Covid-19 (Update)

– in the Scottish Parliament on 17th March 2020.

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Photo of Kenneth Macintosh Kenneth Macintosh Labour

The next item of business is a statement on novel coronavirus Covid-19 update. The First Minister will make a brief statement, followed by the Cabinet Secretary for Health and Sport. The whole Cabinet will take questions at the end of the statement.

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

I will shortly hand over to the Cabinet Secretary for Health and Sport, Jeane Freeman. Following her statement, the whole Cabinet is available for questions. First, I want to make a brief statement.

Scotland today, like countries across the world, faces an unprecedented challenge. Addressing it will involve the biggest peacetime mission that our nation has undertaken in our lifetimes.

The scientific advice that all four Governments in the United Kingdom received yesterday shows that we are now on the cusp of a rapid escalation in the spread of Covid-19. That means that we must take far more stringent steps to suppress—as far as we can—the spread of the virus, to protect and scale up the capacity of the national health service as best we can, and, by doing those things, save lives.

The steps that we recommended yesterday represent a major change for all of us—a change from life as we know it. However, they are essential to give us the best chance of achieving those aims.

Let me summarise the three new recommendations that apply to Scotland, as of yesterday. We had already made it clear that if somebody has symptoms of Covid 19—a persistent cough or a fever—they should isolate themselves for seven days. That means that, as far as is possible, they should not leave the house, and they should reduce contact with other people in the house as much as possible. In addition—and this was the new element in yesterday’s advice—anyone else in a household where someone has symptoms should isolate for 14 days. That covers the seven days for which the first person is infectious, and a further seven days to see if they, or anyone else, gets the virus. Those measures are essential to reduce the chance of spreading the virus to others.

The second measure—which applies to everyone, not just to people with symptoms—is that we should minimise social contact as much as possible. That is vital to reduce the risk, for all of us, of getting infected or, if we do, of passing it on to others—especially those who are most vulnerable. People should, as far as possible, avoid crowded areas and gatherings. That includes bars, restaurants and cinemas. We also want people to use public transport as little as possible, and to work from home if they can.

That advice is important for everyone, but it applies especially strongly to three groups: first, people who are over 70; secondly, people with underlying health conditions—for which they get the flu vaccine—and thirdly, women who are pregnant. We are strongly advising them to stay at home as much as possible, and to significantly reduce unnecessary social contact.

We are not, so far, proposing the blanket closure of schools. At present, our judgment is that the negative consequences of that for the overall wellbeing of children, and the impact on the health service workforce, outweigh the benefits. However, I assure the public that that is under daily review, and that the protection of children will always be our priority.

The third and final step is to shield the most vulnerable, by which I mean specifically people with compromised immune systems. General practitioners and other healthcare professionals will be contacting those patients to ensure that they are fully supported.

As well as trying to reduce the peak of the virus, we are increasing the capacity of our health service. The cabinet secretary will speak in detail about that in a few moments. However, I want to restate my heartfelt thanks to everyone who works in our health and social care services. They are dealing with pressures that are already great, and which will soon become immense. We will do everything possible to support them.

I am also acutely aware of how serious the impact of yesterday’s recommendations will be for businesses and households. The actions that we require to take to mitigate a health emergency will, for many businesses and individuals, cause an economic emergency. We have already announced some support for business, and we are urgently considering what more we can do. We are also speaking to the UK Government about what more it will do for business, and we will set out further actions as soon as possible. We will also be making more information available in coming days on support for individuals who are in financial difficulty.

There is a fundamental principle here, which in many ways goes to the heart of the contract between Government and people. We as a Government are asking people to take unprecedented actions. We recognise—I recognise—that the response from the Government must also be unprecedented.

The next weeks, and possibly months, will be immensely difficult. I know that, for everyone, this is a deeply anxious time. People want to do the right thing to protect their own health, and they also want to do the right thing for their loved ones and for the wider community. The advice that we issued yesterday is intended to help all of us do that. All the steps that we are recommending—isolating yourself if you or people you live with show symptoms, minimising social contact, washing hands for 20 seconds and not touching your face—really matter. By following them, we will all be helping to save lives.

We face a shared national challenge, and we will need a collective national endeavour to meet it. We all have a part to play. We must all show solidarity, compassion and kindness for each other—not simply in person but in our phone calls and text messages, though our social media presence, even in our waves across the street to each other and, of course, in our offers to help where we can. By doing that—by looking after ourselves, our loved ones and our communities—we can, and we will, get through this. I thank everyone across our country in advance for their help and support in the months ahead in doing just that.

The Presiding Officer:

Thank you, First Minister. I call the Cabinet Secretary for Health and Sport, Jeane Freeman.

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I take this opportunity to apologise to my colleagues, the other parties’ spokespeople on health, for the very late arrival of this statement. I am sure that they understand that we are working at pace, but that is not normal practice and I am sorry that they have not had sufficient time to consider the statement in detail. I will, of course, be very happy to answer questions either today or on a future occasion.

Our nation faces a challenge to our way of life and to public health in a manner that has never been seen before in our lifetimes. As the First Minister has said, the scale of the challenge is, quite simply, without precedent. The First Minister and I cannot express how grateful we are to the women and men of our health service, care services and emergency services for all the work that they have done so far in addressing this challenge and for the work that they are prepared to do in the weeks ahead. They truly are the best of us, and I know that the whole Parliament will want to join me in recognising them as we confront the impact of Covid-19 on Scotland. [Applause.] Those workers are our front line, and they face a heroic and difficult task, but we can all play our part in helping them.

As of 9 o’clock this morning, 195 positive cases had been recorded in Scotland, but we know that the true number of infections will be substantially higher. I also regretfully advise Parliament that, to date, there have been two reported deaths of patients who have tested positive for Covid-19 in Scotland. Our thoughts are with their families and loved ones at what is a painful time for them.

As the First Minister has just set out, we are asking our society to take some truly unprecedented steps to suppress the spread of the infection and to minimise its impact. Our goal is simple: to protect and save lives. We need everyone’s help to achieve that. I know that we have asked a lot of the people of Scotland, but, in the weeks and months to come, we might have to ask for far more.

Responding to Covid-19 requires a swift and radical change in the way in which our NHS does its work. It is nothing short of the most rapid reconfiguration of our health service in its 71-year history. That is why, today, under sections 1 and 78 of the National Health Service (Scotland) Act 1978, I am formally placing our national health service on an emergency footing for at least the next three months. I am giving my instructions to NHS Scotland and individual health boards to do all that is necessary to be ready to face a substantial and sustained increase in the number of cases of Covid-19. Should I require to lay new regulations to enable our boards to achieve that, I will bring them before Parliament swiftly.

Our first goal is to double the intensive care unit capacity in Scotland. Boards are working towards that by providing the necessary training for staff and by repurposing facilities. Our contingency planning for the supply of oxygen in hospitals and in the community is in place, and we have ordered an additional 450 new standard concentrators for use in the community, as well as additional contingency that can be called on if necessary.

Our current bed capacity in NHS Scotland is about 13,000, and our boards are taking all necessary steps to increase that by at least 3,000. To achieve that, our normal programme of non-urgent elective operations will be suspended. I want to be very clear that vital cancer treatments and emergency, maternity and urgent care will continue.

NHS boards are aware that they must take a structured approach to the postponing of non-urgent elective procedures, with a view that patients will remain on the waiting lists until it is clinically appropriate to have their procedure undertaken. All boards are developing local mobilisation plans to achieve that.

Additionally, we have established a national cancer treatment response group, which will provide on-going advice and support around cancer treatments. The impact of Covid-19 on cancer patients has been a priority in all our planning, and we will ensure that all appropriate measures are undertaken in the present situation to protect those living with cancer.

We are also working closely with the Convention of Scottish Local Authorities, health and social care partnerships and chief officers to get a rapid reduction in delayed discharges. I have set a goal of reducing those by at least 400 by the end of this month. We are also engaged with the independent healthcare sector in Scotland—which is relatively small—so that we can utilise it to maximise available bed capacity, to help the NHS.

All those steps will necessitate some redeployment of staff in our health service. We have issued guidance to health boards and staff on planning and deployment, and we will keep that under regular review, with updates and advice as the situation evolves.

We are also seeking support to backfill posts, including by working with regulators to enable returners to the healthcare profession and by looking to deploy senior students into settings that are appropriate to their skills. In addition, NHS Education for Scotland will be providing a range of induction and training materials on Covid-19 to meet the needs of employers, which can be accessed via the “Turas Learn” NHS website, which goes live today.

As we work to suppress the infection, we will continue a strong testing regime that will ensure that key workers such as front-line NHS staff will be tested, so that they do not self-isolate unnecessarily. As the First Minister said earlier this week, we are scaling up Covid-19 surveillance testing, which will give us a more accurate picture of how the infection is spreading in certain areas. That will help to direct where we can best place resources to try to save lives. Surveillance will be increased fivefold to give an accurate overview of an area with a population of about 1.2 million.

Monitoring will also continue through our laboratories. It will be targeted on the following additional groups: admissions to hospital; admissions to intensive care; and community testing that is dependent on circumstances—for example, specific situations such as a nursing-home outbreak.

The safety and wellbeing of our hard-working NHS staff are a huge priority, and I expect all boards to ensure that staff who are dealing with Covid-19 cases have the appropriate training and personal protective equipment to ensure their safety.

It is not just in acute settings that support is required. Health Protection Scotland’s Covid-19 guidance on PPE for primary care states that, for all consultations for acute respiratory infection or influenza-like illness, GPs need to wear face masks, aprons, gloves and eye protection. Last week, we issued additional supplies of all those items to health boards for onward distribution to GP practices in Scotland. Should practices require further equipment that is in keeping with the guidance, we will work to have it delivered swiftly by boards. I have asked boards to ensure that it is distributed by 20 March.

To cope with a rapid increase in the number of people who are presenting with respiratory symptoms in the current phase of the infection, a new Covid-19 community pathway model is being implemented, with patients being asked to make contact via NHS 24 on the 111 phone number, rather than through their GPs.

We are ready to support local authorities and care providers with supply issues relating to PPE for the social care sector, in order to safeguard vulnerable people in our communities. Extensive work is already under way with our social care partners to put in place arrangements to increase the social care workforce capacity.

One group of people who could be profoundly hurt by a Covid-19 infection are those who are immunosuppressed. Next week, the NHS will directly contact people in that category to advise them of the stringent measures that they need to take to keep themselves and others safe. NHS Scotland will make direct contact next week and will work closely with other social services to ensure that support is provided.

For those in long-term care facilities—people who are often frail with complex needs—HPS has published specific guidance for infection prevention and control in social or community care and residential settings. In addition, the chief medical officer has published specific advice about visitors and admissions to care homes. We are discussing with Scottish Care and COSLA what more can be done to ensure the overall wellbeing of residents in long-term care homes.

We are engaging with third sector partners that have contact with and that already support those who are clinically vulnerable, to ensure that people receive the right advice on what precautions to take and that those supporting them have the best information available on how to keep people safe.

In years to come, when people look back, there will be the time before the infection outbreak and the time after—it is a watershed moment for our nation, our world and, most certainly, our NHS.

We are doing, and we will continue to do, everything that we can to protect and save lives, but it will take everyone. We all have a responsibility and we need everyone’s help.

The Presiding Officer:

The whole Cabinet is here to take questions, depending on the nature of the subject that is raised. The First Minister will co-ordinate with her colleagues. We will start and see how we get on.

Photo of Jackson Carlaw Jackson Carlaw Conservative

Just a fortnight ago, I made it clear that the Scottish Conservatives would offer our full support to the First Minister and her Government as they respond to the coronavirus emergency. I did not do that lightly. Ten years ago, I shadowed Nicola Sturgeon when she led, as health minister, the national response to a previous epidemic, so whatever political differences we might otherwise have—God knows that they are many—I have every confidence in her leading the country’s response to the crisis, at this time.

It is not the time for Opposition parties to exploit our situation or to use partisan and pejorative rhetoric against the efforts that are being made. To those who are venting against the United Kingdom Government or directly to me about “Sturgeon’s Government”, let me be clear: for now, the Scottish Government is a Government for us all, just as the Government in Westminster is a Government for us all.

Will mistakes be made? Possibly. Will our response at times be slower than we would wish? Probably. After this is all over, we can learn from our experience and prepare ourselves for any future event.

For now, I am clear that the Scottish Conservatives will stand with the First Minister. I assure her that the questions that we will ask will be measured and entirely designed to inform and not to hinder the national effort that she is leading, and that we all place our trust in the advice that is received from qualified professionals.

As both the Prime Minister and the First Minister have said, we are all in this together. This Conservative Party, in this Parliament, will stand together with the Scottish Government. [Applause.]

I have a question for the Cabinet Secretary for Health and Sport regarding people who are in receipt of home care support. As other MSPs did, I imagine, I received calls yesterday not from emergency or support services wondering whether they might infect somebody who was receiving support, but from somebody who was receiving support who thought that they might have symptoms and whose entire care package has been removed as a consequence. Obviously, many such people absolutely depend on services being sustained, and are in urgent need of advice about what they should do, as might well be people who are directing the teams that would normally support them.

The First Minister:

I will hand over to the Cabinet Secretary for Health and Sport on the specific question, but first I take the opportunity to thank Jackson Carlaw for his comments. Like many members, I am a politician to my fingertips, but I have never been less interested in party politics than I am right now. [Applause.] In the battle against the virus and what we will face in the months to come, we are all on the same side, and we should never forget that.

I accept and understand the importance of robust scrutiny, which is as important now as it is at all times. We are in a common endeavour, and it is important that we recognise that. We have never faced a situation like this, so I will do something else that is perhaps not normal for a politician. I say candidly that we will make mistakes: we will not always get it right, but we will strive at every turn to do the right thing, for the best reasons and in good faith.

I genuinely appreciate the sentiments of support that Jackson Carlaw has articulated today. I will hand over to the Cabinet Secretary for Health and Sport to answer the specific question.

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I am grateful to Jackson Carlaw. The situation that he has described is a disturbing one, so I would be grateful to know the detail of it. Home care support should not be removed in circumstances in which people feel that they have coronavirus symptoms—a dry cough or fever—or any other illness for which they want to receive clinical care. I will, if I can have the details from Jackson Carlaw, absolutely follow up on that as soon as we have finished in the chamber today.

