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Following the pause of the breast screening programme in March 2020, there was a staged restart. This was based on expert clinical advice and the recommendations of the Scottish Screening Committee, and was agreed with Health Board Chief Executives as part of the planned remobilisation of the NHS. The breast screening programme resumed on 3 August 2020, initially prioritising those whose appointments were cancelled or delayed due to the pause. The programme is now at the stage of offering routine appointments for eligible women aged between 50 and 70.

The recovery of the breast screening programme, including reviewing the pause to self-referrals for the over 70s is monitored by the Breast Screening Programme Board, the National Screening Oversight Board and the Scottish Screening Committee. It should be noted that the risks and benefits of breast screening for people over the age of 70 have not been clearly established. Covid-19 and the measures to control its spread, such as physical distancing and the use of PPE, also continue to pose challenges to capacity in the screening programme. The decision to maintain the pause on self-referrals for the over 70s, though difficult, was therefore taken to allow the service to prioritise those who require to be offered appointments and for whom screening has clear benefits.

Humza Yousaf: The Scottish Government is investigating potential options to ensure that consumers and the wider public can have confidence in the reliability of private PCR tests.

We have issued guidance for employers on setting up private testing programmes which includes information on seeking assurances around test quality: Coronavirus (COVID-19) - employee testing programmes: guidance for employers - gov.scot (www.gov.scot)

UK Government legislation regulating the Coronavirus test devices can be found here: The Medical Devices (Coronavirus Test Device Approvals) (Amendment) Regulations 2021 (legislation.gov.uk) .

The Scottish Government has not received representation within the last 12 months from either Cancer Research UK, or any other cancer charities regarding breast screening for the over 70s. However, there is representation from cancer charities on decision-making committees, including Cancer Research UK on the Scottish Screening Committee and Breast Cancer Now on the Breast Screening Programme Board. This ensures they are regularly updated on the status of the breast screening programme, including the pause of self-referrals for people over 70.

The numbers who may attend marriage ceremonies, civil partnership registrations, funerals and wedding receptions and post-funeral gatherings in public places both indoors and outdoors are set out in guidance. These numbers only apply when the venue has sufficient capacity to hold them, with physical distancing. The position on permitted numbers at these events is as follows:

Level 0 - No more than 200 people should attend

Level 1 - No more than 100 people should attend

Level 2 - No more than 50 people should attend

Level 3 - No more than 50 people should attend

Level 4 - No more than 20 people should attend

Receptions and post-funeral gatherings are not permitted at protection level 4.

We have published guidance on marriages, civil partnerships and receptions and funerals and post-funeral gatherings. I would be happy to write to the member with further information about any points of clarification required.

Data reporting the overage self-referrals is not published with the Breast screening statistics by Public Health Scotland. However, data collated for the Breast screening review for the 3 year period from 2016-17 – 2018-19 reports a total of 32,492 self-referrals from women age 70+ over the period and equates to 5.7% of total screening activity.

a) Assessment of the potential impact of the COVID-19 pandemic; The Scottish Government continues to monitor evidence on the Four Harms of COVID-19. These are the direct impact of COVID-19, other health impacts, societal impacts, and economic impacts.

We are using this information to inform decisions about COVID-19, including how we move through phases of the Coronavirus Route Map .

The virus will impact different groups of people in different ways, and our society will be affected in different ways over time. We’re carefully monitoring the data and regularly update new evidence to COVID-19 in Scotland (data.gov.scot) .

b) Assessment of the potential impact of COVID-19 vaccines on i) Menstrual Cycles; The Medicines and Healthcare products Regulatory Agency (MHRA) have reviewed reports of menstrual disorders and unexpected vaginal bleeding suspected as adverse reactions to vaccination with the three COVID-19 vaccines currently being used in the UK: Pfizer/BioNTech, COVID-19 Vaccine AstraZeneca and COVID-19 Vaccine Moderna.

These reports have also been reviewed by independent experts of the Commission on Human Medicines’ COVID-19 Vaccines Benefit Risk Expert Working Group and members of its Medicines for Women’s Health Expert Advisory Group.

A range of menstrual disorders has been reported as suspected adverse reactions after all three of these COVID-19 vaccines including heavy bleeding, delayed periods and unexpected vaginal bleeding. The number of reports of menstrual disorders and vaginal bleeding is low in relation to both the number of females who have received COVID-19 vaccines to date and the background rate of menstrual disorders generally.

ii) Menstrual Health; The current evidence does not suggest an increased risk of either menstrual disorders or unexpected vaginal bleeding following vaccination with the vaccines reviewed (Pfizer/BioNTech, COVID-19 Vaccine AstraZeneca or COVID-19 Vaccine Moderna). The advice from the NHS remains that the benefits of the vaccine outweigh the risks for most people. The MHRA will continue to closely monitor reports of suspected menstrual disorders and vaginal bleeding with COVID-19 vaccines.

Healthcare professionals are advised that anyone presenting with menstrual disorders and/or unexpected vaginal bleeding following COVID-19 vaccination should be treated according to clinical guidelines for these conditions, as usual.

The safety of all vaccines and medicines is monitored by the MHRA on a UK-wide basis. This includes reports from the Yellow Card Scheme which allows health professionals and patients across the UK to flag up suspected adverse reactions to any vaccine or medicine, as well as reports from worldwide use and on-going scientific evidence.

If a woman is concerned about changes to her period, she is advised to speak to her GP, especially if she experiences bleeding after menopause.

I refer the member to the answer to question S6W-01146 on 1 July 2021. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

Eligible Scottish domiciled (home) students studying towards a degree in Paramedic Science (BSc) at Scottish universities will be eligible for a new paramedic bursary and the additional allowances which will fully replicate the funding and administrative arrangements to the bursary offered to nursing and midwifery students. This Bursary will be offered to all eligible students in time for the beginning of the 2021-22 Academic Year.

We remain on target to decarbonise rail passenger services in Scotland by 2035 as set out in the Rail Decarbonisation Action Plan published July 2020.

Good progress is already being made to decarbonise the East Kilbride and Barrhead routes, Borders line and Fife Circle (providing services to Leven) as a first phase of delivery. Development work is also progressing on the wider decarbonisation plan including decarbonisation/electrification infrastructure and electric, battery and hydrogen rolling stock.

Updates on progress will be published as the strategy develops, key elements of which will also form part of the Strategic Transport Projects Review 2, with phase 1 having been published in February 2021.

Regarding part (b) of the question, I refer the member to the answer to question S6W-00852 on 1 July 2021. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .