– in the Scottish Parliament on 5th March 2020.

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Photo of Jackson Carlaw Jackson Carlaw Conservative

1. This week, the coronavirus spread to Scotland. The First Minister, and the Scottish Government, can be assured that the Scottish Government will have the full and engaged support of myself and all Scottish Conservatives as it deals with the virus. In turn, I thank the First Minister for the constructive way in which she has worked with the United Kingdom Government, just as she did with previous health pandemics some years ago. Both of Scotland’s Governments need to work together constructively and effectively.

In recent weeks, two testing facilities have been set up in Glasgow and Edinburgh, with any positive results being sent to Public Health England for confirmation. Does the First Minister envisage that those two laboratories can meet all the anticipated demand for initial testing, or will she indicate whether there are contingency plans to further expand testing capacity in Scotland, as required?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

I thank Jackson Carlaw for his comments and for his statement about support from the Scottish Conservatives. We face a potentially very serious situation, and we all have a responsibility to work together to make sure that our response is what the people of Scotland would expect.

Before I turn to the specifics of Jackson Carlaw’s question, I confirm to the Parliament that, as of this morning, we have six confirmed cases. I would expect that number to rise, possibly very rapidly, in the days to come.

I want to stress that we are still very much in what is called the contain phase of the virus in Scotland. If people follow the advice, if we ensure that confirmed cases are isolated and that contacts are traced and given appropriate advice, and if the public follow the advice about hand and other personal hygiene, we can continue to have a degree of success in stopping the spread from individual to individual. It is important that we do that for as long as possible.

That said, we all recognise and accept that it looks increasingly unlikely that we will be able to contain the outbreak indefinitely, so it is likely that we will move into what is called the delay phase of the virus. That may be reasonably soon, but that will be guided by the best scientific advice. When we are in that phase, the focus will be very much on seeking to slow down the spread and reduce the peak—the number of people who are infected at any one time. As we take decisions about that, it is important that we are informed by good-quality scientific advice.

Difficult decisions will potentially be involved—ministers will not take those decisions lightly but, equally, we will not hesitate in doing exactly what is required to protect the public for as long, and as best, as we possibly can.

We took early action to ensure that testing facilities were available in Glasgow and Edinburgh, and there are plans in both Tayside and Grampian to potentially have testing facilities there as well. I am satisfied at this stage that we have the capacity to deal with testing.

Although I am not saying that we are close to this at the moment, here, as with any outbreak, we may reach a point at which the spread is such that not every individual is tested, because the presumption will become that, if they are ill with certain symptoms, they have the virus. However, we are not at that stage right now, and we will continue to take the actions that we require to take.

Photo of Jackson Carlaw Jackson Carlaw Conservative

I thank the First Minister for that response. If a rapidly rising number of cases transpires, one emerging issue in consequence is likely to be the availability of beds. In the past few years, healthcare has shifted from hospitals into the community, with specialist services concentrated into one place in larger hospitals. In consequence, we have fewer beds and fewer smaller community hospitals, which has happened in response to changes in demographics, technology and medicine.

Given that the chief medical officer has suggested that a full outbreak will require more intensive hospitalisation, will the First Minister indicate how many extra beds may be required and what contingency plans are being prepared to commission them?

The First Minister:

Numbers are among the issues that we are currently assessing, and which we will assess on an on-going basis. Although it would be premature to give numbers on that right now, it is likely that we will need increased facilities for hospital care—including intensive hospital care—and also to be prepared to treat in the community more people who can be treated there in order to ensure that our hospital capacity is there for those who need it most.

The national health service has in place well-established escalation plans, which are in the process of being implemented. Through the Scottish Government resilience committee, and indeed day-to-day planning, the Cabinet Secretary for Health and Sport and I are overseeing that and making sure that the plans are being refined and developed as we go.