Tomorrow, I will meet my counterpart in political leadership, Councillor Currie from the Convention of Scottish Local Authorities. I will speak to him later today and ensure that the message is delivered loud and clear through our local authorities that either provide home care support or which contract home care support. We must ensure that people who need support receive it, that those who need additional support receive it and that, where clinical or medical attention is needed, people get it as quickly as possible.

Photo of Richard Leonard Richard Leonard Labour

I also thank the First Minister and the Cabinet Secretary for Health and Sport not only for their statements, but for their cross-party co-operative approach to the huge challenge that we face. This is a fight for us all, regardless of party. We can do it only if we work together, stand as one, and stand together with humility in the face of this great challenge.

A few days ago, the head of the World Health Organization said that is not possible to “fight a fire blindfolded”, and that social distancing and hand washing alone will not “extinguish this ...epidemic”. He also said:

“We have a simple message for all countries: test test test. Test every suspected ... case.”

He said that the most effective way to prevent infections, and so save lives, was by

“breaking the chains of ... transmission.”

We should find and test every suspected coronavirus case, not just those in hospital. We need to track and trace on the ground that we cannot fight a virus if we do not know where it is.

We welcome the Scottish Government’s announcement of expansion of surveillance testing for Covid-19 in order to monitor the spread of the virus in the community. However, the inference is that it is clear that not everyone will be tested. What assurance can the First Minister and her Cabinet Secretary for Health and Sport give to patients who suspect that they have the virus, and will be anxious about the news that they might not be tested?

Can we also be given more information about the proposed expansion? When will it begin and where will be the 200 testing practices be?

The First Minister:

I thank Richard Leonard for his offer of support, which is genuinely appreciated.

I will address the point about testing. First, and this was a lesson that I learned during the swine flu pandemic, we must listen to the WHO and the experts, and we must be guided and informed by their views. I take that very seriously.

On testing, right now we are asking everyone across our country who displays symptoms of coronavirus—a fever or a persistent cough—to stay at home and self-isolate. As we move into the next phase, testing absolutely everyone would require significant resources—which I think should be spent caring for people—for tests and for getting test results back to people, when the advice that we would give them, if they were to test positive, would be exactly the same advice as we are giving them, which is to stay at home.

We are not dealing with the situation blindfolded. We have to understand, much better than we have done to date, how the virus is spreading and how it is behaving. That is why the community testing that we have outlined is so important.

In summary, we are expanding our GP sentinel testing. In normal years, when we publish figures from that during the flu season, for the purposes of monitoring flu, most people do not pay much attention to it. Right now, 41 practices across the country, covering about a quarter of a million people, are involved in the programme. We are in the process of expanding it to 200 practices, as a representative sample of the country, which collectively cover a population of 1.2 million. That will allow us to get much better information about how the virus is behaving and spreading than we get from the figures that we currently publish. It is a counterintuitive point, but the figures right now are an underestimate, and do not allow us to get that level of detail.

We will also continue to test everybody in hospital who has symptoms of respiratory illness, or flu-like symptoms, or symptoms of coronavirus. Crucially, in Scotland, we are going to continue to test key workers, because we do not want front-line health staff to be self-isolating unnecessarily.

That is what we are planning to do. It will involve a significant expansion of our testing capacity, and we do not rule out expanding it further, if that can help us in the fight against the virus. I hope that that information is helpful, and I am happy to continue to provide further information, if we build on that in the times ahead.

Photo of Alison Johnstone Alison Johnstone Green

I thank the First Minister for her statement, and the Cabinet Secretary for hers. The Scottish Green Party whole-heartedly associates itself with colleagues’ comments. We will work together, cross-party.

As I said last week, it is essential that no one loses their home at this time. I would like to understand better what steps the Scottish Government is taking to deliver an amnesty from arrears in rent or mortgage payments, in order to ensure that no person or family loses their home as a result of being unable to work. Can the Government confirm that a “no evictions” policy will be applied, and that steps to implement such a policy will be supported?

The First Minister:

I thank Alison Johnstone for her supportive comments. What she has outlined is absolutely what we seek to deliver. There will be more announcements on the subject in the days to come. I ask Aileen Campbell to give a brief summary of the work that we are involved in.

Photo of Aileen Campbell Aileen Campbell Scottish National Party

I will be able to give more detail in the statement on Thursday.

Alison Johnstone has made a good point. This is not just about the medical response, driven by the science; it is also about the need for us to tackle other vulnerabilities. Finances, including people’s ability to pay their rent, will be one of those. The Minister for Local Government, Housing and Planning is already actively engaged in work on that.

We are looking to ensure that we can protect people who potentially face rent arrears, if they have no income, in order to make sure that they can keep their homes, and to make sure that everyone—registered social landlords and local authorities—understands that we must not compound the situation and make it worse. We are working with partners to ensure resilience on broader social matters such as Alison Johnstone has outlined. We will be able to furnish her with more information when we make the statement on Thursday.

Photo of Willie Rennie Willie Rennie Liberal Democrat

To be frank, we are all afraid. However, I am comforted by the fact that the First Minister has taken such a professional approach. That gives members confidence that all that can be done is being done. That is why I say to everyone, even to those who have doubts, that they need to listen to the First Minister and her excellent advisers. That is the best thing that they can do for themselves and their loved ones.

I spoke to many businesses and people yesterday. They are afraid about getting food on the table, about having a roof over their heads, and about whether their businesses will continue through this. We need a massive programme of investment, and I hope that the chancellor will set that out this afternoon. What steps does the Government think will be necessary to make sure that those businesses continue, that mortgages and rents continue to be paid, and, most important, that people have food on the table?

The First Minister:

I thank Willie Rennie for his comments. I also take the opportunity to record my gratitude—I know that I also speak for the health secretary—to our advisers, particularly the chief medical officer, the deputy chief medical officer, and all the officials and experts who are advising us. They, too, are facing an incredibly challenging situation. Although I am grateful every day for the advice and expertise of experts and officials, I have never been more grateful for it than I have been in the past few days.

I will ask Fiona Hyslop to answer the questions about businesses. Aileen Campbell has already addressed the point about individuals, and there will be more information on that later this week.

Photo of Fiona Hyslop Fiona Hyslop Scottish National Party

Although this is primarily a health issue, the impact on the economy will be significant. Therefore, how we respond and how we work with the UK Government will be important. This afternoon, the Cabinet Secretary for Finance, Kate Forbes, will speak to the Chief Secretary to the Treasury, and I will speak to the UK Secretary of State for Business, Energy and Industrial Strategy. We will encourage and urge them to use every lever that they have to ensure that businesses stay in business, that employment continues where at all possible, and that we keep productive capacity so that there are jobs for people to return to. Obviously, there are issues about making sure that—as has been announced—there is enough payment for statutory sick pay and so on from day one.

I have already met representatives from the business organisations and the Scottish Trades Union Congress; indeed, many of the issues that were addressed can be supported by the Scottish Government. However, the economic impact that the situation will have needs a UK-wide and global response. We will encourage the UK Government to use every lever that it can to do that.

Part of that is about making sure that the banks deliver support. The banks are already dealing with loan repayment deferrals in a number of areas, and a variety of different steps are being taken. I make the point that the country supported the banks in recent times, and that it is now time for the banks to support the country.

The Presiding Officer:

Members will not be surprised to hear that there is an unprecedented level of interest in asking questions today. We will try to get through as many as possible.

