 members. The official report.

Covid-19 (Loneliness and Social Isolation)

Linda Fabiani (Scottish National Party, East Kilbride)

Good morning, everyone. Before we begin, I remind members that social distancing measures are in place in the chamber and across the Holyrood campus. Please take care to observe those measures during today’s business.

The first item of business is a member’s business debate on motion S5M-23326, in the name of Rachael Hamilton, on understanding the impact of the Covid-19 pandemic on loneliness and social isolation. The debate will be concluded without any questions being put.

We are a bit pushed for time today so please stick to the timings.

Motion debated,

That the Parliament recognises what it considers the damaging impact of social isolation and loneliness throughout the ongoing COVID-19 pandemic; considers that it has had a pronounced effect on older and vulnerable people; understands that studies have shown that, in the long term, it can be as bad for human health as smoking or obesity; acknowledges the recent University of Stirling study, which found that 56% of people said social distancing had made them more lonely; notes the concerns raised in the recent British Red Cross report, Lonely and left behind: Tackling loneliness at a time of crisis, that 32% of UK adults agree that they worry something will happen to them and no one will notice; commends the British Red Cross’s work, especially in Ettrick, Roxburgh and Berwickshire with the Coronavirus Resilience Calendar, and notes the calls on the Scottish Government to consider the report’s recommendations in full in order to tackle social isolation and improve mental health and wellbeing.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

I thank all members who signed my motion for helping me to bring the debate to the chamber today.

On the day that Parliament finishes up and we turn to Christmas, it is absolutely right that we should debate loneliness and social isolation. Loneliness has a negative impact on the mental health of one third of the adults in Scotland, which is quite astounding. At this time of year, with its long dark winter nights and cold days, it is far more pronounced than it is at any other time, and now the Covid pandemic has exacerbated the situation. We now face a crisis that is on the precipice and is tipping in the wrong direction.

I am sure that many of us watched last Saturday’s announcement in shock, sadness and disappointment as restrictions were tightened over Christmas. I cannot begin to imagine the upset and distress caused to many older and vulnerable people when they learned that Christmas is effectively cancelled, or certainly scaled back for many parts of the country.

The effect of the new restrictions will be felt acutely by care home residents and their families. When I was listening to BBC Radio Scotland this morning, I heard people who I know phoning in and talking about the distress that they felt about not seeing their families during Christmas, especially those who are in care homes. That was really hard to listen to.

According to Age Scotland, more than 150,000 over 65s in Scotland expect to feel lonely during the festive season, and I suspect that, sadly, that figure will be higher this year. We know about the devastating impact that loneliness can have on mental and physical health. As my motion mentions, it can be as bad as the effect of smoking or obesity. As we debate here today, we must ask ourselves what damage the situation is doing to our loved ones and those who are alone.

I would like to thank the charities that, throughout the pandemic, have been instrumental in tackling the rising levels of loneliness and isolation. Age Scotland, the MS Society Scotland, Glasgow’s Golden Generation, the Salvation Army and many more have all worked tirelessly to help older and more vulnerable people who are experiencing social isolation.

I especially want to praise the British Red Cross, not only for the research that it has done into loneliness and its assistance with today’s debate, but for the tremendous efforts that it has made during the pandemic. Its volunteers have worked selflessly to help those who are in need. We saw volunteers helping with food parcels and running a support line to help people to cope with feelings of loneliness, mild depression, isolation and grief after bereavement. It is continuing with its fantastic work by assisting St John Ambulance to roll out the new Covid-19 vaccine.

In my constituency, the local group created a coronavirus resilience calendar, which pointed people in every town and village to the right support. That was completely invaluable to me, my constituents and my parliamentary team, as it helped us to get support to people quickly. We owe that group a huge debt of gratitude.

Not only has the British Red Cross’s help been invaluable during the pandemic, its research has the power to shape policy. The report “Lonely and left behind: Tackling loneliness at a time of crisis”, which is mentioned in my motion, published findings and recommendations that are based on evidence on loneliness that it gathered throughout lockdown. The report found that 41 per cent of United Kingdom adults felt lonelier than they did before the pandemic, and 35 per cent of UK adults are concerned that their loneliness will get worse. In these winter months, with renewed stricter restrictions, that will, sadly, be the case.

The report explored the experiences of people who had recently been shielding and isolating or were continuing to do so. An overriding theme was the lack of face-to-face contact and a reluctance to admit to friends and family that they were lonely. The experiences of the people surveyed were just a snapshot of a widespread issue that exists in not only the United Kingdom but across the world. Although there can be immediate short-term fixes, such as outdoor physical exercise or social prescribing, it can be difficult for many to participate in outdoor activities; and some people do not have a garden or are not physically able to take a walk or go for a run.

A recommendation on which work has been done through Connecting Scotland, albeit at a slower pace than we would have liked, is that of promoting alternative ways to connect. A fund was announced back in 2018 to support the roll-out of digital technology to assist older people. However, it was only recently that we saw that put into action with the advent of the pandemic. I have long campaigned for better digital inclusion. What struck me most during the first lockdown was the digital divide. Many supermarkets asked older people to book slots online but, as we know, 44 per cent of over 75s do not have access to the internet. Better advice on choosing and using technology would help older people to participate in video calls and order food shopping, for example.

I hope that the Scottish Government will consider the Red Cross recommendations in full, as we need to see action now to prevent the situation worsening as we head into January and February. Undoubtedly, we all face a long haul until we all get vaccinated.

It is not just the Red Cross that has put together a Covid impact report; similarly, Age Scotland and Sight Scotland provided briefings for this debate. I thank them for sharing those with me. Age Scotland highlighted the situation in care homes, as care home residents have been particularly impacted by limited visiting opportunities. Family members have reported seeing marked declines in their loved ones’ wellbeing over the months. As we know, chronic loneliness can seriously impact on an older person’s health.

Things were moving in the right direction with rapid testing, but I suspect that the level 4 restrictions now mean that, sadly, we will go back to a limited position. Donald Macaskill said this morning on BBC Radio Scotland that we are now losing more people to the effects of isolation than we are to the virus. For me, that was chilling to hear and something that I never thought we would hear.

For those who are visually impaired or have lost their sight, the impact is even more pronounced. A Sight Scotland survey found that 70 per cent of those who participated said that their sight loss had made lockdown a worse experience and over 40 per cent said that they were still not confident about getting back into the community with social distancing measures in place. The picture is dramatic, and it is multidimensional, because we have not only the issue of loneliness but how it affects different groups and to what degree.

That is why I want the Scottish Government to provide an enhanced loneliness and social isolation strategy that pulls together the recommendations of the Red Cross and other charities and organisations. We are going to go through a tough few months, but I want to leave a message of positivity today. Age Scotland said that 94,000 over 65s in Scotland say that they would not have got through the pandemic without the kindness of strangers. As we leave here today, we must remember to look out for one another this Christmas. I urge people to check on their elderly neighbours and to help those who are less able than ourselves. Kindness and support go a long way, but we also need the Scottish Government to step up to the mark.

The Deputy Presiding Officer

We move to the open debate. I ask speakers not to take longer than four minutes, please.

Stewart Stevenson (Scottish National Party, Banffshire and Buchan Coast)

I congratulate Rachael Hamilton on securing the debate and giving me the opportunity to talk about this important subject.

Today, as it did yesterday and will do for the days to come, Covid-19 erodes the human spirit and hard times are here for us all. The burden is physical, mental and, for many, spiritual; and the weight continues to bear down on us all. It is hard to accept—it is not rational and not chosen—and people across the planet are struggling. That is no wonder, because Covid-19 has hammered our global society, stealing the lives of family and friends, and it is direct, violent and destructive.

To slow Covid’s rampant advance, we have been forced to adopt social distancing and other necessary measures so that we may somehow reduce or allay its destructive force. However, we are a social species, and those measures come at a cost. That cost is social isolation and loneliness. According to the British Red Cross’s report “Lonely and left behind”, more than half of adults say that reduced social contact has made life harder, and two thirds say that concerns about coronavirus have caused them to minimise their interactions, even when the rules permit it. What is worse is that two fifths of adults across the UK report that they have not had a meaningful conversation in the past fortnight.

Those are clear signs of a deteriorating psyche, with serious consequences. For the vulnerable, that is even more the case. Unable to see their friends and families, their lives are affected more than most, and the insidious force of loneliness penetrates, pervasive and enduring. Confidence decays, hope begins to hollow and wellbeing vanishes. We are trapped in the dark, suffering alone and under immense stress, for the simple reason that we cannot hold our loved ones or have the luxury of seeing our friends.

That comes with physical costs as well as mental costs. When someone needs support, it is in our nature to offer a hand. When others speak, we should—and mostly do—listen. We laugh together and we cry together. Our connection is obvious. We depend on each other, and that is what gives our lives meaning. The pandemic has shaken that.

There are solutions, though. We just need to innovate. Thankfully, that is happening. Vaccines are being created and new ways to connect, such as the one that we are using today, are being developed.

I join my colleague in commending the British Red Cross on its creation of a coronavirus resilience calendar. That is the kind of impressive innovation that we need, and I hope that it will be shared with others. I also agree that the calls by the Red Cross are well made. This is a far-reaching issue.

In my youth, Christmas day was a working day that was not much different from normal days, but it has become a day for family and for connection. We should all do what we can to help those who are lonely and affected by this dreadful virus and their lack of contact with other human beings.

David Stewart (Labour, Highlands and Islands)

I, too, congratulate Rachael Hamilton on securing this important members’ business debate and on the quality and depth of her speech.

Social isolation recognises no age, class or gender. As the motion describes, the British Red Cross has rightly warned about worsening loneliness and social isolation this winter. That has been brought into even sharper focus given that many parts of my region of the Highlands and Islands will move from level 1 to level 4 restrictions later this week.

In my early 20s, I volunteered to work with the Samaritans in my home city of Inverness. Many of the calls that I answered were from desperately sad lonely people, some of whom had physical or mental health problems. They just needed someone to speak to—a shoulder to cry on. The challenging geographic and population demographic of the Highlands and Islands always increases the potential in many communities for loneliness and isolation among vulnerable groups and individuals. However, we have even greater cause for concern this year, given the impact of the Covid-19 pandemic.

The available evidence shows that loneliness has a negative effect on health, wellbeing and resilience. There is a risk of heart disease, stroke and higher levels of alcohol consumption and smoking. Loneliness also substantially increases the chances of dementia among older people. As the research from the British Red Cross has shown, those who feel lonely find it even more difficult to cope with the pandemic than those who are supported by friends and family, which is why it so important that we do everything that we can to raise awareness in our communities of the support that is available.

That is why I highlight and praise The Press and Journal’s excellent connect at Christmas campaign, which is supported by all party leaders. The campaign aims to ensure that as few people as possible suffer the harmful effects of loneliness this festive season.

The British Red Cross has been instrumental in supporting hundreds of people across the Highlands and Islands through doorstep deliveries of emergency food parcels and medication. In addition, it has supported NHS Highland, across the whole of the board’s area, to provide care homes, independent care providers and personal carers with essential personal protective equipment to keep people safe. That has included volunteers delivering items of PPE to people who need them in every part of the region.

Excellent local examples of such work include that in Dingwall in Ross-shire, where the British Red Cross has been working in partnership with Connecting Carers to support vulnerable local families and individuals, enabling it to keep operating in a challenging environment. I mention such families and individuals in particular because research has shown that, as lockdown restrictions and the Government’s guidance on shielding relaxed, many participants reported feeling left behind as they watched others resume their social lives. The additional connectivity challenges in the Highlands and Islands, both physical and digital, have made it even harder for the most vulnerable people in our society to restart their lives and reconnect with people. We must be alive to that issue as we enter another period of tighter restrictions.

I echo members’ earlier comments in welcoming the introduction of Scottish Government funding that aims to tackle loneliness and isolation. It is essential that such support for local authorities and health systems is in place, to identify those who are at most risk of loneliness and to address it through a dedicated fund and guidance.

I will end my contribution with a quote from an uncredited source:

“We sometimes think we want to disappear, but all we really want is to be found.”

This winter, we must ensure that those facing loneliness and isolation receive the support to which they are entitled. I praise organisations such as the British Red Cross and all volunteers who are going above and beyond to support those who need their assistance over this most challenging of winters.

Emma Harper (Scottish National Party, South Scotland)

I am pleased to speak in this members’ business debate and congratulate Rachael Hamilton on securing it. It is unusual for us to hold such a debate in the morning but, as Ms Hamilton reminded us, today is the day before Christmas eve.

For many months now, we have been discussing the fact that 2020 has been a year unlike any other. The social, physical, mental health and financial challenges that many people have faced over the past nine months have been the most difficult for everyone in our nation in recent history. However, throughout that time, many communities across Scotland have demonstrated great strength in their support for neighbours, front-line health care workers and our local producers and shops while still complying with difficult and often-changing restrictions. The community spirit and selfless attitudes that have been evidenced by complete strangers, which other members have also described, are a key way to help to tackle social isolation and loneliness. We must retain those as we emerge from the pandemic.

It is welcome that there is positive news on vaccines and that the vaccination roll-out programme is under way. As a nurse who is still registered, I have been able to join the Dumfries and Galloway vaccine team, all of whose members have been extremely professional throughout my induction and training.

The Covid-19 pandemic has undoubtedly had an impact on the mental health of everyone, but particularly those who are at risk of social isolation and loneliness and those who have already been identified as being isolated. They include many people across Scotland’s rural areas and those who have been identified as being in the shielding category, many of whom are in my South Scotland region.

The impact of the pandemic has particularly affected our farmers and agricultural workers. This year, all the agricultural shows—from those held in Dumfries and Stranraer to even the Royal Highland Show—which usually allow farmers to connect with one another, even for just a single day in the year, have been cancelled, which has obviously had its own impact.

Two local groups that I was working with before the Covid pandemic—the Dumfries and Galloway Farmers Choir and the Dumfries and Galloway retired farmers group—have been raising awareness of and tackling social isolation and loneliness. Recently, both have been keeping in touch with their members over Zoom, through email and on the phone. Indeed, the farmers choir, which last year sang in the Parliament’s garden lobby, has also been supporting members of the community by helping with shopping and being a friendly voice on the other end of the phone. I was able to help the group to distribute its members newsletter by post, because it would normally be handed over face to face at its meetings.

During the pandemic, many people across the country volunteered to help in their communities. I was able to participate with Third Sector Dumfries and Galloway to join its touch base telephone programme. Volunteers were assigned to speak to people who had been identified as being isolated. Regular appointment phone calls were made to touch base with them, to ensure that essential medical supplies and food deliveries had been organised—and even just to have a blether. Third Sector D and G has asked whether a national network of volunteers could or should be created, with the necessary funding, to support and co-ordinate such volunteering in the community. Third Sector D and G and Age Scotland have called for better co-ordination and vetting of volunteering activities by the Scottish Government, and I would welcome clarity from the minister on steps in relation to volunteers and support.

Our intensive care units across Scotland have been using videoconferencing technology to connect patients with family members who are outside ICUs. We could talk about so much—I know that the Government has a winter plan and that a lot is going on, which I am sure that the minister will expand on.

The message from me is that, over Christmas and new year, we should look out for, keep an eye on and be kind to one another.

John Finnie (Green, Highlands and Islands)

I, too, congratulate Rachael Hamilton on giving us the opportunity to discuss this important issue. The motion’s title refers to understanding the impact, which is what we should all try to do. It is clear that social isolation is damaging. Covid has contributed to that and

“has had a pronounced effect on older and vulnerable people”,

as the motion says. [Inaudible.] I commend the work of the British Red Cross on tackling social isolation and improving mental health.

In the previous parliamentary session, I was a member of the Equal Opportunities Committee when it undertook what was understood to be the first parliamentary inquiry in the world into age and social isolation. For evidence purposes, we took Professor Mima Cattan’s definition, which was:

“Social isolation could be defined as an objective, measurable state of having minimal contact with other people, such as family, friends or the wider community.”

It was significant that Professor Cattan considered that, although it might be possible to measure social isolation, the feelings of loneliness are personal and individual and therefore more challenging to measure objectively.

For that inquiry, we visited two very different communities—Easterhouse in Glasgow and the Isle of Islay in my region. We found that folk are folk—the issues are the same regardless of where they are and are not a matter of geography or architecture; things are personal to us all, no two people are the same and the myriads of relations that we have all differ.

We heard from committed individuals from across Scotland who highlighted social isolation and loneliness and were tackling its causes. The many briefings would confirm where we are with that. We were told that early steps for people who have been affected by loneliness to make connections are crucial. I commend the outstanding work by the many who help people to take those first steps.

In Sight Scotland’s briefing for the debate, I was taken by its quote from someone who said:

“I once bumped into someone and they shouted at me that ‘I shouldn’t be out.’”

Covid has compounded many issues, but it has not changed them for people who already felt a bit excluded.

The pandemic has brought into sharp relief many inequalities of our society. The crisis has brought new struggles for everyone but, in most cases, it is those who are on low incomes, in insecure work or vulnerable for the other reasons that have been highlighted who have borne and continue to bear the brunt of the virus’s devastation. People who work in essential services such as care or in our supermarkets have put their health at risk to ensure that the rest of us could cope with the crisis. Like others, I commend the Scottish Government’s recent announcement that it will expand the eligibility criteria for the self-isolation support grant, which Scottish Greens have been very supportive of.

In many respects, the pandemic has been a microcosm of what we have already, such as the haves and the have-nots. I say gently that the UK Government’s welfare reform programme does not help with that; people will be socially isolated if they cannot afford a bus fare. A person can be lonely in a crowd or content on their own. Seeing the mental health challenges as part of a more holistic approach to health is important.

I thank all who provide support, such as statutory agencies, the third sector, support groups and faith groups. There is hope because of the vaccines, and I know that all those organisations will play their part in trying to end the blight of social isolation.

Sandra White (Scottish National Party, Glasgow Kelvin)

I thank Rachael Hamilton for securing this important debate. I know from personal experience how difficult it has been for people and families who have a loved one in care. I thank care home staff, who are doing a fantastic job in these difficult times. Like others, I also thank the many organisations, both professional and voluntary, that have provided help and support during the pandemic period and will continue to do so.

I thank the Minister for Older People and Equalities, Christina McKelvie, for attending our meeting last week of the cross-party group in the Scottish Parliament on older people, age and ageing, which had many voluntary organisation representatives and other individuals present for a question-and-answer session. On behalf of the cross-party group, I thank the minister for her enthusiasm and for her succinct answers to the many questions. It was a lively discussion and I am sure that she might refer to it in her summing-up speech.

I will pick up on some issues in my constituency and refer to groups in it. Rachael Hamilton referred to the Golden Generation, which is based in the Glasgow Kelvin constituency. The organisation has worked hard to develop a fantastic digital app that is dementia friendly and easy to use for those who have no prior experience of digital technology. The app not only has set-up instructions but, crucially, shows what the organisation offers. The organisation has a team of digital champions who are trained to assist users over the phone. One of the users gave some fantastic feedback, saying:

“I’ve never had a tablet computer before. It’s all new to me, but it’s lovely to see the familiar faces of the charity staff on the screen. Having access to the app makes me feel less alone, less isolated and helps me keep in touch with the team and I enjoy the activities which are put forward on the app. It gives me something to do and keeps me active during the day. So thank you very much the Golden Generation.”

The Golden Generation has produced many other initiatives, but too many to mention in the short time that I have here. However, the organisation has made 17,000 befriending phone calls to older community members, which have been delivered by its 50 key workers.

There is also the Annexe Healthy Living Centre in my constituency, which I have mentioned, like the other community facilities there, many times previously. The centre’s stalwart staff are based in the community and are a great support to the people there. Volunteers staff the visiting centre, which opened up for meals for older people that they could book. I attended one of the meals and chatted with some users and staff, who I thank as well.

The organisation has even gone beyond doing that, though. It adapted to the restrictions that were put in place and co-ordinated what is called PATCH—the Partick and Thornwood community help scheme—which delivers thousands of care packages to older and vulnerable members of the community. The organisation’s support, through regular telephone calls and so on, has been invaluable. Others can learn from how the Annexe Healthy Living Centre has been able to change and adapt as various measures have come in.

My time is up, but that is just a snapshot of the fantastic work that is being done in my community, and I am sure that similar work is being done throughout Scotland.

The Deputy Presiding Officer

I ask Christina McKelvie to respond to the debate. You have up to seven minutes, minister.

Christina McKelvie (Scottish National Party, Hamilton, Larkhall and Stonehouse)

I thank Rachael Hamilton for bringing this debate to Parliament today as we approach the end of the parliamentary term in what has undoubtedly been the most difficult year. I thank all the members who have contributed to this timely debate. However, I thank Sandra White in particular for her lovely words in building up a sister. We sometimes need a bit of building up, so I am grateful for that.

In December 2019, I spent time with a great wee organisation in Edinburgh called Vintage Vibes. It was sending Christmas cards to older people who might be isolated or lonely. It was a humbling but fun experience. Hearing about the positive impact of such small acts of kindness—a wee card with a few words in it—really builds up and lightens our hearts. Christmas 2020 could not be more different, yet those small acts of kindness, many of which we have heard about in the debate, are even more important now.

A lot of statistics have been quoted this morning, including from the University of Stirling and the British Red Cross. Although none of those statistics makes good reading, it is crystal clear that we understand how damaging social isolation and loneliness can be. We treat it as a public health issue in Scotland; when we hear from David Stewart about the work that he did locally with the Samaritans, we understand why. It breaks my heart that some older people, schoolchildren, home workers, residents in care settings, furloughed employees, unpaid carers and many more feel that way.

Nonetheless, every day of the past 10 months, communities all over Scotland have demonstrated their hope and resilience, and they have done so in countless ways, many of which we have heard about this morning. We heard about the Golden Generation’s digital champions in Sandra White’s Glasgow Kelvin constituency—17,000 befriending phone calls is just amazing. We have stood in the street to clap our national health service heroes, we have knocked on neighbours’ doors to offer to get their shopping in, we have made countless Zoom calls and we have simply picked up the phone or given somebody a friendly wave.

In the examples mentioned by Rachael Hamilton, Stewart Stevenson, David Stewart, Emma Harper and John Finnie, tackling social isolation and loneliness starts at an important but simple place: kindness. We have talked a lot about that this morning. Left unchecked, loneliness can run rampant through communities. It does not have to be that way, though. I was struck by a statistic that Stewart Stevenson gave us this morning. Imagine Stewart Stevenson giving us a statistic—who would have thought it?—but he gave us an important one, which is that two in five adults have had no meaningful connection or conversation with anyone in the past two weeks. That should stop us all in our tracks and make us think about the people who we see in our communities who we do not say hello to. Maybe we should all endeavour to say hello to them in the next couple of weeks.

It is not the job of Government alone to tackle loneliness and isolation. It is important that we come together today in our Parliament to commit that each and every one of us will be kind and remember others, whether or not we think that they are coping. A phone call or a knock on the door might be just what someone needs.

On 11 December, I announced details of nearly £1 million funding for tackling loneliness and isolation right now. That was part of a wider £6 million funding package to promote equality, tackle social isolation and loneliness, and improve an important aspect of our winter plan—digital inclusion. I will provide more details on the volunteering aspect of that to Emma Harper. It is the responsibility of another cabinet secretary, but I will get Ms Harper an update on the volunteers plan, because a lot of work is going into that.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

With regard to the connected Scotland strategy, can Christina McKelvie update the chamber on how the national implementation group is looking at the changing landscape during the pandemic?

Christina McKelvie (Scottish National Party, Hamilton, Larkhall and Stonehouse)

Rachael Hamilton has anticipated my next page of notes. I will come to that and give her an update.

I want to give Parliament a wee insight into one of the organisations that will benefit from the funding that I have announced. Generations Working Together is Scotland’s intergenerational expert and a key member of our national implementation group and older people’s strategic action forum. It worked with pupils at Bertha Park high school to create a YouTube Christmas show for care home residents. Please watch the show—it is wonderful and it will make you feel better. I have watched it a couple of times. There is a poem in it called “Hope” by a young woman called LilyAnna. At the end of the poem, she says, “Embrace it, hope.” That is an excellent message, especially at Christmas, but also when we have hope in our vaccine coming.

The children worked hard to learn the music, songs and jokes. They participated in the show in the knowledge that they will brighten up the day of thousands of care home residents across the country. Their talent is boundless—it is wonderful. Members have to hear Dan singing “Bridge Over Troubled Water”—it is incredibly poignant at this time. Please watch it.

I am sure that Rachael Hamilton will be pleased to hear that I was delighted to meet Maria and Kenneth from the British Red Cross on 25 November to hear about their recommendations and respond to the letter. They will continue to work with us on that. It was also a pleasure to confirm something that Emma Harper will welcome, which is what we have done to focus on loneliness with our clear your head campaign. We have targeted funding to focus on connections and to tackle isolation and loneliness throughout the pandemic. That becomes more important as we head into winter.

We have also provided additional investment to tackle digital isolation. I can respond to Rachel Hamilton’s intervention by saying that we have targeted 5,000 older and disabled people with the connected Scotland programme. It has been important for people to come together digitally.

Emma Harper talked about a retired farmers group and a farmers choir and I look forward to hearing them singing here.

The digital Scotland programme will be important. We have a target to connect 5,000 older and disabled people, but we are doing much more. We are benefiting diverse groups including befriending networks, the time to live fund, the Scottish Men’s Sheds Association, the Scottish ethnic minority older people forum, Generations Working Together, YouthLink Scotland and Chest Heart and Stroke’s kindness calls—some of which I have taken part in. We have also worked with the ethnic minority resilience network BEMIS, Intercultural Youth Scotland, the Minority Ethnic Carers of People Project, LGBT Health and Wellbeing, Glasgow Disability Alliance, national support for learning disability, the British Deaf Association, Deafblind Scotland and families that are separated because a parent is currently in prison.

Research that came from the House of Commons library yesterday tells us that the overall cost to older people in Scotland of not having their television licence provided for free this year could be as much as £40 million. I hope that the United Kingdom Government will overturn that decision, especially when people are facing loneliness at Christmas. The ending of the free licence is doubly cruel as we ask people to stay home while we battle a global pandemic. I hope that the UK Government will do better.

Keeping connected to others is important and today’s debate has shone a spotlight on that, as John Finnie said. It is a priority for me, for the Government and, I hope, for the Parliament. I am proud that we have come together on the day before Christmas eve to debate this. I wish you all a safe, happy and connected festive period.

Covid-19 (Vaccine and Testing Programmes)

Lewis Macdonald (Labour, North East Scotland)

The next item of business is a statement by Jeane Freeman on an update on Covid vaccine and testing programmes. The cabinet secretary will take questions at the end of her statement, so there should be no interventions or interruptions.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I welcome this opportunity to update Parliament on our extended testing programme and our NHS Scotland Covid-19 vaccination programme.

The discovery of a new and more transmittable Covid-19 variant is a bitter blow, but we now have many more tools to fight the virus than we had in March. Vaccination and testing are critical to suppressing the virus and preventing the harms that it causes. Following the announcement last month to expand testing across a number of areas, significant progress has been made. Two of our three new national health service regional laboratory hubs went live on a phased basis last week, with the west and the north hubs now receiving samples. The east regional hub will be operational by the end of January.

Processing of the weekly tests of 42 per cent of care home staff has now moved to our NHS labs as planned, and we will complete that transition by the end of January. Testing of all admissions to hospital is under way and is to be completed by the end of the month.

Twice-weekly testing has been introduced on a phased basis for all patient-facing staff in NHS Scotland hospitals, Covid-19 assessment centre staff, the Scottish Ambulance Service and all Covid-19 vaccinators. That is on track to be fully implemented by the end of January 2021.

All care homes now have the equipment for lateral flow testing, and a rolling programme of training is under way to provide testing for care home visitors, with lateral flow testing to support professional visitors to care homes from the beginning of January.

All students at Scottish universities and colleges who are going home for the winter break were offered testing during a two-week testing window from 30 November. More than 26,000 students were tested, with 106 positive cases found, which was a very low overall positive-test rate of 0.2 per cent. Testing will be offered on a similar basis to support the staggered start of the university term next year.

In January, our pathfinder testing programmes will begin, with the aim of developing a sustainable programme of asymptomatic testing among school staff. We are working closely with a number of local authorities and volunteer schools to develop detailed plans. The first model will involve in-school testing using lateral flow devices, and the second will involve at-home PCR—polymerase chain reaction—testing using the satellite testing channel that has previously been used in the care home sector. We expect those pilots to inform the development of a scalable and sustainable approach to asymptomatic testing of school staff at the earliest opportunity.

We have completed our community testing pilots. Between 26 November and 9 December, we targeted testing resources at eight communities with stubbornly high Covid-19 prevalence levels, as part of a community testing pilot. That involved deployment of six mobile testing units and more than 4,000 home test kits, and establishment in Johnstone of the asymptomatic test site using lateral flow devices. Over the course of the pilot, 22,133 tests were completed and 850 positive cases were identified, giving an overall positive-test rate of 3.8 per cent.

We will now expand that strategic and targeted use of testing through a community testing programme in January, which will be delivered in partnership with local authorities. We hope to have in the early part of that month their proposals for communities where that approach will have the greatest impact. With local authorities, we intend to build on that intense targeted period of testing to wrap around a full public health package. That will include continued support for those who are asked to isolate, use of the self-isolation support grant, the local self-isolation assistance service and the national assistance helpline. We will ensure compliance with non-pharmaceutical interventions in vulnerable settings, including schools, care homes and employment settings, and will offer support where we need to.

Finally, I am pleased that, following work with Royal Mail, all 82 mainland postcode areas now have access to home test kits, and that we have met our commitment to have 22 local test sites by the end of this year. From January, we will have access to an additional 14 mobile testing units.

Our NHS Scotland vaccination programme began on 8 December. In the period to 20 December, 56,676 people received their first dose. They include care home residents and staff, and patient-facing NHS staff. Depending on supply delivery, during January we will complete the second-dose vaccinations to residents in care homes, older people and their carers, and to front-line health and care staff.

I have previously outlined the challenges in delivering the Pfizer vaccine, including stability in transportation, storage requirements and pack sizes. Those issues have limited our capacity to take the vaccine everywhere that it is needed. Scottish Government health officials, our health boards, and the Medicines and Healthcare products Regulatory Agency have worked to mitigate those issues and to streamline our process of deploying the vaccine. Thanks to their efforts, we are now able to safely reduce pack size, which has allowed the care home programme to begin, and the transport challenges of getting the vaccine to all of our islands have been resolved.

We anticipate receiving a total of 172,575 doses of the Pfizer vaccine by the end of this week, 50 per cent of which we will retain so that we can be sure to give those who are vaccinated the second dose after the required 21-day period.

A key area that would help to streamline the process further is predictability of delivery, but that is not in our gift. Safety is a paramount concern and there is a rigorous process of safety checks between the vaccine leaving the factory in Belgium, arriving in the United Kingdom and then arriving in Scotland.

Those checks mean that, although we know when the vaccine leaves the factory, we cannot be certain of the date on which we will receive it. That is a challenge for our forward planning of vaccine appointments, but it is one that we share across all four nations of the UK. We are working together with the regulator and the distributor to resolve that challenge. I expect that we will continue to discuss and pursue the matter tomorrow, at my normal weekly meeting of the health ministers of the four nations.

The Joint Committee on Vaccination and Immunisation’s recommendation for delivery of a Covid-19 vaccine is that prioritisation should first be given to those who have the greatest clinical need. Taken together, vaccinating those on the JCVI’s list will help to reduce about 99 per cent of preventable mortality from Covid-19. That is clearly a compelling rationale, and it is right that we follow that advice. People who are clinically extremely vulnerable are high on the JCVI’s prioritisation list, alongside those aged 70 and over.

I understand the concern that people who are terminally ill want, if at all possible, to receive the vaccine earlier. Matt Hancock and I have now both written to the JCVI asking it for further consideration of and clarity on that group, for all the reasons that I know members will understand.

Right now, we have access to just one vaccine. We hope that we will in the near future have access to two. Should it get approval from the MHRA, the new AstraZeneca vaccine will not need to be stored at ultra-low temperatures and will be easier to transport. That means that we will be able to deploy it in a far wider range of settings than has been the case for the Pfizer vaccine. Dependent on the JCVI’s advice, we will likely use it to prioritise vaccination of over-80s who are not care home residents. That group will be vaccinated largely in general practice settings.

Should the AstraZeneca vaccine be approved before the end of this calendar year, we anticipate that we will be able to commence vaccination in primary care locations from Monday 11 January. Vaccine supplies permitting, we aim to have vaccinated all those on the JCVI’s prioritisation list by the spring. Once we have completed that group—again, depending on supplies—we will commence vaccination of the rest of the population.

The dedicated officials and NHS staff who have taken forward the vaccine programme have done remarkable work at pace, for which I am grateful. On 3 December, I said that we would, depending on supply, begin vaccination on 8 December, which we did. We said that we would begin vaccination of people in care homes on 14 December, which, again, we did. All that is down to the hard work of staff. When we have more vaccines and greater numbers of doses available to us, those public servants stand ready to deliver once more.

Today, members will receive initial board maps of primary care settings and other vaccination centres in their areas to meet the scale-up, alongside use of mobile units where those are needed. We are looking at use of larger centres in heavily populated areas such as Glasgow, Edinburgh, Dundee, Aberdeen and Lanarkshire to supplement the local and mobile solutions for people in remote and rural areas, and for those who have particular requirements.

Alongside that, we are building a national scheduling tool that will support wider cohorts of the population to schedule their appointments, which is on track for delivery by the end of January.

Although limitations with vaccine supply have meant that there have been lower initial workforce requirements for the early weeks of the programme, we have nevertheless been keen to ensure that we continue to ramp up capacity. We currently have 1,729 registered vaccinators, and 4,000 people attended national training events on delivery of the Pfizer vaccine. To deliver on our intention of concluding vaccination of those who are on the priority list in the spring, our workforce modelling shows a requirement for about 1,400 vaccinators and 600 support staff. We remain confident in our workforce supply. We are also exploring all offers of assistance from individuals and organisations, for which we are very grateful.

I know that for many people the wait to get the vaccine will be an anxious one. I hope that people will be assured that we will contact them as soon as we have the vaccine supply and can reach their eligible group. It is essential that, once people have been contacted, they attend their first vaccination appointment and return for their second dose.

A vaccination programme of such a scale is unprecedented and is a significant logistical challenge that requires a major nationwide effort. So far, we have secured the enthusiastic support of many partners across our public sector, and we continue to face that challenge with optimism and determination to succeed for Scotland.

The Deputy Presiding Officer

The cabinet secretary will now take questions on the issues raised in her statement. I intend to allow around 20 minutes for questions, after which we will move on to the next item of business.

Donald Cameron (Conservative, Highlands and Islands)

I thank the cabinet secretary for providing advance sight of her statement. I welcome the news that more than 56,000 people have been vaccinated so far, and I pay tribute to our front-line NHS and social care staff for helping to deliver that. Following the news about the new strain of Covid-19, I am sure that any update on the impact of that new strain on the delivery of the vaccination programme would be appreciated.

The cabinet secretary mentioned that those people over the age of 80 who are not in care homes will be largely vaccinated in GP settings. However, she has previously said that GP surgeries will not be significantly involved in the vaccination programme so that they can continue to deliver other services. Therefore, will she provide clarification on the role of GPs in the vaccination programme and on how their participation will affect the on-going availability of primary care?

Secondly, I want to raise another specific matter. The cabinet secretary will be aware of the campaign by Fred Banning, who is suffering from terminal cancer, to give people who are receiving palliative care increased priority for the vaccine; indeed, she mentioned the issue in her statement. Can she provide any further update on that difficult issue?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

On Mr Cameron’s second question, I cannot provide any more information than I have provided so far. As I said, Matt Hancock and I have written to the JCVI to ask it to give consideration to the issue and to provide any further advice that it wants to offer. As soon as we have that, I will update members in what has become a regular weekly update to members when we have new information to impart. I expect that the four health ministers will discuss the matter when we meet tomorrow.

On the role of GPs, we have been working very closely with the Royal College of General Practitioners and the British Medical Association to ensure that the vaccination programme for the over-80s can be delivered partly in primary care physical settings and partly through primary care staff delivering the vaccine to people in that age group who live at home and for whom vaccination at home is the most appropriate way of delivering it to them. In addition, GPs who choose to do so will volunteer in our vaccination centres, and we have reached an agreement with them on the overall cost of that.

The GP practices are giving careful consideration to how they can manage to deliver the vaccination programme and to maintain their normal primary care service provision through extended hours or by other means. I am confident that the RCGP and the BMA are looking at that very closely—quite rightly, they share the concern of Mr Cameron and me on this—to ensure that standard, normal GP services are maintained while the additional work associated with vaccination is under way.

With regard to Mr Cameron’s question about the new variant of Covid-19, a great deal of work is under way to ensure that the current vaccines can deal with it; the expectation is that they can. Of course, vaccine researchers and manufacturers are well accustomed to dealing with variation in infection strains—they do that almost every year with respect to the flu virus, which mutates and changes its strains as each year passes. Changes are then made in the vaccine that we deploy as part of the seasonal flu programme.

That work is under way but, at this point, there is no evidence to suggest that the current vaccines will not be effective against the new strain. Of course, the key is to get on and vaccinate as many people as quickly as we can.

Monica Lennon (Labour, Central Scotland)

I thank the cabinet secretary for advance sight of her statement and I welcome Mairi Gougeon to her new role as Minister for Public Health, Sport and Wellbeing.

The Government’s target was to have daily testing capacity of up to 65,000 tests by the end of December, but daily testing numbers are still averaging only about 20,000. Are delivery plans for the cabinet secretary’s intended capacity still on track? She is well aware that we have worried care-at-home staff who want to get testing soon. If we have spare capacity, can that be used to reassure our care-at-home staff?

On a local issue, I am aware that, in NHS Lanarkshire, only half of our eligible staff who work in long-stay old-age psychiatry and learning disability wards were tested last week and that, in relation to about half of those who were not tested, the reason was that the staff declined to test. Is the cabinet secretary keeping a close eye on that? What more can be done to build staff confidence and reassure people that the testing is important to keep both staff and patients safe?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I am grateful to Ms Lennon for her very important questions. The 65,000 figure was split between our expanding NHS capacity and expansion in the Lighthouse capacity. Even though we do not yet have the east hub online, largely because of building issues to do with fire safety and so on, which we need to fix, we still believe that we will be on track collectively to meet that 65,000 target.

Ms Lennon is absolutely right about the importance of extending testing to care-at-home staff. From memory, I believe that it is from the early part of January that we intend to extend regular asymptomatic testing to care-at-home staff. As I said—Ms Lennon will be well aware of this—they are a more complex group of staff to reach on a weekly basis so that we can input the data from those tests, because they are in neither hospitals nor care home settings. However, with the Convention of Scottish Local Authorities and our other partners, we have worked through how we might do that, and we will phase the roll-out, again starting with the areas where the virus has the highest prevalence and working our way through. We will start that from mid-January.

On that and other matters, I commit, as I always do, to ensuring that members are kept up to date. If there are changes between now and the Parliament returning after the recess, I will write to all members with those changes, but I will give an update as soon as we are all back after the recess.

Ms Lennon is also right about people declining to test. We saw a significant proportion of that when we initially rolled out weekly testing to care home staff, and we undertook with Scottish Care providers and our colleagues in the unions a programme of persistent and consistent information, including some short videos about the importance of testing, why to do it and what not to be worried about, and some surgery work to address people’s concerns about it. We have seen the number drop significantly.

We see some of that reluctance to be tested on a weekly basis among our NHS staff, and I kind of understand why. It is not the easiest test to undertake and it is intrusive. Using a similar approach, but also working closely with our unions and our boards, and led by our chief nursing officer, we are looking to see what more we need to do there to reduce that number.

My final point on that is that we must always remember that, setting aside those who decline to test, we will always have a difference between the eligible number and those who are tested. At any time, 50 staff could be eligible in a particular area, but a number of them may be off because of ill health or maternity leave, so we will never get 100 per cent. The decline-to-test figure is the one that we need to pay real attention to, and we are doing that.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

Will the cabinet secretary advise what role the Scottish Government’s new vaccine app could play in ensuring that people are fully informed about the vaccine before it is administered? For those who may not use an app, which I have to say would comprise many people in my Cowdenbeath constituency, how will the Scottish Government ensure that that vital information is equally accessible?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

The vaccine management tool is for staff. It is not a tool for citizens to use for either engagement or information sharing. The point of the tool is that it allows staff to easily record all the details of each vaccination: the patient’s community health index number, the arm in which they were vaccinated, the type and vat number of the vaccine that was used. All that goes into the patient’s record, so that when they return for their second dose, it can be checked.

The vaccine management tool is a management tool, but it is primarily a safety tool to make sure that we meet all the right clinical governance protocols. It is an additional safety measure that offers reassurance to individuals.

We have available printed and online material for patients. When people arrive to be vaccinated, they are given a patient information leaflet and time is taken to explain to them everything that they want to know and to answer all their questions, so that they can give informed consent to being vaccinated.

We will distribute a leaflet through a door drop to every household in the country from 5 January. The leaflet will explain the vaccination programme and answer safety questions and concerns that people might have. It will tell people what they should expect when they get called and give them an idea of where they are on the list. It will have a helpline number too, of course, so that people can phone up and ask for more information.

Maurice Corry (Conservative, West Scotland)

I, too, welcome Mairi Gougeon to her new ministerial role.

NHS Dumfries and Galloway says that care home staff and residents will have received their dose of the Covid-19 vaccine by Christmas eve. That is welcome news indeed, but it comes alongside one care home operator describing the programme as

“so far hugely frustrating and very disappointing”.

Can the cabinet secretary confirm when all care home staff and residents in Scotland will have received their first dose?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

No, I cannot give a definite date for that because, as I keep saying, it is dependent on vaccination supply. I explained that the problem that we have across the four nations of the UK is with the predictability of delivery. We know when the vaccine leaves the Pfizer factory in Belgium but we cannot say that it will be with us in Scotland four days from that date, because the date varies depending on the different safety checks that have to take place before the vaccine reaches us.

All four nations are trying to work with the MHRA and our distributors to smooth the process and make it much more predictable so that we can forward plan on a better basis, but until we do that it is not possible to be definitive about specific dates by which certain things will be done.

What I can say is what I said in my statement: significant progress is being made. We continue to work our way around all the care homes and their staff and residents and we intend to have completed the first and second doses by the end of January. Members should remember that, when I give numbers about the volume of doses that we expect to receive, that needs to be halved to give the number of people whom we can vaccinate, because the MHRA requires us to hold back 50 per cent so that we can give people the second dose.

I do not know who the provider that the member referenced is. Nobody has raised that issue with me. If the member wants to advise me of that provider’s particular concerns, I will be happy to look at them. I think that the delivery across our boards of our vaccination programme, which began on 8 December—a very short time ago—has been remarkable, given its smoothness and the coverage that has been reached. Depending on vaccine supply, we will keep scaling that up and vaccinating more and more people according to the JCVI advice.

The Deputy Presiding Officer

A number of members still want to ask questions, so I ask for succinct questions and answers.

Kenneth Gibson (Scottish National Party, Cunninghame North)

I welcome the cabinet secretary’s statement. I appreciate her comments regarding the difficulties in distributing the vaccine to remote and island communities, and that they have now been resolved. Such communities, including those in Arran and Cumbrae in my constituency, often have a high percentage of older people. Is a catch-up programme being implemented to ensure that vulnerable islanders, who would have already been vaccinated if they lived on the mainland, will now receive the vaccine?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Yes, there is a catch-up programme. There is a catch-up programme for precisely the situation that Mr Gibson referred to and a catch-up programme for not getting everyone at the one time, as we inevitably have with flu vaccines. It might be that every resident in a care home cannot be vaccinated. Someone might be unwell and vaccinating them might not be appropriate.

That simply demonstrates the complexity of the exercise. If people go out to vaccinate 100 people who are over 80, only 75 of them might be able to be vaccinated, so the 25 need to be remembered, and those people need to get back round to do them the second time.

The programme is complex, but there will always be catch-up programmes and mop-ups that are part of the process.

Pauline McNeill (Labour, Glasgow)

I give my sincere thanks to everybody who is involved in the programme, which is incredible.

How will the Scottish Government decide who gets which vaccine, given that there are slight differences in their effectiveness? Will they be rolled out in parallel? Is there a planning date next year for reaching around 70 per cent of the population, which is the figure at which immunity might be reached?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

No, I cannot give a planning date for that. I understand why Pauline McNeill asked that question, and I would like to be able to give that date but, as with everything else, it depends on vaccine approval and the roll-out and delivery of the vaccines. It should be remembered that the manufacturers of the vaccines will deliver and supply to the whole world. Although the UK, on behalf of all four nations, has forward purchased a significant volume of vaccines—more than is needed—delivery and production schedules are inevitably important factors.

We will not determine which vaccine will be used for which cohorts of individuals; rather, we will follow the advice of the Joint Committee on Vaccination and Immunisation and whatever caveats the MHRA may put around its authorisation to use vaccines. As we know, with the Pfizer vaccine, there is a specific caveat in relation to pregnant women, and there is now an additional requirement for a 15-minute sit-down after a person has been vaccinated to ensure that everything is okay before they leave and go about their business. We get that. I expect that we will have comparable caveats around MHRA approval and JCVI advice for the Oxford-AstraZeneca vaccine when it comes forward and for the Moderna vaccine, which we expect to be the third vaccine coming through. However, we must wait for those and then apply those caveats.

Mark Ruskell (Green, Mid Scotland and Fife)

As asymptomatic testing increases, it will inevitably result in more people needing to self-isolate. Has the Government considered making the self-isolation support grant unconditional so that more people can afford to do the right thing? The new variant of the virus appears to make people infectious for longer. Will that have an impact on the length of time for which people need to self-isolate and their need for support during that time?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Both points are linked, of course, and both are important. On the last point, a number of things about the new variant are not yet confirmed. We know for sure that it is more infectious—it infects more people and it does so more quickly than we have been used to since Covid-19 first appeared. However, there are a number of other possible impacts that we do not know yet, and a great deal of work is under way by scientists to try to confirm some of those impacts, including work on whether people are infectious for longer.

The point about the self-isolation support grant is well made. Consideration is being given to what more we can do to support people to self-isolate. With clinical advice, we have, of course, reduced the period to 10 days. Nonetheless, that is still a significant ask of individuals, and it has implications for domestic circumstances in a number of different ways.

We continue to consider what more we can do in order to help people to do what we need them to do for themselves and for all of us, because that is critical in breaking the chains of transmission.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

There have already been reports of several hundred missed appointments for the vaccine. Given the fragility of the vaccine, can the cabinet secretary confirm whether those doses are wasted or redeployed?

Secondly, can the cabinet secretary give us some detail about how, when we come to vaccinate the remainder of the population in the spring or early summer, that process will operate equitably? Everyone will want that vaccine yesterday, and some people may not be online and may not be able to access portals to book in.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

On the latter question, once we have worked our way through the JCVI list—our objective is to do that in the spring of next year—we will then move to those who are under 50. At that point, we expect that, over time, the JCVI will give us further advice about any prioritisation that we will follow for that final group of the adult population. We will be able to answer that part of Mr Cole-Hamilton’s question more definitively at that point. We will, of course, look to ensure that, as we roll out the vaccination, we follow the advice in an equitable manner.

On missed appointments and vaccines being wasted, I encourage everyone not to miss their appointment. If they cannot make it for some reason, they should get in touch, using the information that they will have been given, and rearrange it. We are happy to rearrange appointments, but missed appointments simply mean that somebody else who could have been vaccinated on that day at that time will not be.

However, missed appointments do not necessarily increase wastage, because each vial is made up with sodium chloride into five doses, and those doses can be kept for a limited amount of time in normal refrigerated conditions at 2°C to 8°C. If, say, I do not turn up and Mr Cole-Hamilton is next in line, the dose that I was going to receive will simply be used for him, and on we go. By the way, when my time comes, I will turn up—both times.

Essentially, X number of missed appointments does not necessarily equate to X number of wasted dosages. However, there is always a risk that, if the person who misses their appointment had the last appointment of the day, there will be no one else to receive that dose, and that will be a wasted dose. The more we can minimise wastage, the more people we can vaccinate quicker.

Shona Robison (Scottish National Party, Dundee City East)

I add my thanks for the incredible efforts of all those involved.

As I understand it, the initial guidance on the roll-out of the vaccine indicated that unpaid carers would be placed in the priority group. Can the cabinet secretary provide some clarity around when and how unpaid carers will receive the vaccine?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Today, all members will receive what is becoming the weekly letter from us to them. In this week’s one, we give the JCVI priority list and its definition of what it means by people in the priority 1 place on the list, who are residents and workers in care homes for older people. Members will see that in the number 6 place on the list are unpaid carers, including all adult carers and young carers aged from 16 to 18. They are where we said they would be.

On the issue of how we will reach them, we are using a number of different channels to do that. Obviously, our colleagues in Social Security Scotland will ensure that those who are receiving carers allowance are advised, when we get to that stage of the programme, without giving away any confidential information. We will use third sector organisations, social media and other news channels, and, of course, our general practitioner and primary care practices will be of assistance to us. We will try to maximise the reach that we have to that group of people, including through the use of national media, in order to encourage them to get in touch and get their appointment booked.

Jamie Greene (Conservative, West Scotland)

Can the cabinet secretary elaborate on the large vaccination centres that were mentioned in her statement in urban and other populated areas? Where will they be, when will they come on line and who will staff them? In the interests of time, I would be happy to receive that information later in writing.

Can we offer assurance to recipients of the vaccine that they will be vaccinated against the new strain of the virus, which we are all incredibly concerned about?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I will answer the last point first. A great deal of work is under way to get more confirmation around aspects of the new strain. However, there is no evidence at this point to suggest that the current vaccinations will not be effective against that new strain.

With regard to large vaccination centres other than those in the cities that I have talked about, I am happy to write to Mr Greene about the kind of centres that we are looking at and to share that information with all members. Those will be for when we start moving into the 60-year-old and younger population. For that group we will be looking at large numbers of people, and we believe that they will be more easily able to go to large centres, whether drive-through or walk-through. We are looking at a range of possibilities. As we narrow them down, we will give members much more information on that.

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

I have been contacted by constituents in the Chryston part of my constituency, which includes the small towns of Gartcosh, the Moodiesburn estates, Auchinloch and Chryston. There are worries that access to the vaccine will be difficult for vulnerable members of those communities who do not have access to a car. I am in contact with NHS Lanarkshire about the matter; we have had helpful conversations and it is working to address those concerns. However, can the cabinet secretary give my constituents in those communities any reassurance that the vaccinations will be offered as locally as possible, and that they will be fully supported to access the vaccinations when transport is a barrier?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I can give that assurance without any doubts. I am glad that NHS Lanarkshire has been helpful to Mr MacGregor. As I have said, today all members will receive, along with a letter, what is essentially the first set of board-by-board maps of where the local centres will be. Those are set up for the over-80s phase of the programme, but we will continue to add to them.

In addition, the mobile vaccination units are not just for remote and rural areas. They are also for urban areas where there are villages and citizens in the community for whom access to city or town centres remains difficult, such as people who do not have their own transport and public transport is also not readily available. There are lots of situations like that in my own constituency, so I well understand the difficulty.

We will do everything we can to ensure that vaccination is as local and as easily accessible as it possibly can be, because we need people to come forward for their first vaccination and to come back for their second dose. We want to vaccinate the largest number of the adult population in Scotland that we can reach.

The Deputy Presiding Officer

That concludes questions on the statement.

12:17 Meeting suspended.

12:20 On resuming—

First Minister’s Question Time

Kenneth Macintosh (Labour, West Scotland)

Before we turn to First Minister’s questions, I ask the First Minister whether she would like to update the Parliament on Covid-19.

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

Thank you, Presiding Officer. I will give a short update on today’s statistics before touching on some other issues.

The number of cases reported yesterday was 1,190—five per cent of all tests reported—and the total number of cases is now 115,566. There are currently 1,025 people in hospital, which is 20 fewer than yesterday, and 56 people in intensive care, which is four fewer than yesterday.

I very much regret to report that, in the past 24 hours, a further 47 deaths were registered of patients who first tested positive in the previous 28 days. The total number of people who have therefore died under that daily measurement is 4,373.

National Records of Scotland has also just published its weekly update, which includes cases in which Covid is a suspected or contributory cause of death, even if it has not been confirmed through a test. Today’s update shows that, by last Sunday, the total number of registered deaths linked to Covid under that wider definition was 6,298, 203 of which were registered last week, which is 23 fewer than in the previous week. Again, I convey my deepest condolences to everyone who has been bereaved.

Before I go any further today, I take this opportunity to say how sorry I am for my breach of the rules that I ask us all to follow every single day. I took my face mask off while briefly attending a funeral purvey last week. I am sure that everyone will have seen in the media this morning a picture of me without it. I want to be clear today that, regardless of the circumstances, I was in the wrong. There are no excuses. The rules apply to me just as they do to everyone else, and the rules really matter. I am kicking myself very hard, possibly harder than my worst critic ever could. More important, I will be making sure that I do not drop my guard again.

I have three further points that I would like to update members on very quickly. The first is the situation in relation to cross-channel trade. The news that France has lifted its ban on accompanied freight vehicles is welcome, but important challenges remain to clearing the backlog. As part of that, it is important that the transport of perishable goods, including seafood, is prioritised, and the Scottish Government is ready to help in any way that we can, including with the testing of drivers.

Secondly, Public Health Scotland has just published its weekly statistical report, which includes an update on vaccinations. It shows that, by Sunday, more than 56,000 people had received their first dose of the vaccine. That is a significant achievement in the short time that it has been available.

My third and final point is that we will shortly publish the latest estimate of the R number. We expect that it will show that the R number is still around 1 in Scotland, which is a concern, given that it is thought that the new variant of Covid could raise the R number by 0.4.

Those final two points demonstrate where we are at present. The progress with vaccinations gives us grounds for hope, but the overall state of the pandemic is a cause for concern. Our immediate priority has to be to get through these next few weeks and months as safely as possible. That will be even more difficult than expected, given that the new variant of Covid seems to transmit more easily than other strains of the virus.

That is why, unfortunately, we are imposing such tough restrictions from boxing day onwards. It is also why the safest way for indoor Christmas day celebrations is within your own household and in your own home. Please do not meet other people indoors if you can possibly avoid it.

It is also why all of us, however hard it is, need to continue to stick to the current rules and guidelines, and that includes FACTS. So, with an enormous dose of humility, I remind everyone—most importantly, myself—of FACTS: people should use face coverings; avoid crowded places; clean their hands and surfaces regularly; keep 2m distance from people in other households; and self-isolate and get tested if they have symptoms. Those actions will work against the new strain of the virus and they mean that, while the vaccination programme proceeds, we can continue to protect ourselves, our loved ones and our national health service.

I take this opportunity, Presiding Officer, to wish you, everyone in the chamber and everyone watching a healthy and peaceful Christmas and—as I think we all hope—a brighter and better 2021.

The Presiding Officer

Thank you. The First Minister will now take questions. I encourage all members who wish to ask a question to press their request-to-speak buttons.

Level 4 Restrictions (Non-essential Businesses)

Ruth Davidson (Conservative, Edinburgh Central)

1. From midnight on Saturday, all Scotland’s non-essential businesses will be closed for a minimum of three weeks. Most people understand why, but the news is still devastating.

Today, we spoke to Ryan Hutchins, who runs a small sofa shop in Linwood. Here is what he told us:

“90% of my customers are outside Renfrewshire … I had only 2 customers in the last 3 weeks. My business is bleeding money to the point I'm close to broke and have very little left to survive because of the lockdown … his next 3 weeks lockdown will cripple me if I don’t get help. I have 2 children, one that lives with me full time. I have £754 in the bank with my rent due on January 1st and other bills”

Ryan cannot survive until some unknown date in January without receiving grant support, so what can the First Minister tell him?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

First, I want Ryan and everybody else—there are many in Ryan’s position—to know how sorry I am for the situation that we find ourselves in. If I thought that there was another way to do this, I would grasp it in a heartbeat. Nobody wants to be in this position. That is true in Scotland, in the rest of the United Kingdom and in much of the rest of the world.

Businesses that are required to close by law in level 4 areas are, of course, able to apply for strategic framework business fund support. Businesses that are required to close are eligible for a grant of up to £3,000—the level depends on rateable value. A grant of £2,100—again depending on rateable value—is available for businesses that can remain open but are required to modify their operations by law. Those grants are provided to eligible businesses for every four weeks of restrictions.

I repeat what I said earlier in the week. The Cabinet Secretary for Finance is reviewing what additional support we can make available to businesses, because we know that this extra period of disruption and, for many, closure will be very difficult to bear, even with the funding that is currently in place. We will continue to do everything that we can, within the confines of the resources that are available to us, to help as far as we possibly can.

Ruth Davidson (Conservative, Edinburgh Central)

I thank the First Minister for that answer, but I am not sure that it will be enough for Ryan. I am not sure that it will be enough for the Edinburgh shop owner who writes saying,

“I’ve already run the payroll for this month due to the Christmas holidays”

and asks what he is supposed to do now. I am not sure that it will be enough for the Borders hairdresser who says that the new shutdown will be the

“final nail in the coffin”

for her salon. She says:

“I’ve adhered to all the health and safety measures we were advised to do before we reopened after the last lockdown, but financially I will struggle to keep afloat this time”;

I am not sure that it will be enough for the boss of the chain of women’s clothes shops who is desperate to protect the 131 jobs that her shops sustain, but who is also terrified that she will not make it.

They, and thousands like them, have done everything that has been asked of them, but they have no reserves left. How long will it take for the schemes that the Scottish Government has announced to open? How long will it be before money actually hits the bank accounts of those businesses, which are teetering on the edge?

The First Minister

First, as I have said, I understand that; it breaks everybody’s heart to hear experiences of the kind that have just been recounted to us in the chamber. I know that it does not help anybody in that position for me to say this, but it is, nevertheless, important that I say it: in doing the really difficult things that we are doing right now to suppress this virus, we are providing a more sustainable recovery for the economy in the medium-to-long term. If we allow the virus to get out of control, experience tells us that the damage to the economy will be longer lasting and much deeper than it would otherwise be. That does not take away the short-term pain and I am acutely aware of that.

The support funds that I spoke about in my original answer are already open for applications. They are administered through local authorities. We work with local authorities to get that funding to businesses as quickly as possible. As members across the chamber know, there are other funding streams that we have announced. Some of them have been in place for a while; others have been announced more recently. I know that businesses that may have been able to cope on the funding that we have made available thus far will find it much more difficult to do so the longer the disruption of this pandemic goes on. That is exactly why the finance secretary is urgently looking at what more we are able to do to help businesses in that very difficult situation.

I have been candid all along in saying that, with the best will in the world, we will never be able to compensate every individual and every business for every loss that the pandemic has foisted on them, but we will do our level best to provide as much support as possible. The Government—ministers and civil servants; all of us—will be working throughout the Christmas break to ensure that we do everything that requires to be done on every aspect of the handling of the pandemic.

Ruth Davidson (Conservative, Edinburgh Central)

Throughout the crisis, even when the Government has promised to help, it has been far too slow in getting support out the door to protect jobs. The Fraser of Allander institute told us that, for months, the Government sat on £1 billion of funding that was designed to help those who were struggling.

Figures that were released last week showed that more than 106,000 applications were received for two schemes—the small business grant scheme and the retail, hospitality and leisure scheme. However, as of 8 December, only 91,000 had been processed. Those schemes closed five months ago. Five months on, 15,000 businesses are still waiting, and fewer than 500 applications were processed in the period between September and December. Given that record, what confidence can businesses have that the schemes that have been announced in December will pay out in January?

The First Minister

It is right and fair for us to be challenged to get the money out as quickly as possible—we are seeking to do that, and we will continue to seek to speed up the process as much as possible. Many of those grant-funding schemes are administered through local authorities, so we are working with them in order to do that. It is an enormous burden on local authorities, and we recognise the hard work that the people who work in those authorities are doing.

I do not accept that we sit on money—we have allocated all the money that we have at our disposal. In the Scottish Government, we have to ensure that we build in contingencies because, while every penny of consequential funding is welcome, we often do not know what it is meant to cover or how long it is meant to last. We therefore have to look ahead and ensure that we are budgeting to get us through the remainder of the financial year.

It is really important that we get every penny that we can out to businesses. We are determined to do that, as far as we can, for every business across the country that is living—just as individuals are—with the horrendous implications of what the virus is doing to us.

Ruth Davidson (Conservative, Edinburgh Central)

Most small businesses understand the need for the new restrictions. What they do not understand is why they, and the jobs that they support, are so often treated as an afterthought by the Government. Andrew McRae of the Federation of Small Businesses Scotland said that moving to tier 4 so quickly was a “hammer blow” to many of his members.

We are about to enter what should be the busiest time of year for Scotland’s small businesses. Instead, small firms across the country are facing Christmas not knowing whether they can survive to new year.

On 9 December, a multimillion-pound set of schemes was announced for businesses such as photographers and taxi drivers, those in the wedding sector and travel agents and tour operators. However, people have not been told when those schemes will open, how they can apply or—crucially—when they can actually expect any money to hit their bank accounts.

When will those firms get the support that they need? What about the help that was announced on Monday for those who are affected by the next lockdown? How far into the new year will it be before applications open, never mind how many months before they are processed?

Ryan Hutchins and thousands of small business owners like him are calling on the First Minister to deliver on her promises and free up the millions of pounds that have already been passed to the Scottish Government. When will she do that?

The First Minister

Many of those funding schemes are open for applications; businesses are, and have been, applying, and many businesses have got money.

We are announcing new streams of funding as often as we can. Often we need to put in place guidance to allow local authorities to judge eligibility, and we will continue to work to speed up that process as much as possible.

I understand why businesses and individuals living in extreme circumstances right now may possibly think that their circumstances are an afterthought, but I assure people that that is not the case. I will ask the Cabinet Secretary for Finance to update members in writing on the different funding streams: what stage they are at, when they opened or will open and what the timescales are for getting money to people.

We announced quickly the start of level 4 from Saturday. If we had not decided to impose that quickly, we would face a situation in which businesses may end up being closed for longer because of the virus running out of control. We see similar restrictions in place across much of the rest of the United Kingdom and Europe. These are horrendously difficult circumstances. I take very seriously our responsibility to try to suppress the virus and support people as we do so, and the Government will work every single day to ensure that that is done as quickly and effectively as is humanly possible.

Covid-19 (Care Homes)

Richard Leonard (Labour, Central Scotland)

2. Back in July, the Scottish Human Rights Commission questioned whether what had happened in our care homes was a violation of the human rights of their residents: of the right to be free from inhuman and degrading treatment, of the right to non-discrimination, and even of the right to life itself.

The commission said that a public inquiry was needed, and that it should be

“independent, prompt, determine responsibility, subject to public scrutiny”.

The Government agreed with that. Why, six months later, are care home residents and their families still waiting?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

We work every single day with those on the front line and those who are working so hard in our care homes to keep their residents as safe as possible. As it is for businesses, this continues to be an incredibly difficult time for those in care homes and for their families.

We have given a clear and unambiguous commitment to an independent public inquiry, with human rights at its heart. We will pursue the implementation plans for a public inquiry as quickly as is feasible.

I made this point yesterday, and it is a really important one. Right now, particularly in the light of what we are facing with the new strain of the virus, my principal responsibility and the principal responsibility of the Deputy First Minister, the Cabinet Secretary for Health and Sport and every single minister in the Government is to focus on taking decisions now, on learning lessons and on changing policy where we can to ensure that we get through the next phase of the pandemic.

I referred to this yesterday: I noticed that the chief executive of Scottish Care, Donald Macaskill, when asked about this a few weeks ago, said that the organisation wanted an inquiry, but realised that

“we cannot take staff away from the front-line duties of fighting a virus”.

If that happened, it would be, to use his words,

“a dangerous distraction which will cost lives”.

There is no doubt about the commitment to a public inquiry. I may be wrong, and events may have overtaken me, but I believe that we may still be the only Government in the UK that has given that clear and unambiguous commitment to a public inquiry.

However, we must focus on saving lives now. The virus is not done with us, unfortunately; it has just learned how to spread itself faster. The responsibility that I and my Government owe to the people of Scotland is to keep our focus on what we must do now, every single day.

Richard Leonard (Labour, Central Scotland)

It is not just the Scottish Human Rights Commission that is making that call. Just this week, the Equality and Human Rights Commission in Scotland also called for a public inquiry into Covid deaths in Scotland’s care homes. It said that that was urgent, and it reported:

“We were told of situations where there were reduced or no visits by GPs and community nurses ... Residents were not being transferred to acute settings and people nearing the end of their lives were not receiving palliative care.”

We know that, until mid-May, the Scottish Government guidance advised that anyone who was a long-term care home resident should not be admitted to hospital. Why on earth, 10 months into the pandemic, does the First Minister think that the EHRC still finds it necessary to recommend that Scotland’s care home residents must have

“full and equal access to ... healthcare”?

The First Minister

I am sorry, but I just do not accept that characterisation of the Scottish Government’s advice. We have had this exchange before. Government often puts in place policy frameworks in the shape of advice on such matters, but the issue of whether or not an individual—whether in a care home or living in their own home or anywhere else—is admitted to hospital is a decision for clinicians, as is right and proper. It should never be for politicians to second-guess that.

The guidance makes the point that, for older people, particularly those nearing the end of their life, the best place for them to receive appropriate care is often in their own homes. For many older people, a care home is their own home. However, if a clinician thinks that they should be in hospital, that is exactly where they should be.

I do not disagree with what the Equality and Human Rights Commission is saying or with any of the calls for a public inquiry. It is not a question of whether there will be a public inquiry; on behalf of the Scottish Government, I can say that there certainly will be a public inquiry. It is a question of when it will be sensible and safe to have that inquiry.

My judgment, with which people are absolutely entitled to disagree—I appreciate that some in the chamber do—is that my responsibility right now is to focus on the immediate challenge of getting us through the next phase of the pandemic. We are perhaps at the most dangerous juncture now since February or March and my focus has to be there.

There will be a full public inquiry into not just care homes but all aspects of the handling of the pandemic. That is right and proper. Right now, however, the most important thing is to keep steering us through the pandemic as carefully and as safely as possible.

Richard Leonard (Labour, Central Scotland)

The First Minister says that the advice is clinical and not governmental, but the letter that was issued on 13 March was from the Cabinet Secretary for Health and Sport, Jeane Freeman. I have the letter here—it is on Scottish Government-headed notepaper.

To go back to the situation that is affecting people in care homes, let me describe what daily life has been like in our care homes for the past ten months. Both of Angela’s parents live in the same care home in Livingstone. Angela said that

“since March, they have been isolated, every day on their own, in their small rooms, almost imprisoned for being old. My mother is isolated, her health deteriorating, and she is losing the will to live because there are not enough staff to support the restrictions. For her, Covid has meant that she has lost the right to see her husband and family, to practise her chosen religion and to leave her home for even a bit of fresh air.”

We understand that the virus is highly contagious and that we must protect the most vulnerable, but care home residents deserve better than this.

In 2020, we have seen a record number of Covid-related deaths in Scotland’s care homes and the violation of the human rights of care home residents. Families have been torn apart from their loved ones. Will the First Minister work with all parties across the Parliament in 2021? Will she listen to the Scottish Human Rights Commission and the EHRC? Will she set up the long-awaited public inquiry and listen to the voices of people such as Angela, so that all our older people are finally treated with the dignity and respect that they deserve?

The First Minister

Before I come to the really important matters, I will clear up something from Richard Leonard’s question. I did not say that the guidance was clinical advice rather than Scottish Government advice, but questioned Mr Leonard’s characterisation of what the advice said.

The guidance is Scottish Government advice, but I made the point that it does not countermand the decisions of clinicians, if the latter think that an older person should be in hospital. Those are important issues; let us not mischaracterise what we are each saying on the matter.

All of us understand that the pandemic has possibly affected no group in our society more, or harder, than the people who live in care homes and their families. I had occasion this past week to write, for the first time in my experience, to somebody whom I knew personally, who had lost their husband in a care home. Thousands of families across the country will have had the experience of dealing with the pandemic in a care home setting.

Our hearts break for them every day. I will not wait until 2021 to listen to people such as Angela; I listen to those voices, views and opinions literally every single day. I cannot always find the perfect balance for everybody in that situation, because there is no perfect balance: the virus is not fair, neither for people in care homes nor for anybody else.

We have to juggle all those difficult factors every single day and come to the safest possible outcomes for people. We will try to do that as best and as well as we can every day. In 2021, I hope that we will see the start of a public inquiry, because I hope that we will then be out of the acute phase of the pandemic at least, so that we can turn our attention to the inquiry.

I come back to the point that I would not do any favours or any good at all to people in care homes, families or anybody else across the country right now if I—with my Government and all the people with whom we have to work, including the care home sector—do not focus 100 per cent on trying to deal with those issues day in and day out. That is what we will continue to do.

Covid-19 and Brexit (Disruption to Food Supplies)

Patrick Harvie (Green, Glasgow)

3. We are dealing with the extremely dangerous new strain of a deadly virus at the same time as Boris Johnson still seems determined to drive us off the Brexit cliff. The first of those crises is already disrupting the border, and the second threatens to do even worse.

A United Kingdom Government source told The Times that there were

“contingency plans in place for absolutely everything.”

I honestly doubt that that is even possible, but it is vital that Scotland is as ready as we can be. Yesterday, the First Minister told the Parliament that,

“if the situation is not resolved in the next day or so, we may start to see pressure on some fresh produce after Christmas.”—[Official Report, 22 December 2020; c 10.]

Will the First Minister set out what types of fresh produce are the greatest cause for concern, when she expects the issues to be seen—in relation to either Covid disruption or Brexit disruption—and what action her Government is taking to ensure that those who are in greatest need, including people on low incomes and those with young families, are not left facing additional hunger or price gouging in the days and weeks ahead?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

My responsibility here is to deal with the Covid impacts. My views on Brexit are well known. We are getting ever closer to the cliff edge, and I still hope that we can avert the reality of going off it. We have seen some of the contingency plans that were prepared for Brexit having to be activated in the past couple of days due to the border issues associated with Covid. People themselves can judge whether the disruption that we have seen in the past couple of days suggests that, in the eventuality of a no-deal Brexit, those contingency plans would be anywhere near adequate for what we would be dealing with. My view is that they would not be, but I will leave others to deal with that.