We are still in a phase of learning more about the operation of the virus—that point would be made right now not just in every country across the UK, but in every country across the world. Our knowledge is incomplete, which makes it all the more important that we have in place plans that are well established and developed, but also flexible enough to respond to the reality as we face it. The Scottish Government will continue to ensure that that work is done.

Photo of Jackson Carlaw Jackson Carlaw Conservative

Again, I thank the First Minister for that response. We know from previous outbreaks of pandemics that protecting our dedicated health workforce will be essential. However, staffing in the NHS is already under significant pressure; it is—after all—the end of winter, with staff already sprinting to stand still.

The UK Government has announced that it intends to recruit retired doctors and nurses to augment and support the health service in England and Wales. Will a similar initiative progress in Scotland, and how will it be achieved if required?

The First Minister:

First, I pay tribute to our front-line NHS staff, which I am sure will be echoed across the chamber. We do that each and every day; however, at times such as this, the pressure and demand on them increases and we are all appreciative of the work that they do. Yesterday, I v isited NHS 24 in Clydebank, whose healthcare workers are among those who are at the sharp end of that increased demand.

We have record numbers of people working in our NHS in Scotland, who work incredibly hard and under incredible pressure; nevertheless, the numbers have been increasing. We also have more staff per head of population than other parts of the UK. That is not to diminish the pressure that our staff are under now or will be under, but that is an important foundation.

Of course, we are also looking at contingency plans to encourage and ask those who are recently retired from the national health service to come back, if that is required. We are obtaining lists of retired healthcare professionals from—for example—the Royal College of Nursing and the Royal College of Midwives, and we are looking to get such a list from the General Medical Council as well. Those plans are under way.

It is very important to be frank and honest with the public and to give them as much information as possible—that was a very important approach during the swine flu pandemic just over a decade ago—and to seek to reassure the public that, although this is a serious situation that is being taken seriously, there are well-established plans in place that are in the process of being implemented.

It is also very important that we continue to reassure the public that, although very big numbers are being cited right now, we are planning on the basis of worst-case scenarios; and that, whatever the numbers turn out to be, the vast majority of people will have mild symptoms. Part of our focus in seeking to reduce the number of people who are infected at any one time is to minimise as much as possible the impact on society and, in particular, on our national health service. That is the basis on which we will continue to take forward our planning work.

Photo of Jackson Carlaw Jackson Carlaw Conservative

Finally, on that point about reassurance, as we have seen from the development of the virus in other parts of the world, those in the most vulnerable groups could be the most susceptible. I in no way wish to be alarmist, but many people watching who are going through treatments for cancer or other conditions and who have compromised immune systems will clearly be concerned. Has the First Minister considered how we offer specific reassurance and target resources at that most vulnerable group, who inevitably will be particularly affected and concerned?

The First Minister:

The public generally will have a degree of anxiety, given what they are reading in the newspapers and watching on the television, but that will be heightened for those who already suffer vulnerabilities, whether those are health vulnerabilities or the vulnerabilities that come with age. To go back to a point that I made earlier, it is important for us all as politicians—as First Minister, I take this responsibility very seriously—to be frank and honest with people but not to seek to sensationalise, and to base our decisions on good-quality scientific advice and not on reasons of political expediency.

To reassure people in such groups, I again point to the importance of the containment phase. We may not be able to contain the virus indefinitely, but every day and week in which we manage that and thereby take a potential future peak out of the winter period and into spring and summer, we help to reduce the impact. The messages to all of us to wash our hands properly and to follow the advice on what to do when we cough and sneeze are important. I am very aware that politicians telling people how to wash their hands sounds patronising, but it is really important. If all of us who are healthy do that, it helps to protect those who are more vulnerable. In all of our planning for potential escalation, it is absolutely the top of our priority list to make sure that we target resources to the most vulnerable.

I appreciate the support from across the chamber as we take forward those plans. I again say that the situation is potentially very serious, but we are not powerless in the face of it. There are many things that we can and will do to reduce the impact as much as possible, and that is what I am focused on as First Minister, as is the health secretary and indeed the entire Government.