I ask members to begin by indicating to which cabinet secretary or minister they are addressing their question. Although the First Minister will be able to respond to many, if you know which minister or department you are addressing, please say so.

Photo of Angela Constance Angela Constance Scottish National Party

The Cabinet Secretary for Health and Sport will be aware that there is much discussion in our communities and in the media about the scientific advice at home and abroad, and how it informs the restrictions that are placed upon our daily lives. I would be grateful if the cabinet secretary would provide her assurances that the steps that the Government is taking to protect us all are based on the best possible scientific advice, and explain how that advice is tested and scrutinised.

Photo of Jeane Freeman Jeane Freeman Scottish National Party

The scientific advice comes to us in a number of ways, primarily through the scientific advisory group for emergencies, which has another group working alongside and feeding into it. The individuals on those groups are drawn from a range of particular specialisms from across the UK, including Scotland. They look at the data from elsewhere in the world and constantly model what it tells us about the nature of the virus, the biology of how we expect it to affect individuals, the way in which it is spreading, and the efficacy of the different sets of measures that need to be introduced to delay its spread, manage it, and suppress the peak so that we can treat those who will be most impacted. Of course, the scientific and clinical advice that comes to us also identifies the groups of people who are most likely to be seriously impacted by the virus.

My other point is that we have our own advisers—our chief medical officer, deputy chief medical officer and the others who have been mentioned by the First Minister—who are engaged in scrutinising all that work. Neither the First Minister, nor I, nor to the best of my knowledge any of my Cabinet colleagues, are clinicians. We are not scientists, so our scrutiny of and challenge to what is being proposed to us is critical so that we have the confidence to take decisions, including those that we took yesterday, so that we can get to the situation that we want to get to, in which we protect the most vulnerable and save as many lives as we can.

Photo of Miles Briggs Miles Briggs Conservative

My question is for the health secretary, but it also goes beyond the health service. It is about clarity with regard to the rapid testing system. NHS and social care staff are clearly keen to get back to work if they can possibly be tested to see whether they can do so. Our oil and gas workers are also concerned about going out to the rigs and the destabilisation of the energy industry. What steps are being taken to plan and extend rapid testing across Scotland?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

That work is under way with a number of critical front-line workers in our emergency services more broadly, not simply the health service. We need to be careful and considered in who we identify in those areas, which stretch to some of our other critical infrastructure sectors.

The work is under way to ensure that we can rapidly test, produce the results and allow people to safely return to work, if they do not have the virus. My colleagues across the Cabinet will feed in to me who else they believe from their respective sectors qualifies as a critical front-line worker so that we can ensure that steps are taken to include them.

Photo of Monica Lennon Monica Lennon Labour

I welcome the health secretary’s update that health boards have received additional supplies of personal protective equipment. I have no doubt that that will continue, but an immediate challenge has been raised on behalf of Scottish Ambulance Service staff by the Scottish Joint Industry Board, which I know wrote to the First Minister on Friday. The board is concerned about the lack of PPE among crews. It wrote on Friday because a paramedic who had been sent to a suspected Covid-19 patient without PPE was later confirmed as having the virus, as was the patient. Staff are naturally very concerned and worried. What immediate steps have been taken to reassure Scottish Ambulance Service staff about the vital PPE that they need?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

The ambulance service has already distributed supplies to about a third of those in its workforce who require the equipment and training. It is working to ensure that all relevant ambulance personnel receive the face-fit mask and the other protective equipment that they need, and that it has covered rapidly all relevant paramedic and ambulance staff. The service is about a third of the way through the exercise, which is continuing.

The ambulance service is also looking at different ways by which it can achieve its aim. For example, at Ninewells hospital, it has deployed a member on the basis that most of the crews will eventually get to them at the accident and emergency department. As the crews come in with the relevant patient and hand over, they can very quickly get their face masks fitted. They are then ready for training, and it can be moved along as quickly as possible. I assure Ms Lennon that the ambulance service is taking the issue very seriously indeed. It already has its plans in place and is working through them, and we are monitoring the situation closely to make sure that it meets the necessary timescales.

Photo of Bruce Crawford Bruce Crawford Scottish National Party

My question is for John Swinney, the Cabinet Secretary for Education and Skills. I have received representations from a number of constituents—I guess that he will have done, too—about the potential closure of schools. Although schools are not to close at this stage, I am also being asked what is being done to provide guidance to education authorities, schools and concerned parents about whether children with significant respiratory conditions should be removed from school to protect them from potential harm.

Photo of John Swinney John Swinney Scottish National Party

I acknowledge the concerns that Mr Crawford has raised. I have heard many of them from members of the public around the country, as has the First Minister, and she addressed many of those issues in her remarks.

The situation is clearly evolving. The recommendations for social distancing that were set out yesterday, particularly for those with challenging health circumstances, apply to school pupils as much as to any other members of society. The guidance is clear: a young person in those circumstances should not be expected to attend school. Schools should understand and support young people in that.

On the wider question of the availability of schools, we are in active discussion with our local authority partners and with professional associations. As the First Minister said yesterday and earlier today, those issues are kept under active and daily review. We will have further discussions on those questions later today.

Photo of Jamie Greene Jamie Greene Conservative

I will carry on in that vein with my questions for the education secretary. I appreciate that he is striking a difficult balance between local autonomy in decision making and mandatory, nationwide advice to schools.

I have some specific questions. Are parents currently being advised to take children out of school if a whole household has to self-isolate for 14 days? Should those children return to school thereafter? What conversations is the Government having with local authorities about how and when those who are in charge of educational settings may take individual decisions to close institutions if they deem that appropriate?

There is also some confusion about whether any teachers who fall into a vulnerable group must still attend their place of work. That applies especially to pregnant teachers and those who have existing health conditions or who may present with symptoms.

Photo of John Swinney John Swinney Scottish National Party

I will link Mr Greene’s first and third points together, as my response to them is the same. If a pupil is part of a household, the 14-day requirement applies to that pupil as it does to that household. That is based on the population-wide general advice that has been made available. The same applies to members of the teaching profession. If an individual member of the teaching profession experiences symptoms of Covid-19, they should stay at home for seven days, and, if they are part of a household, that would invoke the 14-day rule for that household. The situation for teachers and pupils is no different from the situation for any other person in the country. That is based on the advice that was issued yesterday.

On the question of individual decisions about school closures, the statutory power to run and to deliver education at local level is exercised by local authorities under the Education (Scotland) Act 1980. We are in discussion with local authorities about the question of school closures. There was a further discussion this morning between my officials, COSLA and the Association of Directors of Education in Scotland, and we will have further discussions on such matters later today.

Individual local authorities have had to take school-by-school decisions. A lot of those have been made in Beatrice Wishart’s constituency of Shetland, although other schools have also closed: Dunblane high school, Perth high school, Hazlehead academy, Montrose primary school in Angus and Lanark grammar school. A range of schools have had to take those decisions because of their individual circumstances.

I want to take any system-wide decisions collaboratively, and we are having those discussions. I place on the record that I had a very helpful conversation this morning with Gavin Williamson, the United Kingdom Secretary of State for Education, who is wrestling with many of the same questions.

