Seòmar agus comataidhean

The arguments have been well aired. The points that Mr Mason and Mr Rowley have made recognise that the pandemic is not over in any shape or form. As a consequence, we must have measures available to enable us to respond, should the situation deteriorate.

On the issue of local outbreak management, which Mr Fairlie raised with me, the Health Protection (Coronavirus, Restrictions) (Directions by Local Authorities) (Scotland) Amendment Regulations 2022 provide for the necessary interventions for effective outbreak management in trying to deal with local outbreaks that might create a wider difficulty.

The Government seeks this extension to enable us to have the capacity to respond should we need to. It is not because we will exercise the powers; it is to give us the capacity to do so, as members of the public will expect. I would therefore appreciate it if the committee would support the regulations that are in front of it.

There will always be a degree of waste—I suppose that there is no better word for it—in the vaccination programme. I think that we all accept that, and ministers have made it very clear that we want to minimise that. If memory serves, I think that the vaccination programme commenced with an assumption that there might be as much as 5 per cent waste, but the practical reality is that, throughout the programme, there has been less than 1 per cent waste. If it is a question of performance against expectation, I think that we would have to say that that was a very good performance.

I would have to check the detail of the newspaper report that you referred to, but we are endeavouring to maximise participation in the vaccination programme. We are doing that because vaccination is absolutely the key to minimising the harm of Covid. One thing that concerns me about the narrative with regard to the discussion in recent weeks about Covid—particularly omicron—is the suggestion that omicron has been milder than previous variants. I think that that is the wrong way to look at the issue. I think that the vaccination programme is giving a lot more protection from what happens to be called omicron. There are numerous cases of people with the omicron variant who have faced very severe health consequences, because they have been unvaccinated.

We have to be careful about undervaluing the impact of the vaccination programme, as it has been crucial in tackling the effect of Covid, whether that be omicron or whatever. Fellow citizens of ours are having a very hard time with omicron—in many cases, that is because they are unvaccinated. The strength of the arguments in support of vaccination is, in my view, absolutely overwhelming, and the Government is using those arguments to encourage uptake of vaccination.

The more we have a sense that the worst of Covid is past us, the more there might be a sense that people do not need to get vaccinated. I would take entirely the opposite view and say that it is vaccination that is giving us the protection against Covid that people need.

The testing programme has been delivered through a number of channels. Some testing is delivered under the auspices of the NHS in Scotland, and some is delivered within the test and protect infrastructure that was put in place by the UK Government and its contractors.

There are different employment relationships in there. For example, the NHS in Scotland turned over substantial proportions of its lab testing environment for the purposes of Covid. There will be ways in which that will be redeployed for other purposes. There are therefore different ways of approaching the matter.

The key point—this is where I agree with Mr Rowley, and I want to reassure him—is that we have staff shortages in a range of areas within the health and social care system. Individuals who have been involved in testing have also been involved in that activity, so it would seem natural to make sure that they have access to recruitment opportunities within the NHS, as well as appropriate training opportunities. That will be taken forward by individual health boards, all of which have in place recruitment strategies to fill vacancies at different levels of activity in the health service.

No.

There are two numbers that I encourage Mr Mason to look at. The total number of people who are in hospital with Covid is important, but just as important is the number of new admissions week by week, by comparison. The latter number—the number of people being admitted to hospital week by week—is beginning to show a reduction. I was going to say that it is tailing off. I do not think that I could justify saying that, but it is certainly reducing on a weekly basis. That indicates to me that we appear to be getting over the peak of the challenge that we face from BA.2.

On that justification, I think that we are in an appropriate place to undertake the relaxations that will take place on Monday. However, I also note that the Government has taken the difficult decision, which I recognise is not universally popular, that one of the relaxations that was proposed for Monday will not be permitted. That is the relaxation of the legal obligation to wear face coverings in public spaces. We judged that, given where we are in this challenge, it is appropriate and proportionate to extend that measure for a further two-week period, and then to review it. By that time, we should have clearer evidence that we are over the peak of BA.2 and we will be able to more confidently take that step. I appreciate that that position is not universally supported, but I judge the decision that the Government has made to be the right one.

We are looking carefully at the issues around self-isolation grant support. Fundamentally, we need to recognise the interaction between individuals’ practical circumstances and the necessity of interrupting the circulation of the virus. The advice that will be available will encourage people to remain at home, in the same way that we would advise people with other conditions who might run the risk of spreading illness to other members of society.

We are looking carefully at the arrangements around self-isolation, because I recognise the challenge that Mr Mason raises. It might not be financially practical and possible for individuals to be able to self-isolate without loss of income. The points that Mr Rowley put to me about the cost of living crisis that people are facing is another dimension of it, and we are looking carefully at what other arrangements can be put in place.

I stress that the arrangements under the Public Health etc (Scotland) Act 2008 are designed for very limited outbreak purposes, and are not really suitable for the much wider proposition regarding the scenario that Mr Mason puts to me.

We have to persist with the message about the importance of vaccination. As I said in my answers to Murdo Fraser, I am concerned by an attitude of mind that says that omicron is much softer than previous variants. That view is allowed to prevail precisely because of the robustness of vaccination. If we do not have robust vaccination, we will be exposed to much more serious illness.

That brings me back to Mr Mason’s first question, about hospital admissions. If people are more seriously ill and spend more time in hospital, those numbers will not come down, and our hospitals will face a problem. I come back to the point that I have reiterated to the committee on a number of occasions: our national health service came closer to being overtopped during omicron than during any other part of the experience of Covid.

I do not have the precise comparative numbers in front of me today, so I hope that Mr Whittle will forgive me for giving rough numbers based on my recollection. Three weeks ago, when the Government set out the strategic framework, the number of people in hospital with Covid was about 1,060—that is the figure that comes to mind. On Tuesday, that number was a few short of 2,000. It had virtually doubled in the space of three weeks. That high level of in-patients is why the Government has not followed through on all the steps that we intended to take on 21 March.

Obviously, there is a world of a difference between having about 1,000 patients in hospital with Covid and 2,000 patients. It leads to significant challenges relating to the treatment of patients with Covid, such as the need to isolate them from other patients, which undermines hospital capacity.

We really must see those numbers come down significantly. We are seeing signs of that happening now, but we need there to be further reductions to create the space for smoother access to hospital care for people with a variety of other conditions.

Yes, that is a fair assumption. As Mr Whittle has said, the issue that most troubles leaders in the health service right now is that we have come out of an intense period of managing Covid, and it is likely to be followed by an intense period of managing non-Covid conditions.

Winter in the national health service is lasting an awful long time. In fact, winter feels like it is here all the time. Winter pressures tend to last between October to March. We are almost at the end of March and it does not look like the situation in hospitals is improving to any extent whatsoever. That places a huge burden on members of staff, who are already very tired. Some of them will also have been ill, and they might still be trying to fully recover. As we all know, one of the effects of Covid is that people often experience fatigue over a long period. Health service staff are putting in very demanding shifts. If they are tired when they start them as a result of their having had Covid, which is highly likely, given where they are working, that is an additional burden for the health service to manage.

There is not a polite way of describing it.