I hope that we will see no impact on food supplies. It is positive that we are starting to see freight moving again, although it will take some time to get through the backlog of vehicles. As I said yesterday, the Scottish Government is considering the ways in which we can help. There is not much that we can do to help with the backlog that is already at Dover, but there is perhaps much we can do, through testing and other things, to prevent problems occurring in the future.

I will chair a meeting of the Government’s resilience committee this afternoon to take stock of any issues relating to food supply. People will have read in the papers about the kind of fresh produce that might be affected—for example, fresh salad products and citrus fruits—if the situation is not sufficiently alleviated quickly enough. However, we hope that that can be avoided. If I think that it is necessary and appropriate to do so, I will send a note round MSPs after today’s resilience meeting, to update them.

Earlier in the week, we had an update from FareShare, which said that it has no concerns about food for food banks and for those in the most vulnerable circumstances. Again, that is something that we will be monitoring closely in the days ahead.

Patrick Harvie (Green, Glasgow)

I certainly do not suggest that the Scottish Government has caused either Covid or Brexit, but the Scottish Government has a responsibility to ensure the wellbeing of those who are affected. The threat of food price hikes in the new year would come in the wake of the impact that Covid has had on inequality and wellbeing. The Scottish Government’s report on that issue confirms what I think most of us already knew—that the pandemic is disproportionately impacting people in poverty, low-paid workers, children and young people, women, older people, disabled people and minority ethnic groups.

Around a quarter of adults are concerned about providing for their family, and one in five households with dependent children say that they are already in serious financial difficulty. That is the stark reality as we head into Christmas, and the situation is set to worsen in 2021 if we have to start the year with a prolonged lockdown.

What more will the First Minister and the Scottish Government do to support low-income households over that period and to support organisations that are working to tackle food poverty? Does the First Minister agree that Scottish tax policy must actively reverse the growing level of inequality by ensuring that those who have profited immensely in 2020, such as the supermarkets and online retailers, pay their fair share?

The First Minister

I was not suggesting that Patrick Harvie was blaming the Scottish Government, and I was certainly not suggesting that we do not have a big responsibility in dealing with the impacts of Covid and Brexit, even though Brexit is not of our making.

Over the recess period, we will continue to update members on any implications of what is happening at borders just now and on Covid and Brexit more generally.

We are already doing a significant amount to help people who are in the most vulnerable situations. As members should be aware, we recently announced a £100 million winter support package, which contains measures such as extra money that goes directly to families with children who are in receipt of free school meals, extra funding for organisations that work with the most vulnerable and funding to address food poverty. We will keep under review our ability to provide more support and the requirement for that.

In principle, I agree that we should have progressive tax policies in which those who can bear the biggest burden do so and through which we do as much as possible to help those who need the most help. Obviously, the Scottish Government’s tax powers are limited in that respect. Some supermarkets have, rightly, repaid the business rates support that they received, which is extra money that has come back into the Scottish Government’s coffers. We will continue to support a progressive approach to taxation as we look ahead—as I hope that we can—to a Covid recovery in 2021.

Independence Referendum

Willie Rennie (Liberal Democrat, North East Fife)

4. I thank everyone for their work over the past year. In particular, I thank key workers—nurses, doctors, train and bus drivers, teachers, supermarket workers, cleaners and others. From time to time, I have even thanked the First Minister. I also thank the amazing Parliament staff, who have worked so hard to adapt and to keep our democratic process running throughout the crisis.

In the past 48 hours, in Dover, we have had a glimpse of what happens when an economic partnership is broken. However, by this time next year, the First Minister wants to have repeated the same mistakes with her referendum. Christmas is a time for sequels. We have now seen what Brexit 1 is like, and, despite that, the First Minister still wants Brexit 2: the break-up of another economic union. Why does the First Minister want another break-up by next Christmas?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

On a note of Christmas cheer, which I will try to maintain for as long as I can, I echo Willie Rennie in thanking many people, including the staff of the Parliament, who have done a fantastic job in difficult circumstances. We are all deeply grateful to them. I also thank the civil servants who support the Government—they do not always get thanked—who have also done a fantastic job in difficult circumstances. [Applause.]

The only reason that we are faced with the prospect of a no-deal Brexit in Scotland is because we are not independent—it has been foisted on us against our will. Independence is not the same as Brexit; it would see Scotland joining other independent countries in the European Union, working together where we need to, including on matters such as Covid, and charting our own future. It is the positive prospect of charting our own future, being responsible for our own mistakes and building our own success and prosperity, instead of having our future foisted on us by the likes of Boris Johnson and his band of Brexiteers, that sees a sustained majority of the Scottish population supporting Scotland’s becoming a normal, equal, independent country.

Willie Rennie (Liberal Democrat, North East Fife)

At the weekend, the First Minister said that it would be “unconscionable” to carry on with Brexit in the middle of a global pandemic, oblivious to the irony of her planning to hold an independence referendum in the middle of that same pandemic. I want the crisis to stop, but her plans would add to it.

We should put the recovery first. We need to put first the young people who need work; the businesses that are on their knees; the climate, which is in a state of emergency; the people who are waiting ages for mental health treatment; and the pupils who deserve a better education. I know that the First Minister has supported independence for all of her political life, but holding an independence referendum now, in the middle of one of the worst health and economic crises that this country has ever seen, is not the right thing to do. Surely, the First Minister can see that?

The First Minister

I have worked out what Willie Rennie is up to today. He has realised that people are really missing pantomimes, so he has decided to provide one all of his own—it is actually a public service.

Where to start? First, let us not lose sight of the irony of the situation that the Liberal Democrats are now a pro-Brexit party. They have actually given up their opposition to Brexit. I still think that Brexit is a mistake.

Secondly, I am sure that it has not escaped Willie Rennie’s notice that I am not planning an independence referendum right now. In fact, I put planning for an independence referendum on hold when the global pandemic struck. If only Boris Johnson had put planning for Brexit on hold when the global pandemic struck. I am not planning to have a referendum while we are in the midst of a global pandemic, because my focus is on leading the country through the pandemic.

However, as we start to recover from the pandemic and as all of us across the world start to ask ourselves what kind of countries and societies we want to live in, I want the people of Scotland to be in charge of answering that question, not the likes of Boris Johnson. Becoming an independent country is essential to building the Scotland that we know is possible as we come out of this Covid crisis.

Loneliness and Isolation (Festive Period)

Gillian Martin (Scottish National Party, Aberdeenshire East)

5. To ask the First Minister what the Scottish Government is doing to tackle loneliness and isolation over the festive period. (S5F-04690)

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

All of us are acutely aware of the isolation and loneliness that the pandemic has caused. As part of the winter support package that I just talked about in response to Patrick Harvie, we provided nearly £6 million to tackle isolation and loneliness, which included more than £4 million for our connecting Scotland programme to improve digital inclusion for older people and money for partners such as Age Scotland, which is tackling loneliness through its expanded helplines. In addition, £15 million of the winter funding is available to community and third sector organisations to support their work.

I encourage everyone to safely check in on those in their neighbourhoods and communities who they believe might be in need of a kind word or deed this Christmas. I also thank everyone who has been working to provide connection and comfort to those around them over the course of the past very difficult months.

Gillian Martin (Scottish National Party, Aberdeenshire East)

Earlier this week, I launched a campaign asking school-age Scots and their families to help by completing five acts of kindness over Christmas. I know that the scouts in north-east Scotland are already doing that and I am hugely grateful to them for everything that they are doing to make a difference. Acts of kindness could be anything from popping a note through the letterbox of a neighbour who lives alone to donating to a local food bank.

Will the First Minister back my campaign and join me in asking those who are able to do so to look out for others in our communities during what will be an especially tough Christmas for many Scots?

The First Minister

Yes, I will certainly do that. It deeply saddens all of us that this will not be a normal Christmas and I know that the change in restrictions has been a particularly bitter pill for many people to swallow. Although this will be a festive season like no other that any of us has experienced before, much compassion and kindness have been evident across all communities this year.

As, I know, everybody will, I certainly take comfort in the knowledge that so many people—such as those who Gillian Martin talked about—will be doing so much to help make Christmas a bit better for someone else. I welcome anything that encourages others to carry out acts of kindness, large or small, and I am very happy to support Gillian Martin’s campaign.

Travel Restrictions (Exemptions)

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

6. To ask the First Minister what reassurances the Scottish Government can give to communities in the Borders regarding exemptions to travel restrictions between Scotland and the rest of the United Kingdom. (S5F-04694)

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

Communities in the Borders have very close social and economic connections with the rest of the United Kingdom, which are really important. The regulations that prohibit travel between Scotland and other parts of the UK without a reasonable excuse are, unfortunately, necessary and essential at this time. However, they include a range of exemptions for which travel is permitted. Those include but are not limited to: travel for work or for voluntary or charitable services that are essential; travelling to school or university; travel for essential shopping; and travel for healthcare, childcare or parental support services. Those exemptions are set out in full in our guidance on the website. However, for everyone’s safety, we encourage people to keep such travel to an absolute minimum during this period.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

For many people in communities along the border—such as in Paxton, Chirnside and Lamberton—Berwick-upon-Tweed is the nearest town for essential shopping and medical appointments. Police Scotland has said that it will double its efforts along the border. When we combine that with the current coverage in the media, many of my constituents are scared to venture out for essential purposes if they take place a few miles away in England.

I am concerned that elderly people will go without food, essential supplies and medical care, because they are fearful of breaking guidance. Will the First Minister give me and my constituents assurances that the police are aware of the special circumstances in which borderers find themselves? Will she ask the Scottish Government to issue specific advice for the Borders, as well as for areas such as Dumfries and Galloway, so that my constituents and others know that they can carry out essential daily tasks without fear or hindrance?

The First Minister

The guidance and the laws that are in place right now have been written with the particular circumstances of the Borders already in mind. That is why I do not think that it is necessary to have specific guidance. In the example that the member used, of essential shopping being required from over the border, essential shopping that cannot be done in people’s own local area is one of the specific exemptions in law. I think that it is the responsibility of all of us to point such things out to people.

Nobody should be fearful of travelling for an essential purpose. We should all be fearful—not because of the police, but because of the virus—of travelling when we do not have to travel, because that poses risks to our health. However, people should not be fearful of travelling for essential purposes. Anybody who has listened, as I am sure many of us already have, to the chief constable set out how the police will go about the enforcement of the regulations will take some assurance and comfort from that. I have confidence in how the police will do that for the travel regulations over the Christmas period and, if necessary, beyond.

Long Covid (Support)

Mark Griffin (Labour, Central Scotland)

7. To ask the First Minister how the Scottish Government’s new clinical guidelines and definition will support people with long Covid. (S5F-04692)

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

The new clinical Scottish intercollegiate guidelines network guidance provides helpful advice on how to care for people who have symptoms during, or after getting, Covid. That guidance will of course evolve as evidence on long Covid continues to emerge. The guideline will support general practitioners and clinicians in identifying on-going symptoms, and provide a definition of best practice, investigation and treatment options to support people who are living with long Covid.

It is crucial that decisions about treatment are based on the latest available evidence, and are aligned to clinical guidance. The guidance work and our deepening understanding of the symptoms and impact of long Covid will help us continue to tailor diagnosis and treatment to each individual patient’s need.

Mark Griffin (Labour, Central Scotland)

I have spoken to a retail worker who contracted Covid-19, was in a coma for weeks, and now has to walk with a stick and is in immense pain; I have also spoken to a social care worker who also now uses a walking stick, has never recovered her sense of taste and smell, and has been referred to a respiratory clinic. Both are women, and both contracted Covid-19 at work.

I firmly believe that Covid-19 and long Covid are industrial diseases that remain unclassified, especially since Public Health Scotland has stated that healthcare workers are three times more likely to be hospitalised from it. Industrial injuries benefit does nothing for those who catch Covid-19 at work. Will the First Minister say to those key workers who are still suffering how the newly devolved employment injury assistance will support key workers who have long Covid, particularly since they are in female-dominated workplaces, which have been largely ignored by the current industrial injuries scheme?

The First Minister

That is an important point. I am not able to answer it in detail right now. I undertake to take that away and look specifically, within the devolved benefits for which we are now responsible, at whether and to what extent we should and could be looking at providing support for those who may live with long Covid for some time. It is a very legitimate point to raise. Among the other work that we are doing on understanding and responding to the challenges of long Covid, I undertake today that we will consider that and come back to Mark Griffin, and to the Parliament more generally, in due course.

The Presiding Officer

We turn to supplementary questions.

Health Service (Winter Pressures)

Clare Adamson (Scottish National Party, Motherwell and Wishaw)

The winter often brings pressures on our health service, which we are used to and which are well understood, but this year those pressures are compounded by the Covid outbreak. Will the First Minister update the Parliament and my constituents on the best ways to protect the health service and to access urgent medical care over the festive period?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

All health boards, including NHS Lanarkshire, which covers the member’s constituency, are under serious pressure right now. We continue to support health boards as much as possible. The health secretary recently launched our redesign of urgent care programme, which aims to ensure that people are seen safely during winter and can access the right care, in the right place and at the right time. We have increased funding to the health and care sector, to help it to deal with Covid.

I encourage everyone to do all the things that all of us need to do to suppress the virus, and to continue to use the health service when they need it, through the usual channels of NHS 24 and—of course only where necessary—accident and emergency and our Scottish Ambulance Service. The health service is under huge pressure right now, but it remains open for those who need it.

Stone of Destiny

Elizabeth Smith (Conservative, Mid Scotland and Fife)

Will the First Minister join me in congratulating all those who have been involved in the hard and successful work to persuade Her Majesty the Queen and the commissioners for the safeguarding of the regalia that the stone of destiny should return to its spiritual home in Perth, with all the economic benefits that that will bring?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

This a phrase that in my younger days I would probably never have predicted that I would utter: as one of the commissioners for the safeguarding of the regalia, I am pleased that we were able to announce today, with the consent of Her Majesty the Queen, the relocation of the stone of destiny to—and I agree with Liz Smith’s use of this term—its spiritual home, which is Perth. I think that many members were delighted years ago to see the stone of destiny return to its rightful home in Scotland; now it will return, in due course, to be the centrepiece of the redevelopment of Perth city hall. That is really good news.

I thank the people in Edinburgh who safeguarded the stone so well over the years, and I am sure that everybody will be delighted—[Interruption.] Well, I am sure that the Edinburgh members are as delighted as the rest of us are that, in the next few years, we will all be able to go to Perth to see the stone of destiny.

The Presiding Officer

We come next to Neil Findlay.

I am sorry, Mr Findlay—your microphone is muted. We will try one more time.

Mr Findlay, we will come back to you in a few minutes.

British Transport Police

Christine Grahame (Scottish National Party, Midlothian South, Tweeddale and Lauderdale)

I thank the First Minister for making it clear that, for people who live in the eastern Borders, travel to Berwick—to Morrisons for groceries, for example—can be essential.

Given that the British Transport Police is responsible for policing the rail network, including the Borders railway, how will the BTP liaise with the Scottish Government and Police Scotland on cross-border travel?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

I thank Christine Grahame for taking a responsible approach in standing up for her constituents to ensure that they can travel for essential purposes, while recognising the public health need to limit travel in the way that we are doing.

Christine Grahame is right to point to the role of the British Transport Police. When the chief constable joined me for one of the daily updates earlier in the week, he set out that Police Scotland is in close liaison with the British Transport Police, which is taking—in what is, of course, an operational matter for it—the same proportionate and sensitive approach on the railways as Police Scotland is taking in relation to what are operational matters for it elsewhere. I am very grateful for that.

The Presiding Officer

I will go to Sarah Boyack while we try to reconnect to Neil Findlay.

Vaccination Programme

Sarah Boyack (Labour, Lothian)

Last week, we had an excellent briefing from NHS Lothian. Delivery of all three waves of the vaccination programme will take a long time and full roll-out will take six to eight months. Although the first wave is under way, by the end of March only people over 65 and those who have specified conditions will have been vaccinated in phase 2. What does that mean for keeping key workers safe while they must still take safety precautions and wear personal protective equipment? What does it mean for keeping our schools open and keeping safe all the staff who support our school students?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

I am happy to consider any specific detail that NHS Lothian provided, but I will respond in terms of the general overall programme, and about our ambitions for it and our determination to carry it out. The biggest and central constraint on our ability to be absolutely definitive about that is supply of the vaccine, which is a massive logistical exercise that health boards are working extremely hard on.

However, vaccine supplies permitting, our intention is to follow the Joint Committee on Vaccination and Immunisation priority list, which means that we will have vaccinated everybody over the age of 50 by the spring, if we can. As we go into the summer, the rest of the population will follow. That is not an easy undertaking and it involves a lot of planning and logistics but, as long as the supplies come in the timeframe that we expect, we are confident that we can achieve that.

As I said earlier, more than 50,000 people in Scotland have already had their first dose of the vaccine, which is very good progress, given the short period in which supplies have been available.

National Tutoring Programme

Jamie Greene (Conservative, West Scotland)

The First Minister might be aware of warnings from Professor Lindsay Paterson that plans for blended learning might only exacerbate the attainment gap that we are all trying to close. He is not the only one; our inboxes are full of emails from parents who have genuine concerns about the further loss of face-to-face teaching and wonder why, on one hand, they are told that schools are safe but, on the other, are asked to keep their children at home.

Will the First Minister finally give serious and sensible consideration to our proposals for a national tutoring programme, which has the simple aim of helping the young people who are at the greatest risk of falling behind in their education?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

Tutoring is available through the e-Sgoil initiative, and we can make details of that available.