Photo of David Stewart David Stewart Labour

My question is for the Cabinet Secretary for Health and Sport. The chief medical officer for England predicted that nearly all the Covid-19 cases will hit in a heavily concentrated burst—50 per cent in a three-week period and 90 per cent over nine weeks. Does the cabinet secretary recognise those estimates for Scotland, and does she share that pandemic modelling?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I recognise those numbers, but I remind David Stewart that the measures that were announced yesterday aim to bring down those numbers as low as we possibly can over a long period—it is not a short-term exercise—in a way that will allow our national health service to manage those who require treatment. We have done that modelling across the UK so that our modelling on how we can scale up the NHS in Scotland matches what it is anticipated can be done south of the border and elsewhere. We have now taken those particular steps partly to enable the increased capacity to meet the demand.

I remind the member that we said that those measures are in the mix but that we must take them at the right time in order to secure maximum impact. On the basis of scientific and clinical evidence, we have judged that now is the right time to take those steps, as we begin to see an increase in case numbers.

Photo of Gillian Martin Gillian Martin Scottish National Party

My question is for Fiona Hyslop, the Cabinet Secretary for Economy, Fair Work and Culture. Like many colleagues, I have had calls from business owners who are concerned that their insurers will not cover them if they are required to close for a period as a result of Covid-19. That could result in businesses being forced to close permanently and staff being unnecessarily laid off and left without income. Can the cabinet secretary advise what steps have been taken to support businesses and their employees who are facing this worrying situation? I welcome her comments about the banks, but what is her response to the information that I have just given about insurers?

Photo of Fiona Hyslop Fiona Hyslop Scottish National Party

As it stands, the Scottish Government has no powers to close pubs, restaurants and other businesses. However, the emergency legislation that is currently being prepared and presented to the UK Government—although it is UK legislation, there is a role for this Parliament in that—will provide those powers. That will help to resolve issues for some companies and businesses that have insurance policies that would depend on the Government instructing businesses to close.

I am acutely aware of the immediate issues that many tourism and hospitality businesses, including pubs and restaurants, face. We are quite clear that those powers are needed soon—perhaps the UK Government could consider shortening its timescale, but I will leave it to my colleague, the Cabinet Secretary for the Constitution, Europe and External Affairs, to liaise with the UK Government on that. That might require that this Parliament take action as well, but those powers are needed before any such action can be taken. We are very aware of that and will urgently bring that to the attention of the UK Government.

Photo of Rachael Hamilton Rachael Hamilton Conservative

My question is for the Cabinet Secretary for Communities and Local Government. Individuals who are self-isolating on statutory sick pay or who have just lost their jobs are experiencing huge pressures on their household incomes. What little they have to live on is being prioritised to feed their families and to heat their homes. What advice is the Scottish Government giving to local authorities to help residents who cannot pay their council tax bills or who may, indeed, need further financial help?

Photo of Aileen Campbell Aileen Campbell Scottish National Party

We are working very closely with our partners in local government to work through our local resilience plans. I am acutely aware of the scenarios that Rachael Hamilton speaks about and the financial vulnerability that is being caused by the response to Covid-19.

We are currently working on a number of measures to support those who are financially vulnerable. That includes looking at an increase to the Scottish welfare fund, providing support for renters, as I outlined in my response to Alison Johnstone, and working with energy companies to look at ways in which we can support people who are fuel poor or are unable to keep their homes warm.

We are also looking to respond to food insecurity issues. We have already worked quite closely with FareShare in preparation for Brexit, so we have existing good contacts and networks. In addition to that, we are not ruling out the need for us to purchase food.

We are working through a number of areas because of the financial vulnerability that people are experiencing, to ensure that they do not face hardship. At the most basic level, we want to ensure that people are kept safe, warm and fed, and that is guiding our actions and our approach, which will be outlined in more detail on Thursday.

Photo of Elaine Smith Elaine Smith Labour

I have been asked by a number of student nurses to clarify some issues, so my question is for the Cabinet Secretary for Health and Sport. What guarantees will be given to final-year nurses who will be needed to work on the front line—will they be offered early registration through crediting the hours worked as placement hours, which are needed by their course?

What pay band will they be on? Will they receive the normal two-to-four week induction period, with the necessary extra support, before entering a ward? Will they be professionally insured? Who should provide the PPE? Some hospitals are saying that it should be the university, and the university is saying that it should be the placement provider, so there is a great deal of worry.

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I will be grateful to all the final-year nursing and midwifery students within six months of qualifying who will step forward and assist us in that way. There are about 3,000 such individuals, whose engagement will be voluntary. We have been in discussions yesterday and today, and we hope today to finalise a four-nation agreement with the Nursing and Midwifery Council that will allow that to happen with no detriment to those final-year nursing and midwifery students, so that they will be credited for that work and will not be held up in finally qualifying. I do not have directly to hand which nursing band they will be on, but I will be happy to advise Elaine Smith on that.

On PPE, I have little time for squabbles like that, so I will sort out exactly who will be providing the PPE. It will be the health service, and if we think that it should have been the university, we will have that argument another day. However, we will ensure that the students have PPE and the necessary induction.

Photo of Bob Doris Bob Doris Scottish National Party

This is for the Cabinet Secretary for Communities and Local Government. I had a meeting this morning with Glasgow North West Citizens Advice Bureau and partners, including housing associations and the Trussell Trust, and we are mapping out the provision and co-ordination of matters such as emergency food need and supply, welfare and benefits, and energy, which is particularly relevant for those on prepayment meters. How does the Scottish Government intend to assist such a community-level response, not just in practical terms but financially? How will it support trusted community stakeholders who know their communities well and are prepared to do all that they can on the ground to assist at this hugely challenging time?

Photo of Aileen Campbell Aileen Campbell Scottish National Party

There is a lot that is incredibly negative about this situation, but one of the things that has given us a lot of heart has been the incredible response that we have seen in many of our communities. The desire to help those who are most vulnerable in our communities is exactly the kind of work that we want to support financially. As Jeane Freeman said, this is an unprecedented situation, and it requires an unprecedented response. It will require us to move at scale and pace to help those who are most vulnerable. That includes financial support for community endeavours, and giving community activists the guidance necessary to keep them safe and healthy, too.

In response to Rachael Hamilton I outlined some of the areas in which we are looking to do further work. That includes fuel poverty, food security and working to support people to keep their homes. That will require us all to work together. It is not just about national and local government; it includes the community endeavours that will be absolutely necessary to ensure that we will emerge from this situation. We will outline more of the detail of the finances and the numbers on Thursday. However, if there are community organisations that members want us to know about, this would be the best time to tell us, so that we can direct the resources in the most appropriate way.

Photo of Gordon Lindhurst Gordon Lindhurst Conservative

This is a question for the Cabinet Secretary for Economy, Fair Work and Culture. Self-employed people are facing particular difficulties at the moment, and possibly loss of their livelihoods. Can the cabinet secretary provide detail of what help and financial assistance is available to self-employed people in Scotland, and how they can quickly and easily access that help and assistance?

Photo of Fiona Hyslop Fiona Hyslop Scottish National Party

The Scottish Government will do what we can. On Saturday, my colleague Kate Forbes set out a number of ways to help companies, particularly using the rates system. She has circulated that to members.

There are particular issues around the ability of the self-employed to claim and get support. I understand that the employment assistance system can be in place but, again, those are Department for Work and Pensions and jobcentre issues.