I do not want young people to have blended learning if we can avoid it. We have made it a priority to have schools open full time and, in my view, that has happened safely and successfully until now. In the past week or so, what has changed is the new variant of the virus, which we are still trying to understand. As I have set out before, we know that it appears to be more transmissible but, as I said yesterday, we do not yet fully understand whether, as some scientists think might be the case, it is infecting children and young people more easily than previous strains did. In those circumstances, we have a duty to be precautionary until we have greater clarity and understanding of that.

We want to get schools back full time as quickly as we can, which we very much hope will be from 18 January. However, we have been candid with parents that, in the circumstances, we must keep that under review. In any period in which blended learning is necessary—whether that is for all schools, which I very much hope will not be the case, or whether that is on a school-by-school basis, which might sometimes be the case, depending on local outbreaks of the virus—we will do everything that we can to make sure that those who are not in school have the support that they need.

Care Home Visiting

Neil Findlay (Labour, Lothian)

Yesterday, care homes were advised that, under new level 4 restrictions, only essential outdoor visits—in Scotland in December—can take place and that only one visitor is allowed for outdoor visits.

This week, the Equality and Human Rights Commission produced a scathing report about human rights abuses of older people in care homes. Why has the Scottish Government ignored the commission’s findings in the publication of the new care home guidance? Should effective infection control measures not facilitate rather than prevent safe family contact?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

Yes, they should, and that is what we tried to achieve. We are not ignoring the Equality and Human Rights Commission, but we are listening to the clinical advice that we are getting. The chief nursing officer and chief medical officer have written this week to care home managers to outline what the level 4 restrictions—which will come into place on Saturday for most of Scotland—will mean for care homes.

Those decisions are not taken lightly. All that I can do is repeat that we are faced with a strain of the virus that appears to be spreading perhaps 70 per cent faster than previous strains. We do not yet know all the implications of that or why that is the case. Therefore, difficult though it is for everybody who is affected—I am under no illusions about that—again, we must act on a highly precautionary basis.

Rightly and properly, we talk here about—and, rightly and properly, the Government gets acute scrutiny on—the number of people who have died in our care homes and the conditions that people who live in our care homes have had to ensure. All of us decision makers feel the burden of that very heavily, indeed, but that also makes it more important that we are very careful about the decisions that we take.

I very much hope that we get better news about the new variant that makes us all less concerned than we are at the moment, or that, in a few weeks’ time, we are more confident in our ability to suppress it and that we can quickly get back to where we were in trying to open up care homes to visitors. However, all of what we are doing at the moment—people might agree with it or disagree with it, which is understandable and legitimate—is being done with the intention and the desire to keep people in care homes as safe as we can.

Dementia Support

Emma Harper (Scottish National Party, South Scotland)

What is the Scottish Government doing to support people with dementia and their carers during the pandemic?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

The dementia and Covid national action plan was published yesterday, and it has been endorsed by the Convention of Scottish Local Authorities. The plan is the result of extensive engagement with stakeholders, including people with dementia and their carers. Pre-Covid, estimated annual spend on dementia by health and social care partnerships had already increased significantly, but the plan sets out work with COSLA, health and care partnerships and Alzheimer Scotland to review and assess the provision and the design of post-diagnostic services, to identify best practice and to look at the barriers that exist to further expansion of the services.

The plan also details work that we have undertaken to ensure that all carers have access to short breaks that are suitable for those who are self-isolating and physical distancing through the £3 million voluntary sector short breaks fund. Unpaid carers of loved ones with dementia will also get more support, with new funding for counselling being provided through Alzheimer Scotland.

Planning (Flamingo Land Ltd)

Ross Greer (Green, West Scotland)

My constituents in Balloch were, frankly, gutted to discover yesterday that the Scottish Government’s enterprise agency has extended the exclusivity agreement given to Flamingo Land Ltd for the development of a private resort on what is currently publicly owned land at Loch Lomond. The fact that our community campaign against Flamingo Land’s unsuccessful first proposal lodged more than 60,000 objections made that application the most unpopular application in Scottish planning history. Now, we face months and—in all likelihood—years more of a saga that should have ended this year.

Why is the First Minister’s enterprise agency so unwilling to accept that Flamingo Land is the wrong developer and that its proposal is the wrong development, which would cause unacceptable damage to the local environment and community, and that it is simply utterly unwelcome within our world-famous national park?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

As I understand it, such decisions are not really decisions for Scottish Enterprise. Scottish Enterprise will sell the land at West Riverside to Flamingo Land only if a new planning application is consented. Loch Lomond and the Trossachs National Park Authority is the planning authority, and it will be the body that considers any new planning application that is submitted to it. As I understand it, a new proposal has not been lodged with the national park authority.

It is really important that the processes in question are robust, and it is probably important that I do not express views on them at this stage. Given that I was involved in not dissimilar issues in my constituency quite a few years ago, I absolutely understand the concerns of the public on such issues, but I think that it is important that the processes are followed appropriately, and they will be.

Outdoor Activity (Nursery-age Children)

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

What measures are in place to ensure that our nursery-age children can continue to enjoy learning and having fun outdoors in the winter months in the light of the current pandemic?

I would like to take a cheeky opportunity to pay tribute to the absolutely fantastic and amazing Gaelic nursery at Tollbrae primary in North Lanarkshire, which serves kids across the council area and which my youngest son attends, and to wish its staff and all early years workers a merry Christmas.

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

I join Fulton MacGregor in wishing his son’s Gaelic nursery a very happy Christmas and thanking it for all that it does. Given that I have met him a few times, I also take the opportunity to wish Fulton MacGregor’s son—in fact, both his sons—a very happy Christmas. [Interruption.] I have been challenged to do it in Gaelic, but I think that that would be a challenge too far for me to even begin to accept. I will get Kate Forbes to give me some lessons later.

Fulton MacGregor raises an important point. Playing, learning and having fun outdoors is really important for everybody’s mental and physical health, but it is particularly important for that of children. Even though the new strain of the virus might be 70 per cent more transmissible, we still believe that it is less transmissible outdoors than it is indoors. That is an important principle for all of us to bear in mind. Guidance for childcare settings advises them to maximise the amount of time that is spent outdoors.

We announced a winter outdoor clothing fund to ensure that more children are able to spend time outdoors as part of their funded nursery experience, and that should help to reduce inequalities for children whose parents perhaps cannot buy suitable winter clothing just because we are in a pandemic.

We also fund Virtual Nature School, which provides training and support to early learning and childcare practitioners. More than 1,000 practitioners and 40,000 families have benefited from that programme, and I know that a further 500 teams will take part in the winter programme to support the delivery of high-quality all-weather outdoor experiences.

Mental Health Support Service (Vale of Leven Hospital)

Maurice Corry (Conservative, West Scotland)

Presiding Officer, I have some good news for you. Yesterday, a new mental health support service was officially launched at the Vale of Leven hospital in my West Scotland region as a result of my working with the Defence Medical Welfare Service and NHS Greater Glasgow and Clyde. That demonstrates the effectiveness of the armed forces community covenant in our area. The service will make the Vale of Leven hospital a rising centre of excellence in mental health support work, with several patients and the hospital staff already benefiting immensely.

Will the First Minister join me in congratulating Bob Reid, Scottish director of the Defence Medical Welfare Service; Margaret O’Rourke, operations manager at the Vale of Leven hospital; and NHS Greater Glasgow and Clyde on launching that excellent new service at the Vale of Leven hospital at a time when we need mental health support more than ever?

Nicola Sturgeon (Scottish National Party, Glasgow Southside)

Yes. I am delighted to whole-heartedly agree with that and thank all those who are involved in the new service at the Vale of Leven hospital. I am sure that it will be a shining example of that type of service.

We have had different groups of people to thank today, and I take this opportunity to thank our armed forces and everybody who serves. Many of them are used to experiencing what some will be experiencing for the first time this year: spending Christmas away from their families. I recorded a happy Christmas message to them yesterday evening, but I say that again today on behalf, I am sure, of us all. We owe them an enormous debt of gratitude and, wherever they are right now, we wish them and their families a very happy Christmas.

As this is, I think, my last answer, Presiding Officer, I end by wishing you, the Parliament and everybody across Scotland at this very difficult Christmas the happiest one possible.

The Presiding Officer

Thank you, First Minister. That concludes First Minister’s question time. Before we move on to portfolio questions, there will be a short pause while we change seats.

Education and Skills

Christine Grahame (Scottish National Party, Midlothian South, Tweeddale and Lauderdale)

Any member who wants to ask a supplementary question should press their request-to-speak button or, if they are participating remotely, indicate that in the chat box.

Education (Attainment Gap)

Finlay Carson (Conservative, Galloway and West Dumfries)

1. To ask the Scottish Government what progress has been made on closing the attainment gap between pupils from the most and least deprived backgrounds. (S5O-04873)

John Swinney (Scottish National Party, Perthshire North)

The attainment Scotland fund year 4 evaluation reported that the attainment gap had narrowed on a number of indicators and that 91 per cent of headteachers reported improvements as a result of the Scottish attainment challenge.

The equity audit, which we will publish in the new year, will provide a further assessment of the pandemic’s impact on pupils from disadvantaged backgrounds. In the meantime, the international council of education advisers recognised in its report last week that

“Scottish education exhibits many strengths”,

among which is the value that we place on equity as well as excellence. That is why we will continue to invest in the Scottish attainment challenge in 2021-22, including with over £127 million in pupil equity funding.

Finlay Carson (Conservative, Galloway and West Dumfries)

Can Mr Swinney be confident in his claims that the attainment gap is closing in areas such as Dumfries and Galloway when, according to Professor Lindsay Paterson, who is a professor of education policy in the school of social and political science at the University of Edinburgh, no Scottish national standardised assessment data has been collected in my constituency since the assessments were introduced, in 2018?

John Swinney (Scottish National Party, Perthshire North)

We decided not to collect the achievement of curriculum for excellence levels data, which should have been collected in June, because of the pandemic and the disruption to education. We will return to the collection of that data at the earliest possible opportunity, and I will aim to do that in June 2021. That will enable us to continue to build the data that demonstrates the progress that we are making. Of course, we have published data over a number of years to demonstrate the progress that has been made, and we will return to that at the earliest possible opportunity.

Iain Gray (Labour, East Lothian)

We know that the period of remote learning earlier this year compromised progress on closing the attainment gap, and we now face a further period of remote learning, which will perhaps be short, although we do not know. A few minutes ago, the First Minister referred to a tutoring scheme through e-Sgoil that is designed specifically to address that. Can the cabinet secretary give us more details and tell us how many pupils have benefited from that scheme?

John Swinney (Scottish National Party, Perthshire North)

Supported study activity undertaken by e-Sgoil is available to pupils the length and breadth of the country. I do not have it in front of me, but I would be very happy to provide members of Parliament with data on the extent of the utilisation of that service.

Obviously, a range of services are provided through the e-Sgoil network, which involves supported study to reinforce the work that is going on in schools. It also includes a collection of recorded lessons, to which teachers the length and breadth of the country are contributing, and the provision of direct educational delivery where we have, for example, interruptions to education as a consequence of temporary school closure.

All of that builds on the offering that is developed in individual schools to make sure that digital learning is available in all schools around the country.

The Deputy Presiding Officer

Question 2 was not lodged.

Covid-19 (Instrumental Music Tuition)

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

3. To ask the Scottish Government what action it is taking to support schools in safely facilitating instrumental music tuition during the Covid-19 pandemic. (S5O-04875)

John Swinney (Scottish National Party, Perthshire North)

Music is an important part of curriculum for excellence. Covid-19 presents an additional challenge, but I am pleased to say that schools and teachers have risen to the challenge creatively to ensure that young people continue to benefit from music education.

In addition to providing guidelines on risk mitigations that schools should have in place, Education Scotland has worked with teachers across the country to collect and share emerging practical examples of how teachers are managing music learning under Covid-19. Creative ideas include the use of music technology apps on smartphones, running online masterclasses with professional musicians and using technological solutions to facilitate rich and rewarding physically distanced lessons.

A new version of Education Scotland’s music guidelines, which was published on 18 December, set out new thinking on how to manage brass, woodwind and voice lessons effectively, following further clinical advice.

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

I thank the cabinet secretary for that very positive response. Music tuition has always played an important role in the secondary schools in my constituency, with St Ambrose, St Andrew’s, Coatbridge and Chryston high schools all having a proud history. Of course, music offers one route out of poverty for people in our communities.

I have been contacted by pupils who have been impacted by current restrictions on their music tuition, and by their parents. One specific question that has been put to me is about the provision of bell covers for brass instruments, which help to stop the spread of the virus while allowing learning to continue. Has the Government given any consideration to that?

John Swinney (Scottish National Party, Perthshire North)

I can certainly corroborate Mr MacGregor’s points about the quality of music tuition, having witnessed that with my own eyes and ears on my visit to St Ambrose high school, in his constituency.

Guidance on Covid and music tuition that was published by Education Scotland includes advice on brass and wind instruments and is informed by expert public health and scientific advice. At present, the advice is that young people should not engage in playing wind and brass instruments with other people, given that those activities pose a potentially higher risk of transmission.

That does not mean that those activities cannot take place at all, however, and creative approaches may be taken to the provision of those lessons. The examples that have been given include the use of technology to facilitate collective participation. Brass, woodwind and singing candidates have now been given permission by the Scottish Qualifications Authority to choose to record assessment performances at home during Covid-19 restrictions.

We will keep the guidance under close review and will give consideration to any further mitigations that might help to support the safe provision of music tuition in schools.

The Deputy Presiding Officer

Mary Fee has a supplementary question, but we cannot contact her, so we will move on. I will come back to her if we manage to contact her.

Questions 4 and 5 were not lodged.

Schools (Specialist Support Staff)

Johann Lamont (Labour, Glasgow)

6. To ask the Scottish Government what its response is to the reported decreasing trend in specialist support staff in schools. (S5O-04878)

John Swinney (Scottish National Party, Perthshire North)

Specialist support staff and teachers play a vital role in supporting their pupils. We have continued to support the recruitment of additional teaching and support staff this year to ensure that children and young people receive the support that they need with their learning. Current figures indicate that 246 support staff have now been recruited. Our funding support includes an additional £5 million to local authorities, which is in addition to an additional £15 million every year to further enhance staffing capacity to respond effectively to the individual needs of children and young people.

Johann Lamont (Labour, Glasgow)

In a submission to the Public Petitions Committee on the role of specialist support staff for young people with additional support needs, the Educational Institute of Scotland reported a pattern over 10 years of a decreasing number of staff and an increasing number of children with additional support needs.

The Tes newspaper recently reported that nine councils had taken on no new support staff during the pandemic and that

“in over half of Scottish councils, special schools received no additional teaching staff to help them cope with the return to school during the pandemic.”

We can see that young people with additional support needs were already being let down. That disadvantage will be magnified immeasurably by the impact of the pandemic.

What practical measures—measures that are properly resourced and focused on already hugely disadvantaged young people—will the cabinet secretary take to reverse the long-term denial of support, which is amplified by the current crisis? Regardless of the figures that he has quoted, surely it is evident that more of the same cannot be an option.

The Deputy Presiding Officer

Can we have shorter supplementaries, please?

John Swinney (Scottish National Party, Perthshire North)

I am sure that Johann Lamont will be familiar with the fact that, as a consequence of the pandemic, the Government has announced additional funding for local authorities, which has resulted in the recruitment of more than 1,400 additional teachers and in excess of 250 additional support staff. That is added to by the previous support of £15 million that was in place for additional support for learning staff.

The number of pupil support assistants and the number of teachers are rising. The number of teachers in Scottish schools is at its highest level since 2008, and rising numbers of staff are coming in as a consequence of the pandemic recruitment. Not all of them will show up in the recent statistics, which showed a 12-year high in teacher numbers.

I acknowledge the importance of ensuring that young people with additional support needs have those needs met by the provision of high-quality learning and teaching staff. The Government is committed to ensuring that that is the case.

The Deputy Presiding Officer

I will take Kenneth Gibson’s supplementary to Johann Lamont’s question before Mary Fee asks her supplementary to Fulton MacGregor’s question.

Kenneth Gibson (Scottish National Party, Cunninghame North)

Since 2009, the number of pupils with additional support needs has rocketed from 37,000 to 208,000—to 27 per cent of primary school children and 35 per cent of secondary school children. It is no wonder that the provision of support staff cannot keep pace. Have additional support needs changed markedly over the past decade, and are they consistent across all schools and local authority areas? When does the cabinet secretary envisage that that meteoric rise in numbers will cease?

John Swinney (Scottish National Party, Perthshire North)

It is important that I explain that there are two main reasons for the increase in the number of children and young people who are recorded as having additional support needs since 2009. The first is that, in 2010, we changed the way in which national statistics on pupils with additional support needs are collected. Prior to then, only pupils with co-ordinated support plans or individualised educational programmes, or pupils who were attending a special school, were captured. The definition was expanded at that stage.

The second reason is that the needs of children and young people are being appropriately identified and recorded, in line with the statutory requirements set out in the Education (Additional Support for Learning) (Scotland) Act 2014. That act provides a national definition of additional support for learning, supplemented by a statutory code of practice. It is important that we ensure that, in all circumstances, the needs of young people are properly recorded and then addressed as a consequence.

The Deputy Presiding Officer

I will now take Mary Fee’s supplementary question to question 3.

Mary Fee (Labour, West Scotland)

Early in December, a report by the Incorporated Society of Musicians showed that Scotland has been the most negatively impacted country of the four United Kingdom nations in terms of the provision of music tuition across primary and secondary schools during the pandemic. Some teachers have highlighted concerns that local authorities are interpreting the guidance in different ways. I welcome the cabinet secretary’s comment about updated guidance, but what further steps can he take to ensure that music tuition takes place safely and consistently across Scotland?