I happened to be in my local jobcentre on Monday having a discussion on what was available to the self-employed and businesses in particular. Some of the measures that the UK Government can bring in—and indeed, has brought in to an extent—around availability of support, particularly if people are not eligible for statutory sick pay but can get employment and support allowance, are an opportunity to help the self-employed. We will make sure that we communicate what we have and what is available to the self-employed and we will support people where we can, but we will need to do that together with the UK Government.

Photo of Jackie Baillie Jackie Baillie Labour

I know that the Cabinet Secretary for Health and Sport recognises the important work of social care providers. Will she work with the Convention of Scottish Local Authorities to ensure that social care providers are paid for the services that they are commissioned to deliver, irrespective of the impact of Covid-19? As part of that, the cabinet secretary will be aware that social care providers base their financial modelling on a 4 per cent sickness absence rate. If they hit absence levels of 20 per cent or more, which is projected, the impact on providers will be significant. Will the cabinet secretary turn her attention to that urgently, given the need to sustain social care services?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I assure Ms Baillie that my attention is already on that matter. COSLA and I are working very closely together on a range of social care matters. Social care provision is vital at the best of times and absolutely critical in these times—not least because there will be increased demand on social care. We are looking at how we ensure the sustainability and resilience of that workforce and how we make provision to cope with a greater-than-normal absence level so that there is no dip in the care that people receive and the packages that they require. Some of that will involve having some of the individuals that we talked about earlier—perhaps final-year nursing students, AHPs and others—working to the level of their competence, but not beyond, and being supervised appropriately.

We will look at all those matters and, as I said to Jackson Carlaw, if any member has any specific instances of concern where someone’s package has been altered in some way or they feel that they are not receiving the care that they require, I need to know that in detail, and I will act on it as soon as I receive it.

Photo of Patrick Harvie Patrick Harvie Green

The Scottish Government has had a fair work agenda for a good number of years. Despite the sincere efforts that have been made, there are still vast numbers of people in Scotland who endure poverty wages, precarious incomes and many forms of workplace exploitation. This crisis is exposing their vulnerability like nothing before. I am sure that many of us are aware of individuals who are losing pay or losing their jobs altogether already and of many who are reporting that they are being given no choice by their employers but to turn up to work despite having symptoms.

Does the Scottish Government recognise that whatever level of support is provided to businesses, it needs to filter through to individuals and fair work conditions need to be attached? Is the Government aware that a number of countries are responding to this emergency with policies akin to a universal basic income and that the case for that direct financial provision to individuals will only grow stronger the longer this situation lasts?

Photo of Fiona Hyslop Fiona Hyslop Scottish National Party

There are a number of issues there. Fair work is very important to the Scottish Government and has been and will continue to be. The statement that Kate Forbes made on Saturday in relation to business rates specifically referred to the fair work agenda and its importance. Last Wednesday, I met business leaders and the STUC and fair work was central to that discussion, because if we ask people to take tough decisions about their businesses and put front-line workers in jeopardy in any way, we have to make sure that they are supported.

We should make it absolutely clear that everyone—businesses and employees—should respond to the health advice on what is acceptable in relation to how people work. People who are symptomatic should not be in work. Part of that responsibility lies with businesses. That is the discussion that we had with the business organisations, who I will continue to speak to. As of now, we are trying to make sure that businesses stay as businesses, and that means making sure that there are jobs for people to go to. We will absolutely pursue the fair work agenda and I will meet the STUC again tomorrow on the issue. We have to be realistic about where businesses currently find themselves. Keeping people in jobs in the first place is important.

In relation to Mr Harvie’s point about a wage subsidy or a universal basic income, that is a wider, longer-term issue. However, some countries, such as Denmark, are putting a wage subsidy at the heart of their response. That is important because many businesses are facing crisis because demand has fallen. Those are profitable and well-run good businesses, that in other circumstances would not need support. Cash flow is an issue, and the responsibility for addressing it should be shouldered not only by the banks, as I said, but by Governments. We have seen Governments in other countries take action on that, and we can discuss the matter with the UK Government.

Photo of Beatrice Wishart Beatrice Wishart Liberal Democrat

This is an islands-specific question for the Cabinet Secretary for Health and Sport.

Shetland does not have an intensive care unit at the only hospital on the island. Can the cabinet secretary provide reassurance that, when patients with Covid-19 require to be evacuated from the Shetlands or other island groups to ICUs on the mainland, those medical evacuations will be carried out safely and efficiently?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

That is a very important question for our island communities. I am pleased to say that I can confirm that the Scottish Ambulance Service will ensure that any patient who has a clinical need to be transferred from any of our islands will be transferred in that way. An issue that had been causing concern was to do with the use of fixed-wing aircraft and the PPE that was required for those who would pilot the aircraft and those who would work with the patient, but that has now been resolved.

On Friday, the Scottish Ambulance Service held a conference call with all the chief executives of our Highlands and Islands NHS boards and produced its specific plan for the retrieval of patients in such circumstances. It has also held discussions about and set in place a plan for the use of a ferry, if that is appropriate. That includes arrangements for road transfer thereafter, once the ferry has docked.

The Presiding Officer:

I am conscious that the hour that we allocated for the statement and questions has been used up. If members are agreeable, I will let the session run on, perhaps up until half past 3. We will probably still not get through all the questions that members have, but there will be other opportunities this week to ask questions.

Photo of Annabelle Ewing Annabelle Ewing Scottish National Party

I have a question for the Cabinet Secretary for Health and Sport.

Given the unprecedented position that we are all now in, can the cabinet secretary advise how the people of Scotland can best access advice on everyday healthcare concerns without putting unnecessary pressures on our front-line services?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

The best way not only to alleviate pressure on our GP services but to obtain accurate, reliable and up-to-date information is to use the NHS inform website. I encourage everyone, including members of the Scottish Parliament, to use that website and to keep up to date in that way.

Photo of Liam Kerr Liam Kerr Conservative

Could the Cabinet Secretary for Justice update Parliament on what consideration has been given to any measures that are required in prisons to ensure that prison staff are sufficiently protected, that prisons operate with sufficient staff and that prisoners receive adequate healthcare?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

The Scottish Prison Service has a national coronavirus response group, which has implemented the service’s pandemic plan. Local governors will oversee those plans in local establishments.

We have a multitude of concerns, which are primarily for our staff and those in our care. With regard to staff, we have ensured that the SPS has secured sufficient levels of PPE for the next 10 weeks, but those levels will be kept under review and increased when necessary. With regard to prisoners, we have clinical protocols and guidelines for the testing of prisoners. We also want to ensure that we allow the regime to continue to operate on a business-as-usual basis, as far as that is possible, because we have seen what has happened in other countries. In Italy, unfortunately, there were riots that led to deaths in prisons, not because there were cases of infection, but because visits and leisure activities were stopped, with prisoners being confined to their cells for up to 24 hours at a time.

Of course, when it is necessary, when people in our care are displaying symptoms, they will be isolated, but as far as it is possible within the guidelines, we will continue to ensure that visits can take place and that other activities can continue. We are working hand in glove with the NHS to provide healthcare in our prisons. A number of our prisoners—the majority of them, in fact—require medication. As things stand, medication stocks are plentiful, but we continue to keep that under review.

I give Liam Kerr an absolute assurance that the safety of our staff, who do an immense job in our Prison Service, and of those in our care is, of course, our number 1 priority.

Photo of Neil Findlay Neil Findlay Labour

Will the First Minister explain the testing a bit further? The World Health Organization’s advice is clear: it is to

“Find, isolate” and

“test ... every case”.

That does not appear to be the position that the First Minister set out. Given that the World Health Organization has all the institutional and practical knowledge of dealing with the pandemic and that it knows what works and what does not work, will the First Minister explain why we are maybe not following its guidance to the letter?

The First Minister:

Before I do that, I should explain that Fiona Hyslop has just left the chamber because she has a call with the UK Secretary of State for Business, Energy and Industrial Strategy that is due to take place at 3.15 and which she mentioned earlier. If there are further questions for her, Kate Forbes or I will pick them up.

I have taken great care to understand the advice that has come to me, and I will continue to do so, because I understand the importance of having an approach that is informed by the best possible advice. My advice in Scotland is that, if we tested every single person who displayed symptoms, that would, because we are asking them to stay at home, involve such a magnitude of resource that we would take resource away from other parts of the health service in which people need it. Crucially, if somebody was self-isolating and tested positive, the advice that they would get would not change in any way from the advice that they are getting right now.

I will continue to interrogate that position. I do not know what is happening in other countries, but I consider what would be required here to test every single person who has any symptoms of coronavirus, and I simply have a doubt in my mind about whether that is happening in other countries in exactly that way.

However, I know how important it is that we have much better information than we have from the figures that we have published so far in order to know how the virus is progressing. That is why the surveillance testing is so important. We must ensure that we do everything that we can to protect the resilience of our key workers in the national health service and social care in particular, and in critical infrastructure. That is why we are intent on testing people in those categories.

We have to continue to consider whether there should be further expansion beyond that. There has been discussion about how we can develop much quicker testing—almost testing that could be used by individuals themselves—to give individuals clarity about whether they have had the illness and perhaps enable them to go back to work.

I treat all those things really seriously, and I understand people’s concern about an apparent discrepancy between the strictness of what the WHO is saying and what we are doing in practice. I reassure Neil Findlay and other members that a great deal of care and thought is going into what we are doing to ensure that it meets all our needs. My mind is certainly open, and I will continue to interrogate what we might do beyond the systems that we have put in place.

Photo of Kenneth Gibson Kenneth Gibson Scottish National Party

My question is to the Cabinet Secretary for Rural Economy and Tourism, Fergus Ewing.

Today, I have been contacted by concerned residents of Cumbrae. Some 30 per cent of the island’s 1,400 residents are over 75, and there is only one small store on it. Mainland supermarkets do not deliver to Cumbrae, and CalMac Ferries is likely to reduce its services in the weeks ahead. How will vulnerable people in Cumbrae and other island communities be supplied with food and other essentials at this difficult time?

Photo of Fergus Ewing Fergus Ewing Scottish National Party

It is essential that the more remote areas, such as the Isle of Cumbrae, which is in Mr Gibson’s constituency, receive equity of supply. In other words, shops and general stores should continue to receive the supply of food that is received and taken for granted in the cities.

I have had two conference calls with major retailers in the past week. They are doing a fantastic job in keeping the shelves replenished in the face of huge demand, and I pay tribute to all those in the workforce in those shops, who are making a sterling effort to serve their customers in difficult circumstances. I have received assurances from each of the national retailers that there will continue to be equity of supply across Scotland, including in the more remote areas.

We have also been working over the past week to ensure that deliveries of goods to shops can be made more flexibly. The chief planner wrote early last week to each local authority, urging them to allow restrictions on the hours within which goods are permitted to be delivered to stores to be lifted. I am very pleased to say that there has been a terrific response from local authorities to enable that to happen.

Finally, I suspect that drivers’ hours will increasingly become an issue, as there are—quite appropriately—restrictions. I have had discussions with the UK Government on the extent to which and when drivers hours should be looked at. That will be done precisely to address the question that Mr Gibson raised—which applies to many islands and many remote communities in Scotland—and ensure that communities can continue to receive basic supplies of food during the coming difficult weeks ahead.

Photo of Brian Whittle Brian Whittle Conservative

Irvine & Troon Cancer Care has been in touch with me to point out that it is still taking patients to and from the hospital for treatment, as I am sure is happening across the country. That organisation is now restricting each transport to one patient per car, whereas it has usually been three per car; therefore, its running costs are going to triple to around £10,000 per month. I ask the cabinet secretary whether the Scottish Government is able to commit anything to help meet those additional costs.

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I am grateful to Mr Whittle for that question. Other vital cancer-related third sector organisations across the country are doing the same excellent job that the one in our constituency is doing. I am happy to have discussions with organisations that are taking the precautions that we advise them to take but which come with an additional cost.

I am happy to pick that up with that particular organisation, but the Scottish Cancer Coalition network is another group whose views, as well as any additional asks or concerns, I would want to ensure that we have, so that we can address them.

Photo of Sarah Boyack Sarah Boyack Labour

My question was for the fair work secretary, but as she has left, I will address it to the Cabinet Secretary for Finance.

I have just been made aware of a staff member of a major retailer being sent home because she was wearing a scarf to shield her mouth. She has a child at school and her partner has chronic obstructive pulmonary disease, so she is concerned about infections. She has been sent home without pay.

Can the cabinet secretary speak to employers, in particular retailers, so that we can urgently ensure that people have the right protective equipment? That way, where possible we can have business as usual, with both staff and customers being protected. I imagine that such issues will be raised in a number of industries.

Photo of Kate Forbes Kate Forbes Scottish National Party

I would be grateful if Sarah Boyack would supply me with more detail on the specific case that she mentioned, so that we can look into it further.

We are working very closely with businesses, not just on supporting them but on ensuring that they protect their workers and that appropriate guidance is given to workers. Ultimately, what we really care about is protection of workers, just as we care about protecting the rest of the population.

Photo of Emma Harper Emma Harper Scottish National Party

There has been a massive amount of social-media traffic from volunteers who wish to help. My question is perhaps best aimed at Aileen Campbell. Will the Scottish Government issue guidance to local authorities on optimal co-ordination of support, including for volunteers, to help vulnerable groups and people who are self-isolating?

Photo of Aileen Campbell Aileen Campbell Scottish National Party

We are currently working with our local authority partners in COSLA and in the Society of Local Authority Chief Executives and Senior Managers, in particular around their local resilience plans, but we are also taking on board the clear need for us to provide guidance on some parts of the community response in order to keep communities safe and to ensure that we harness community endeavour and the volunteers who are so eager to play their part in response to the situation in which we find ourselves.

We are working closely with a number of other third sector partners, including the National Emergencies Trust and the British Red Cross, to ensure that that guidance can be worked out, and that we can provide leadership to enable people to do what they need to do in our communities, and in the large-scale resilience effort that is required.

Photo of Ruth Davidson Ruth Davidson Conservative

According to the most recent data, 59,640 people in Scotland receive home care services such as help with getting in and out of bed, washing, dressing, feeding and toileting. That is almost 60,000 of our most vulnerable people, who are often entirely dependent on visiting care workers. I ask the Cabinet Secretary for Health and Sport what specific contingency plans have been put in place to ensure that nobody is left untended when members of care teams have to start self-isolating or stop work due to their own care responsibilities?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

We have already covered that, but I will go back over it again.