John Swinney (Scottish National Party, Perthshire North)

I hope that my earlier answer to Mr MacGregor reassured Mary Fee that the Government attaches the greatest importance to ensuring that music tuition is part of Scotland’s curriculum and is delivered as effectively and as consistently as possible in our 2,500 schools.

It is important that music education forms part of the curriculum for young people of all ages. It is fundamental in our primary education system and, of course, as I expressed in my answer to Mr MacGregor, it can provide an important route for young people to fulfil their potential in secondary education.

Of course, there are some challenges in relation to the delivery of music education because of the need to minimise the transmission of the virus, and I very much regret that those constraints are in place. However, the guidance from Education Scotland is designed to find ways in which we can still enable, in these difficult and constrained circumstances, the delivery of effective music education. I give Mary Fee the assurance that that will be a priority for the Government in our dialogue with local authorities and schools.

School Exams Cancellation (Pupils in Socially Deprived Areas)

James Kelly (Labour, Glasgow)

7. To ask the Scottish Government what action it will take to ensure that school pupils in areas of social deprivation will not be unfairly affected by the cancellation of exams. (S5O-04879)

John Swinney (Scottish National Party, Perthshire North)

On 8 December, in acknowledgement of Covid-related disruption to young people’s education this academic year, I outlined to Parliament that national qualifications in 2020-21 will be awarded on evidence of demonstrated attainment, supported by local and national quality assurance processes. I have judged that that approach is the safest and the fairest way to ensure that individual learners’ achievements are recognised. The alternative certification model offers flexibility and will help to alleviate some of the impacts on learning.

Collaboration from across the education system will ensure that the assessment and quality assurance approach for 2020-21 is clearly communicated, and that appropriate support for teaching staff and learners is in place.

James Kelly (Labour, Glasgow)

In considering the alternative certification model, it is important that there is no repeat of the debacle of earlier this year, when, despite assurances from Mr Swinney on the initial awarding of grades, pupils in areas of social deprivation were unfairly affected.

What steps will the Deputy First Minister take to ensure that the alternative certification model is fair and transparent and ensures that pupils in areas of social deprivation receive fair and equitable treatment?

John Swinney (Scottish National Party, Perthshire North)

On transparency, the details of the model have been published by the Scottish Qualifications Authority, which has led on its development. It is crucial for Parliament to recognise that the model has been developed collaboratively with directors of education, professional associations and the college network in Scotland. Its development has been led by the Scottish Qualifications Authority, which has engaged substantively with young people and the education profession around these questions. There is a transparent explanation of the model.

The application of the model will be driven by the demonstrated attainment of young people. That will be influenced by local and national quality assurance processes, which are being established and which will engage the teaching profession in taking forward those priorities to ensure that there is fairness to all candidates.

The Deputy Presiding Officer

Maureen Watt, your question will be called next but your card is not showing up. The console that you are sitting at is the console that I sit at, so I am vindicated—it must be faulty. I will call you after Jamie Greene, if you move.

Jamie Greene (Conservative, West Scotland)

I am glad that my card is working, Presiding Officer.

The previous question was perfectly reasonable, because those in our most-deprived communities were twice as likely to have their grades downgraded by the national moderation scheme this year.

The devil will lie in the detail: it is not just transparency that we need—it is detail. Will the cabinet secretary tell us exactly how and why the Scottish Qualifications Authority is taking that approach? Will there be national moderation, or will the cabinet secretary guarantee that individual moderation will take place in the case of every pupil?

John Swinney (Scottish National Party, Perthshire North)

The member asks how moderation works in the model. Support will be provided in advance of any formulation of estimated grades by the teaching profession to enable staff to understand the standards that are anticipated in all national qualifications. Schools will then be provided with materials—which are now available—that contain assessment exercises that young people can complete in their routine school activity. Teachers can assess the completed exercises against the standards that are expected. There will be moderation by SQA appointees, who will work with individual schools, and there will be local authority support for the process into the bargain. Crucially, the model relies on the whole of the education system playing its part in delivering that moderation. From all that will come estimated assessments.

It will of course be necessary to look across the system to ensure that consistency of judgment is being applied. However, there is time to do that. I remind Parliament that I took these decisions much earlier in the academic year than was the case last year, when the circumstances made that necessary. This year, there is time for that dialogue and that moderation to take place to ensure fairness for all candidates.

Covid-19 (Testing in Schools)

Maureen Watt (Scottish National Party, Aberdeen South and North Kincardine)

8. To ask the Scottish Government whether it will provide an update on the Covid-19 testing measures in primary and secondary schools. (S5O-04880)

John Swinney (Scottish National Party, Perthshire North)

On 25 November, we committed to undertake a number of pathfinder testing programmes upon the return of schools in January. As the Cabinet Secretary for Health and Sport set out in her statement earlier today, we have been working closely with a group of interested local authorities and volunteer schools to develop detailed plans. The schools involved will communicate with their staff, pupils and local communities in due course to ensure that they are informed about and comfortable with the plans.

We expect those pilots to inform the development of a scalable and sustainable approach to asymptomatic testing in schools. Those plans are in addition to the asymptomatic testing route that is available for school staff via the employer referral portal.

Maureen Watt (Scottish National Party, Aberdeen South and North Kincardine)

Perhaps the cabinet secretary could tell me whether schools in Aberdeen city or Aberdeenshire are taking part in those tests.

Schools will now be returning later and via staged learning. Does the cabinet secretary believe that that will allow time to ensure that any proposed testing will be taken forward in a manner that reflects and acts on the views of teachers and parents?

John Swinney (Scottish National Party, Perthshire North)

I will have to return to Maureen Watt on the specific question of whether any Aberdeen city or Aberdeenshire schools are involved in the pilots. From my recollection, I do not think that any are, but I will confirm that in writing to her.

It is important that we take the greatest of care in the implementation of such a testing approach. It is crucial that the testing environment is delivered effectively and sustainably, and the phased reopening of schools in January will give us the opportunity to do some of that work.

I reiterate the importance that I attach to the commitment that the health secretary gave to the provision of an asymptomatic testing route for school staff via the employer referral portal. That is an important part of the extra provision that is available for school staff in order to provide greater reassurance.

The Deputy Presiding Officer

Daniel Johnson has a brief supplementary.

Daniel Johnson (Labour, Edinburgh Southern)

Testing is an important precaution as we seek to reopen schools, but it would be made unnecessary by vaccine roll-out. Will the Scottish Government prioritise teachers and school staff to follow on from health and social care workers and receive the vaccine as a matter of priority?

John Swinney (Scottish National Party, Perthshire North)

I acknowledge the importance of ensuring that reassurance is provided for teaching and all other school staff, but the Government has accepted the clear advice of the Joint Committee on Vaccination and Immunisation on the prioritisation that should determine the delivery of the vaccine. Mr Johnson will be familiar with the prioritisation that has been put in place by the JCVI.

Obviously, some teachers will be involved in the vaccination process earlier than others, because of the degree of prioritisation that has been put in place by the JCVI. The Government will at all times carefully seek to ensure that we continue the safe delivery of education in our schools. That will be an on-going priority for the Government.

The Deputy Presiding Officer

That concludes questions on education and skills. Before we move on to questions on health and sport, I should point out that, because three education questions were not lodged, I could allow longer questions and answers. That is not the case for questions on health and sport. I am just eyeballing those members whom I can eyeball to make sure that they understand that. Oh dear! I don’t feel Christmassy at all, despite my little bit from the Christmas tree.

Residential Drug Rehabilitation (Impacts)

Miles Briggs (Conservative, Lothian)

1. Presiding Officer, I think that we are all in shock that you are giving us more time, but the season of good will seems to have reached the Parliament.

The Deputy Presiding Officer

You were not listening, Mr Briggs—I am not.

Miles Briggs (Conservative, Lothian)

To ask the Scottish Government what impact any reduction in residential drug rehabilitation treatments has had on recovery rates and the level of drug-related deaths. (S5O-04881)

Angela Constance (Scottish National Party, Almond Valley)

Residential treatment plays an important role in supporting recovery and in preventing drug-related harm and deaths. The residential rehabilitation working group has now provided advice on how we ensure that everyone who requires residential rehab has access when they need it. We will respond to all the recommendations made by the working group and, in the new year, set out how we will substantially increase the provision of residential treatment in the short term.

Miles Briggs (Conservative, Lothian)

I thank the minister for her answer, and I welcome her to her position. We all must wish her well in trying to turn this situation around.

It is now widely accepted that cuts to drug rehab beds and addiction programmes have been hugely damaging to the reduction of drug-related deaths across Scotland. Will the Scottish Government now agree to review the methadone programme and undertake a review of treatment option assessment and access to treatment across the country?

Angela Constance (Scottish National Party, Almond Valley)

Mr Briggs was the first parliamentarian to write to me, last Friday night at 10 o’clock, and he is the first parliamentarian to ask me a parliamentary question.

Let me be clear with him. I am committed to residential rehab, as I know the power that it has to change lives. I am also committed to offering a full range of treatment options to ensure that people get the right care, treatment and support at the right time. There is a substantial body of evidence that supports having a methadone programme.

We must stop talking about people whose lives are blighted by drugs as though they are one big, homogeneous group, because they are not. Different treatments and different supports will work for different people at different times in their lives. However, I reassure the member that medical approaches have their place, as do rehabilitation and services in the community.

Monica Lennon (Labour, Central Scotland)

I, too, welcome the minister to her post and am grateful for the discussions that she and I have had so far. Will she say a bit more about how she will engage with people who have experience of residential rehab and treatment, their families and service partners?

Will the minister also say something about the festive period? Some people are worried about how they are going to cope with their addiction or dependency during this time, especially in the light of the further restrictions that are coming. A lot has been done to get people online for 12-step meetings and so on, but this is a worrying time, especially for families. What can the minister say to those people?

Angela Constance (Scottish National Party, Almond Valley)

My engagement has already started. The first people I have met in my role as minister have been people with lived experience, and I have also spoken to people whose families have been devastated by addiction and drug use.

The member made points about the pandemic and how increasing restrictions bring the danger of increasing isolation. It is that isolation that our services on the ground, including our emergency response, must overcome to reach people—and when we reach them, we must keep hold of them. We know that people with addiction problems have good times and bad times, and we have to work with them, put our arms around them and see them through both on their journey to a full and better life.

Cancer Services

Anas Sarwar (Labour, Glasgow)

2. To ask the Scottish Government when cancer services will be fully restored. (S5O-04882)

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

With your permission, Presiding Officer, before I answer the question, I will put on record my congratulations for a number of important senior appointments that have been made today in health. I congratulate Dr Smith, who has now been confirmed as our chief medical officer, Professor Amanda Croft, our new chief nursing officer, and Caroline Lamb, the chief executive of NHS Scotland and director general for health and social care. They are an absolutely excellent team who will serve us well, I am sure.

NHS Scotland has continued to provide emergency and urgent care throughout the pandemic and will continue to do so. There have been occasions when, as a clinical judgment, clinicians have wished to make changes to individual treatment plans in the light of the infection threat of the virus to a particular patient.

Cancer screening services have all now restarted. The services have resumed in a phased, careful and prioritised way as part of the remobilisation of our health service, with the initial focus on higher-risk screening participants. Good progress has been made in the first stages, with routine screening appointments now taking place for breast cancer and cervical cancer, and bowel screening home testing kits have been posted out since 12 October.

On 9 December, I announced and published the cancer recovery plan, which was devised with many of our very experienced cancer charities as well as with our clinical advisers. It includes planned investment of up to £114.5 million to ensure that cancer patients have equitable access to care regardless of where they live. The cancer recovery plan will improve patients’ experience of care and will roll out innovative treatments to improve cancer services.

Anas Sarwar (Labour, Glasgow)

I thank the cabinet secretary for that full response, and I welcome the new appointees to their roles. I look forward to working with them in the coming months.

I have been raising the issue of cancer services from the outset of the pandemic, as well as the fear about the impact that it will have on long-term cancer survival rates. Public Health Scotland’s statistics show that, between July and September, there was a 24 per cent drop in the number of suspected cancer patients being referred. Cancer Research UK also estimates that 1,560 fewer patients have started their cancer treatment compared with the equivalent three-month period last year.

We will face a tsunami of cancer cases in the next year, so I ask the cabinet secretary what statistics are being produced on the excess number of cancer deaths that we are expecting. When will we be able to have confidence that we have a fully returned cancer service at pre-Covid levels of service?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I am grateful to Mr Sarwar and acknowledge his long-standing interest in this area—more than that, his effective scrutiny and, at times, his challenge of what we are doing to make sure that we do not take our focus away from this really important area.

The cancer recovery plan—[Interruption.] I will answer the specific question that has been asked—offers a number of particular and immediate steps that will help with early diagnosis, including two new early cancer diagnostic centres that will be established within our existing infrastructure by the spring of next year and, importantly, a single point of contact for cancer patients that supports them throughout the various stages of their journey.

Notwithstanding the member’s point about statistics, our most recently published cancer waiting times, which were for quarter 3, showed that the 31-day target was being met in 98.4 per cent of cases. The member will know that the target is 95 per cent. However, our 62-day target is the key target that we are now focused on meeting in order to get people a cancer diagnosis as early as possible.

I have been very clear with health boards that, as we see increased numbers of Covid-19 cases putting pressure on particular acute settings in different parts of the country, with the trade-off often being that boards have to pause elective and planned work, the one thing that we will not pause is the cancer screening programmes. We will keep them going because they are critically important.

On the member’s specific question, we have asked Public Health Scotland to look at how it can robustly gather that data so that we have as full an understanding as possible of the scale of the challenge that we now have to address and can direct our resources accordingly.

The Deputy Presiding Officer

I appreciate that these answers are very important, but I ask for briefer answers so that I can get everyone in for these essential questions.

National Health Service (Additional Support)

Jamie Halcro Johnston (Conservative, Highlands and Islands)

3. To ask the Scottish Government what additional support the NHS will require over the first quarter of 2021. (S5O-04883)

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

We have, so far, provided £1.1 million of additional funding to support the NHS in its response, and, as I have said previously, further funding will be allocated in January. Work is now under way with boards and our partners in social care to identify in greater detail exactly what is required from January onwards. Once we have concluded that work, we will make that detail clear to members and it will be covered in the statement that Kate Forbes will make later in January.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

The attention of many in the national health service is, understandably, focused on the coronavirus pandemic and the efforts to protect communities across Scotland. However, as is usual at this time of year, the routine work of the health service will also be affected by seasonal issues, and increased pressure will be put on local services and health staff.

What concerns does the cabinet secretary have about the impact of both the pandemic and normal winter issues on locally delivered routine health services over the next three months? I am thinking, in particular, of those in remote and rural areas, of which there are many in my region. What further impact may routine services face as a result of any—very welcome—increased roll-out of new coronavirus vaccines over that period, and how can the Scottish Government provide additional support to minimise that impact?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

That is a detailed question that deserves a detailed answer, so I give a commitment that I will write to Mr Halcro Johnston later with more information. I would point him now to two things: our NHS winter preparedness plan and, for the first time ever, our equal plan for social care, which seeks to enable us to maintain services and deal with—as far as we can—the backlog in non-Covid health and social care support and services, both of which have additional resources attached to them.

As I have said many times, there is always a trade-off. The more that we—individually and collectively—suppress the virus, the more our NHS is able to deal with non-Covid cases. Where we are not successful in doing that, pressure is put on our services to deal with Covid cases in both primary and secondary care. That inevitably reduces the degree to which we can cope with non-Covid healthcare, which is itself vitally important. As I said, I will write to the member with more detail.

The Deputy Presiding Officer

I ask members not to slip in multiple questions, because they will—quite rightly—not get a specific answer. I call Alasdair Allan to ask question 4. I hope that he has learned a lesson from that. I am sure that he has.

Patient Travelling Expenses Scheme (Review)

Alasdair Allan (Scottish National Party, Na h-Eileanan an Iar)

4. I would not dare do anything else, Presiding Officer.

To ask the Scottish Government what issues will be covered in its upcoming review of the patient travelling expenses scheme. (S5O-04884)

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

The review will cover the scope and arrangements that are in place across Scotland for the provision of financial support for patient travel, where such travel is necessary. It will include consideration of specific issues that have been highlighted to me by members, including Dr Allan, in relation to constituents’ concerns. It will be undertaken early in the new year, and I will provide further updates in the chamber as it progresses.

Alasdair Allan (Scottish National Party, Na h-Eileanan an Iar)

Islanders who are going through something as traumatic as a cancer diagnosis need support. In too many cases in the past, their loved ones have not been able to be present with them. Since the patient escort working group was formed last year to examine those issues, there has been a marked decrease in the number of complaints concerning the issue. Will the Scottish Government’s review consider those issues, and will there be an opportunity for the working group to feed into that work?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I am grateful to Dr Allan because he has ensured, over this period, that I fully understand the issues that are involved. I am pleased that there has been an improvement of the type that both he and I have sought. The review will absolutely consider the issues that members have raised, and it will include the matter of escorts. I expect the work of the Western Isles patient escort working group to be considered fully as part of the review.

Grass-roots Sport (Community Health and Wellbeing)

David Torrance (Scottish National Party, Kirkcaldy)

5. To ask the Scottish Government how important it considers grass-roots level sport is to the health and wellbeing of communities. (S5O-04885)

Mairi Gougeon (Scottish National Party, Angus North and Mearns)

The Scottish Government fully recognises the importance of sport and physical activity in communities across Scotland. That is why the strategic framework allows sport and physical activity to take place at all levels. The Scottish Government has been working with sportscotland and sporting governing bodies to produce guidance to ensure that grass-roots sport can take place when it is deemed safe to do so. I thank the sector for its hard work and patience during these difficult times.