The work that we are doing directly, and joint work with COSLA, which either provides the services directly through local authorities or commissions them through contract with private providers, is looking in detail at workforce planning in order to ensure resilience in that workforce. That work is two-fold: it considers the anticipated level of absences for reasons that Ruth Davidson outlined, and it anticipates the increase in demand for social care as a consequence of other measures that we have introduced.

The workforce planning is looking at what provision can be made available, in part through our local authority chief executives considering what services they could pause and how they might redeploy staff. That will require the Government to provide specific training, and COSLA to ensure that redeployed staff have whatever PPE they need. It will also consider how else we could bring healthcare assistance workers from some of the additional workforce that I spoke about earlier—including those final-year nursing students and year 5 medics.

Photo of Anas Sarwar Anas Sarwar Labour

I join others in thanking all our front-line staff and the thousands of volunteers across the country. I also want to thank all the expert advisors and officials who are working round the clock.

There will be times when the evidence and the advice conflict, and politicians will have to make judgement calls. We might question the advice, and we might question the judgement calls, but what we should never question is that advice is always given, and judgement calls are always made, with the best intentions.

Last week, I raised an issue about GP supplies with the First Minister and the Cabinet Secretary for Health and Sport. I am grateful for their immediate action and for the supplies that have now been provided to GPs across the west of Scotland in Glasgow, Renfrewshire and Lanarkshire.

However, GPs have since contacted me to say that, despite receiving those supplies, they have concerns about them. Many practices have received fluid-resistant masks on which a label has been placed over the expiry date. The label shows that the expiry date is August 2021. However, when GPs have peeled off the expiry-date sticker, the true expiry date is actually April 2016—four years ago. The manufacturer’s published advice says that those supplies can work for only three years after production, which means that they are four-year-old supplies with a false expiry date. That has, obviously, raised serious concerns among those GPs. What actions can the First Minister and the cabinet secretary take, what reassurance can they give those GPs, and what immediate action are they taking to acquire fresh supplies and ensure that they are adequately distributed around the country?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I am grateful to Mr Sarwar for his comments, and also for that particular question.

I am aware of that issue. To be clear, the supplies that have been issued to GPs have been issued according to Health Protection Scotland guidance that is based on the nature of the supplies, which include masks, goggles, aprons and so on. However, we are aware of the particular circumstance that Anas Sarwar described. We are taking steps with the health boards to ensure resupply and that the situation is not repeated. GPs have been contacted so that they know that that is under way and so that they can be reassured.

As I said, my requirement is that all our general practices receive the supplies that they need, and that those supplies are fit for purpose. That requirement also relates to the timescale for receipt of the supplies: they should be received by Friday and I should be advised by Monday that it has happened and that there are no gaps.

Photo of Shona Robison Shona Robison Scottish National Party

Can the Cabinet Secretary for Communities and Local Government say what action she can take to support households with prepayment meters who, in the event of self-isolation, might be unable to front-load their meters. What more should the big six energies companies be doing to help their vulnerable customers in this situation?

Photo of Aileen Campbell Aileen Campbell Scottish National Party

We are working to ensure that households can keep their heating on. Shona Robison is absolutely right that the energy companies will have to play their part, which includes prepayment meters being provided with credit. Licence conditions require all suppliers to be sympathetic to the individual circumstances of people who are in financial difficulties, and to the need to prioritise maintaining their supply. We are working on methods through which we can keep the heating on for people, but we will also be engaging with the energy suppliers, because they have an enormous role to play in ensuring that that can happen.

Photo of Graham Simpson Graham Simpson Conservative

I have an education question. Are any plans in place to allow final-year university students and, indeed, school pupils to sit their exams?

Photo of John Swinney John Swinney Scottish National Party

Mr Simpson has raised a significant issue. At university level, each institution will have to determine how exactly it will handle accreditation of learning by its students. The Government will have no locus in that.

Some weeks ago, I asked the Scottish Qualifications Authority to provide me with options on what would happen should the exam diet be unable to proceed. Three options are available to us in the foreseeable future. First, the exam diet could proceed. Currently, that is the intention and it is the SQA’s position. Secondly, the exam diet could be delayed until later in the year. That would cause significant disruption, but we are facing significant disruption. Thirdly, the SQA could undertake some form of accreditation of learning, based on available evidence, which would include a collection of course work, prelim results and estimations based on teacher judgment that are routinely submitted to the SQA.

I know that that is not a definitive answer to Graham Simpson’s question, but I assure him that contingency planning has been done. We are considering the circumstances that we face. The current intention is that the SQA exam diet will continue as planned and will commence on 27 April.

Photo of Colin Smyth Colin Smyth Labour

The health secretary will be aware that, yesterday, the Government’s figures showed that the first case in Dumfries and Galloway had been confirmed. Today, I understand that there are, in fact, no confirmed cases, because that test was inconclusive, but nobody believes that nobody in the region is suffering from coronavirus. Many people are self-isolating either because they have symptoms or because family members have symptoms, but most of those people will not be tested.

However, the health secretary has said that key workers will be tested. Given what she has said about the need to redeploy people, for example, from one local government job to another in social care, will she ensure that the definition of “key worker” includes not only people who carry out the tasks at the moment but people who could be redeployed from other departments to carry out such tasks, so that we can keep the workforce as strong and as large as possible?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I will make two points in response to that question. Colin Smyth mentioned the false positive test in Dumfries and Galloway and how the community feels about that. That underlines why it is right for us to move to community surveillance and to upscale it, notwithstanding the First Minister’s comments about continuing to press on with other areas of testing. Scaling up community surveillance will give us much more robust data—greater than that which we currently get through individual testing—about the level of infection in communities.

Colin Smyth asked about key workers. We will ensure that the definition takes into account tasks that have to be completed, and not just the individuals who do them. People who are redeployed to key areas of work—whether they are a final-year nursing student or a local authority worker—will fit under the definition of key workers.

Of course, the other area that needs to be assured—we are taking steps to make sure that it is—is work in social care and elsewhere that requires protection of vulnerable groups scheme testing. All those steps will be taken, and we will ensure that the tasks that are undertaken guide us in defining key-worker status.

Photo of Fulton MacGregor Fulton MacGregor Scottish National Party

I have a question for the health secretary. A constituent whose son has type 1 diabetes has contacted me. They are worried about availability of insulin as the virus outbreak continues. Apparently, there has been rationing of insulin in Norway. Does the Government have that issue on its radar? If the matter is on its radar, are there plans in place to deal with the situation?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

Yes, the matter is on our radar. We are paying particular attention to availability and supply of medicines. I am very grateful to our chief pharmaceutical officer, Rose Marie Parr, who has postponed her retirement in order to continue to lead that work with us and her colleagues. That is very helpful.

There are significant connections between our pharmacy work in the Scottish Government, the community pharmacies around our country and the suppliers of medicines. That includes supply into the UK network, and the close working that we have with the UK Government on supply is really important.

We continue to observe the supply of medicines, to speak with the pharmaceutical companies when that is required, and to ensure that our community pharmacists and our prescribers are aware of alternative steps that they can take while we look to resolve any dips in supply of critical medicines.

The Presiding Officer:

I draw the item to a close. I thank members and ministers for their understanding. I am conscious that I have eaten into everybody’s time. Just under a dozen members still want to ask questions. We will have an opportunity to return to the topic tomorrow and the next day, when there will be more Government statements, and at First Minister’s questions.