David Torrance (Scottish National Party, Kirkcaldy)

Lower-league football clubs are vital to our local areas. They often bring much more than just an opportunity for people to get involved in physical activity through providing communities with a hub for bringing people together. What efforts are being made to ensure that funding reaches those clubs at this critical time so as to ensure their long-term future?

Mairi Gougeon (Scottish National Party, Angus North and Mearns)

I could not agree more with the point that David Torrance has made. I have seen that in my own constituency, where football clubs have played such a key role in their local communities. As David Torrance highlighted, they do much more than just provide opportunities for people to get involved in physical activities.

Football clubs are at the heart of their communities, but many of them have suffered real hardships due to the necessary Covid-19 restrictions. We absolutely recognise that. Last week, the Cabinet Secretary for Health and Sport confirmed a £10 million grant funding package that covers the entire football pyramid, from the Scottish Professional Football League championship down to amateur and grass-roots clubs. That funding will provide a lifeline for clubs throughout Scotland.

Coronary Heart Disease (Mortality-rate Reduction)

Alexander Stewart (Conservative, Mid Scotland and Fife)

6. To ask the Scottish Government what action it is taking to reduce coronary heart disease mortality rates across all national health service boards. (S5O-04886)

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Between 2009 and 2018, the mortality rate for coronary heart disease in Scotland fell by 32.4 per cent. We have been implementing the actions from the 2014 improvement plan, and a refreshed plan will be published in spring next year. We continue to implement our heart disease improvement plan, which identifies a number of priority areas for improvement.

Progress is being made on all of that, and there is a real focus on new ways of encouraging heart disease patients to influence their treatment, with an emphasis on specialist heart disease rehabilitation, both to reduce mortality and long-term disability and to improve the provision of supported self-management, physical activity and services. As part of the wider women’s health plan, we are developing pathways to raise awareness of heart disease among women and to take action to reduce the disparities surrounding diagnosis and treatment.

Alexander Stewart (Conservative, Mid Scotland and Fife)

In the current heart disease improvement plan, the Scottish Government quotes the fall in mortality rates, which I very much welcome. Can the cabinet secretary share with me the measures of success relating to atrial fibrillation and heart failure, which were two conditions that were explicitly named in the improvement plan as priorities?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I apologise to the member. I do not have the specific detail to answer his question, and I would want to be certain that I was right in the information that I was giving him. Therefore, I would be happy to send him information regarding the specific reductions and improvements in those areas this afternoon.

Covid-19 Vaccine Roll-out

Alex Rowley (Labour, Mid Scotland and Fife)

7. To ask the Scottish Government what progress it is making with the roll-out of the Covid-19 vaccine across the country. (S5O-04887)

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

As I hope Alex Rowley is aware, the statistics that have been published today show that, in the period between 8 and 20 December, 56,676 individuals received their first dose of the vaccine. That is a significant achievement on the part of all those involved in 13 days.

Initial difficulties around the Pfizer vaccine involving storage, transportation and the reduction of pack sizes have been resolved, as I am sure Alex Rowley is aware, so we can introduce the vaccination programme to care homes, as we did on 14 December. We will complete that and begin the second dose.

In line with advice from the Joint Committee on Vaccination and Immunisation, our first priority groups are, of course, health and social care workers and elderly and vulnerable residents in our care homes. Should we have our hope realised that the Oxford-AstraZeneca vaccine will be authorised shortly, we stand ready to deliver it, with a start delivery date of 11 January, depending on authorisation and supplies. That will allow us to begin the vaccination programme for those aged 80 and over in the community, and it will involve using our primary care and other community settings for providing the vaccination programme.

Alex Rowley (Labour, Mid Scotland and Fife)

I very much share those hopes. Perhaps we can all pray over Christmas that the vaccine can be rolled out.

On BBC Radio Scotland this morning, I heard Alison Leitch, whose mother is in a care home in Fife, say that she was advised that, even when her mother got the vaccine, the care home would still not be in a position to get visitors in.

Last week, I visited the Kinross-shire day centre, where staff are on the front line supporting more than 100 pensioners in Kinross. There seems to be a failure of information. Although I welcome the statement that was made earlier, does the cabinet secretary think that we can step up the information sharing so that care homes and centres such as the wonderful Kinross-shire day centre know what is happening?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

That is an important point. I remind Alex Rowley that the third issue of information directly to members is today. Previously, that was from my colleague Mr FitzPatrick; from now on, it will be directly from me. That is up-to-date information, and it will include from today the individual board plans of local vaccination centres. I know that Mr Rowley will want to share that information with his constituents, including those care homes.

Scottish Care is part of our vaccination programme planning. I will raise again with it and other colleagues the issue of communication to their members so that the latter are all aware of what is happening.

Finally, I remind everyone that there is a national helpline for anyone, including care home providers and families, to ask for information about what is happening in their specific area. They will get that to the degree that we can definitively provide it. That is, of course, always with a caveat about the supply of the vaccines.

Emma Harper (Scottish National Party, South Scotland)

What plans does the Scottish Government have in place to promote high uptake of the vaccine among hard-to-reach groups and the wider population? I remind members that I am now part of Dumfries and Galloway’s vaccination team.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Ms Harper is indeed part of that team, and I am very grateful to her for volunteering to do that work.

On reaching groups that do not traditionally have a long engagement with the health service, I am grateful to my colleagues Ms Campbell, who is sitting beside me, and Ms Somerville for their support in helping us to reach those groups through faith groups, cultural groups and those whom we are reaching through our social security agency. In addition, we are looking to work locally with third sector organisations that have a great deal of knowledge in their local area.

We believe that mobile vaccination units, where it makes sense to have them, will increase our chances of people coming forward to be vaccinated. They will come into their own on that. They are not just for remote and rural areas; they are for our urban settings, too, so that we can take the vaccinations to people. The AstraZeneca vaccine will, of course, greatly assist us in doing that.

I should have made the point in response to Mr Rowley’s question that the vaccine’s two doses are really important. The first dose does not give all the protection that one needs against the virus—the second one boosts the first. Those two doses are critical, so we need to ensure that we encourage people to go back for their second dose.

Care Home Residents (Visits)

Tom Arthur (Scottish National Party, Renfrewshire South)

8. To ask the Scottish Government what action it is taking to ensure that care home residents who are unable to go outside can still meet friends and family. (S5O-04888)

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

That is a really important question. Along with many people across the country, I felt particularly gutted on Saturday when we took the decisions that we had to take in the face of the new strain of the virus. Up until that point, we had done a great deal of work to be ready to ensure that we could test visitors who were going into care homes, in order to open them, as the First Minister spoke about earlier.

It is important to point out that testing is not the only answer. It sits alongside good personal protective equipment and quality infection prevention and control, and we have taken a number of steps in partnership with care home providers and others to ensure that we can open our care homes to more visiting and support.

From 4 January, we will be testing visiting professionals as an additional precautionary and protective measure. We have guidance for adults who are under 65 to allow them to leave their residential setting and go out for the day or overnight with family and friends, as they would have done before the pandemic. Clinical advisers are considering what guidance we can offer for those in particular settings who are over 65, to enable them to do that, too.

At the moment, as we work to deal with the particularly infectious strain of coronavirus, that work is not paused, but we are not yet in a position to implement the improved position.

The Deputy Presiding Officer

That concludes questions on health and sport. Before I move on to the next group of questions, I remind all members to make sure—[Interruption.]

Oh, I beg your pardon, Mr Arthur. I am rushing—how rude. Please ask your supplementary question.

Tom Arthur (Scottish National Party, Renfrewshire South)

That is not a problem, Presiding Officer.

I share the cabinet secretary’s sentiment of feeling gutted that the restrictions that are necessarily in place will mean further restrictions for care homes.

I welcome the roll-out of testing that will be taking place in care homes, and the opportunities that it will create with regard to the ability to relax restrictions further. The cabinet secretary spoke about partnership working with care homes. What support is the Government providing to ensure that families and loved ones have access to the advice and understand the guidance, which, by its nature, can change quite rapidly due to the circumstances that we are in?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Presiding Officer, I am glad that you went back to Mr Arthur. When he thought that he was not going to get back in again, his wee face was a sad sight indeed.

The Deputy Presiding Officer

Before you go any further, cabinet secretary, I will just say that Mr Briggs distracted me, and I have no idea what he was trying to ask me. My apologies to both you and Mr Arthur.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Not at all, Presiding Officer. At times, Mr Briggs distracts us all, and not always in a particularly good way. [Laughter.] I do not mean that—I wish Mr Briggs the very best for the Christmas period.

To answer Tom Arthur, the support that we offer to care homes is significant. We have provided additional support. In particular, should care homes wish it, there is administrative support to allow care homes to administer the tests and do the additional work. Through our health and social care partnerships, our national health service stands ready to provide additional support when staff rotas may be compromised, as members have seen happen in particular situations. The Home Farm care home is probably the example at the forefront of people’s minds in that regard, although it happens elsewhere.

This week, I had the opportunity to bring together our directors of public health, care home providers, the Convention of Scottish Local Authorities and, importantly, the care home relatives group, to discuss with me what more we need to do to remove obstacles to visiting and people going outside, and to increase the confidence of care home providers in relation to their assessment of risk.

Tomorrow, I have a cross-party meeting with members from across the chamber to look at what further work we might be able to do to ensure that, if the right steps are taken, care homes are opened up to visiting as far as is safely possible.

Banffshire and Buchan Coast (Action on Poverty)

Stewart Stevenson (Scottish National Party, Banffshire and Buchan Coast)

1. To ask the Scottish Government what action it is taking in the Banffshire and Buchan Coast constituency to help take families out of poverty. (S5O-04889)

Aileen Campbell (Scottish National Party, Clydesdale)

We remain committed to tackling poverty, as our tackling child poverty delivery plan shows. In 2019-20, our estimated spend on low-income households increased by £554 million to £1.96 billion. The Scottish child payment, which is open to applications for eligible families with children under six, will start payments in February next year.

In response to the pandemic, we have committed more than £0.5 billion, including up to £100 million through our winter plan for social protection. That includes a £100 payment for each child in receipt of free school meals, and more than £130 million to tackle food insecurity, including the provision of free school meals over the holiday periods.

Stewart Stevenson (Scottish National Party, Banffshire and Buchan Coast)

Parts of my constituency are in particular poverty. Will the cabinet secretary advise how many families in my constituency—or, if necessary, in Aberdeenshire—are expected to receive the Scottish child payment?

Aileen Campbell (Scottish National Party, Clydesdale)

The Scottish child payment is an investment that is unique to Scotland. It is expected to benefit families right around the country, including in the Banffshire and Buchan Coast constituency that Stewart Stevenson represents.

The Scottish Fiscal Commission forecasts that the payment could support up to 194,000 children this financial year, which is an increase of around 34,000 children since the pandemic began. Initial management information indicates that, by the end of Sunday 20 September, we had received 52,000 applications.

We are promoting the Scottish child payment via extensive communications and a marketing campaign to ensure that all those who are eligible are aware of their entitlement. I hope that that message is getting out to families in Stewart Stevenson’s constituency.

I will endeavour to write to Stewart Stevenson in the new year to provide a more detailed breakdown of the number of families who are eligible and any further information that is particular to his constituency.

Covid-19 (Community Organisations and Activities)

Brian Whittle (Conservative, South Scotland)

2. To ask the Scottish Government what consideration it has given to preserving community organisations and activities during the Covid-19 pandemic and beyond. (S5O-04890)

Aileen Campbell (Scottish National Party, Clydesdale)

The £40 million community and third sector recovery programme provides funding for organisations as they respond to the on-going impact of the pandemic and as they adapt and restart delivery of their community services and activities. The programme also provides business support and investment to help organisations adapt their operations and income generation to increase sustainability. So far, 376 organisations have been awarded more than £7 million in funding from the programme.

I encourage community and third sector organisations around the country to consider applying, particularly in communities where the winter months will be difficult for many people. More information on the support that is available can be found on the Scottish Council for Voluntary Organisations website.

Brian Whittle (Conservative, South Scotland)

I know that the cabinet secretary is aware of the importance of community organisations and activities such as sport, art, music and drama, and of how they can positively impact physical and mental health. We are in a pandemic at the moment, which obviously has a huge impact on the ability of such organisations to reach out. What will the Scottish Government do to ensure that they are still there at the end of the pandemic, because we will need them then more than ever?

Aileen Campbell (Scottish National Party, Clydesdale)

I absolutely agree. That is part of the reason why, early in the pandemic, I announced the £350 million package of support as a response to the pandemic. As the months went on, we realised that we had to gear up and support our third sector to move into a recovery phase. The adapt and thrive part of the support that we put in place provides third sector organisations with financial support, but also provides advice to help them to adapt to the circumstances around them, so that they can improve their sustainability for the future.

Knowing how critical third sector and community organisations are is also why, just a few weeks ago, the First Minister made a further announcement of financial support through the winter package support measures.

Brian Whittle has put his finger on a critical point: we must work hard to ensure that, beyond the pandemic, we have a thriving third sector, as it has been proved just how essential that is to the resilience of our communities and our country. We will continue to work with our third sector partners to ensure that the sector continues to thrive. Indeed, this morning, I had a call with many third sector organisation leaders and we will continue to work in partnership to ensure that that is the case.

Domestic Abuse (Housing Outcomes)

Ruth Maguire (Scottish National Party, Cunninghame South)

3. To ask the Scottish Government what action it is taking to improve housing outcomes for women experiencing domestic abuse. (S5O-04891)

Kevin Stewart (Scottish National Party, Aberdeen Central)

We must ensure that women and children who experience domestic abuse have a secure place to live and the support that they need, which includes supporting them to stay in their own home, if that is what they want.

In October, we introduced the Domestic Abuse (Protection) (Scotland) Bill, which will provide the police and courts with powers to make emergency notices and orders to protect people who are at risk of domestic abuse by enabling a suspected perpetrator of domestic abuse to be removed from a home that they share with a person at risk. The bill also provides powers for social landlords to change a tenancy to remove a perpetrator of abuse from a victim’s home.

We welcome the recent report by the Chartered Institute of Housing Scotland and Scottish Women’s Aid, and will work with partners on implementing the recommendations to improve women and children’s housing outcomes.

Ruth Maguire (Scottish National Party, Cunninghame South)

As well as identifying existing barriers and providing guidance, the excellent report that the minister mentioned contains a lot of examples of good practice that is already happening. How will the Scottish Government ensure that all social landlords across Scotland use the guidance and take prompt action to improve things for women and children experiencing domestic abuse?

Kevin Stewart (Scottish National Party, Aberdeen Central)

I am very keen to ensure that we export best practice across the piece, particularly in this area. Early in 2021, we will—[Inaudible.]—expert group to lead delivery of the recommendations and transform practice in this area. We will continue to report on progress through our annual report to Parliament on the ending homelessness together action plan. We are already taking forward some of the recommendations, some of which, crucially, we have introduced into the Domestic Abuse (Protection) (Scotland) Bill; that includes the power for social landlords to remove a perpetrator of abuse from the victim’s home.

Covid-19 (Financial Recognition of Local Government Workers)

Sarah Boyack (Labour, Lothian)

4. To ask the Scottish Government what progress it has made on giving financial recognition to people working in local government during the response to the Covid-19 pandemic, as agreed at the recent Convention of Scottish Local Authorities leaders meeting. (S5O-04892)

Aileen Campbell (Scottish National Party, Clydesdale)

I, along with all Scottish ministers, am hugely grateful for the heroic efforts of all key workers across Scotland, including in local government, who have risen to the challenge of responding to the pandemic and kept our essential services available. Although councils are independent bodies, which means that it is for them to decide on any additional support for the wider local government workforce, the Scottish Government regularly engages with local government on issues around pay and workforce. We have also taken decisive action to commit £382.2 million in additional funding to local authorities in Scotland.

Sarah Boyack (Labour, Lothian)

There was agreement across all the parties in the Convention of Scottish Local Authorities that the incredible work of tens of thousands of local government staff has kept services going—from distributing food to keeping our schools open, collecting waste, and keeping our older and vulnerable constituents safe throughout the pandemic—and that those staff should be not only acknowledged, but rewarded, for that work.

Given the massive deficit that our councils face due to Scottish Government underfunding, surely it is time for the Scottish Government to step up, support those staff and enable our councils, which have kept our communities going, to be rewarded for their heroic efforts.

Aileen Campbell (Scottish National Party, Clydesdale)

As I said very explicitly, I—along with the whole of this Government—recognise and am grateful for all the efforts of people across local government who have done an inordinate amount of work to help the country respond to the challenges posed by Covid-19. However, I also mentioned that councils are independent bodies and that it is for them to decide on any additional support for the wider local government workforce.

In addition, I underlined that we continue to regularly engage; indeed, my colleague the Cabinet Secretary for Finance, Kate Forbes, met COSLA yesterday to discuss issues around this, and we will continue to engage with local authorities and to support them financially. As I mentioned, we have committed £382.2 million in additional funding to local authorities in Scotland.

I do not accept the characterisation that we have underfunded local government. We have endeavoured to treat it fairly in all the funding decisions that we have taken as a Government, bearing in mind that we have also borne the brunt of austerity over a number of years. We have tried to work in partnership with local government to enable it to continue to deliver the essential services that are critical for all our communities across the country. I again put on record our enormous thanks to all of them for all that they do day in, day out.

The Deputy Presiding Officer

Could we move on a bit more rapidly? I still have many questions to take.

Islands (Housing for Young People)

Rhoda Grant (Labour, Highlands and Islands)

5. To ask the Scottish Government what consideration it is giving to the calls for young people living on Scotland’s islands to be given first refusal for available housing in order to tackle depopulation. (S5O-04893)