2. I thank the First Minister for advance sight of her statement.

When we started to come out of lockdown, we made clear our view that there must be the agility to pause and to go back, as well as to go forward in the process, and that there must be transparency in the science to back it up. The science tells us that across much of Scotland the virus is on the rise again, and that there is no room for complacency. Therefore, we support the cautionary approach that the First Minister has taken today.

However, something that must concern us all is that, in Scotland’s testing strategy, which was published only last month, the Government said that its target is to have a daily testing capacity of 65,000. Yesterday, only 14,341 tests were carried out. When schools returned a few weeks ago the testing system in Scotland faced extra pressure, and it buckled.

The First Minister can launch a new app today, but at the Covid-19 Committee yesterday Professor Linda Bauld warned that

“If we cannot get rapid testing, we really are in trouble.”

Professor Bauld is right, is she not?

I did not hear the particular comment that Richard Leonard referred to. However, as I said yesterday when I was asked about other comments made by Professor Bauld, I listen to her very carefully. She is one of the many experts we are lucky to have in Scotland. She talks a lot of sense, and her advice is always important.

I am going to try not to be too technical here. The issues that Richard Leonard raised are important and very legitimate, and we are working our way through them to ensure that we continue to build both the capacity and resilience of the testing system. The technical bit, which I will not go into at too much length and which I alluded to in my reply to Ruth Davidson, is that a large part of our testing system is part of a United Kingdom-wide network, including the Glasgow Lighthouse lab and drive-through centres, and therefore capacity and access to testing are managed across the UK.

We are working with the UK to ensure that Scotland’s access to capacity is appropriate and fair, and during the past few weeks we have probably used more than our population’s share. That is partly because of the rise in demand as our schools went back; we have seen that demand recede a little bit. Although there will be issues—there have been some issues about turnaround time with postal tests, for example—over the past few days we have not seen issues with access to testing for people who need it or, as was the case when the schools went back, with people being referred to testing centres that are some distance away.

We have seen—and this will be a reflection of England’s schools going back—a rise in demand in England that reflected ours when our schools went back. I do not want to overstate this, but I have some concern that rises in demand in England might impact on Scotland’s access to testing. That is why we continue to work closely with the UK Government on that.

Right now, and during the last number of days, there has not been an issue with people in Scotland who need testing getting rapid access to it. The figures that Richard Leonard quoted are actually figures that were reported yesterday for 8 September. Today’s figure—which I appreciate is not published yet, so Richard Leonard could not be expected to have it—is that around 17,000 tests were carried out yesterday. Those are tests carried out, not capacity. For some of the reasons that I have mentioned, capacity fluctuates daily right now. The target that he referred to is still the one that we are looking at. I assure Richard Leonard and the chamber that, on a daily basis, the health secretary and I look very closely at all those issues to ensure that people in Scotland who need testing have access to it.

I thank the First Minister for that answer, although I reflect that the actual number of tests carried out yesterday—or the day before and reported yesterday—is still 50,000 below the target figure.

Let me move on to something else. Any new restrictions and local lockdowns have a significance because they have an impact on all our lives and wellbeing. However, research shows that Scotland’s children and young people, and younger children in particular, have found the past six months especially hard to cope with—so much so that mental health organisations came together last Friday to unite in warning of the coming mental health crisis.

The Scottish Children’s Services Coalition forecast that Scotland’s children and young people face “a perfect storm” and called for “a national crusade” to tackle that. It also said:

“The Government needs to work urgently with the relevant authorities to ensure that not only is there sufficient provision available at the local community level, but that this is clearly communicated and easily accessible for young people and their parents or carers.”

What urgent action is the Government taking to calm that perfect storm?

The First Minister:

I thank Richard Leonard for that question, but first I want to cover off part of his previous question, in the interests of public understanding. The target figure is for capacity. We have been deliberately seeking to build the capacity that we will need in winter, which is much higher than the capacity required by the demand that we have now. The figure that Richard Leonard quoted for the day before yesterday, and which he is right about, is the demand figure. It is demand-led. It is not accurate to compare those two figures . I know that such things are complex. We have a capacity target that is designed to reflect what we anticipate demand will be in the winter, which is not necessarily what demand is now.

On the issue of young people and mental health, there are few more important things in our response to the crisis than catering to the needs of young people. Everybody has found the past six months difficult, but there is no group in our population that has suffered more than young people. They have spent months out of school, away from their friends, and often they have not seen their grandparents for long periods of time. The impact on their mental health and wellbeing has been significant.

That is why it was so important to get children back to school full time. I am pleased that we were able to do that and that, so far, we have been able to keep schools open. The cautious approach that Richard Leonard has supported is partly to enable us to keep schools open. We are also mindful of the need to ensure that mental health services are appropriate.

As members have commented and interacted with me on, we already had a challenge with child and adolescent mental health services. Before Covid, we were in a process of re-designing and investing in those services. That work continues and we must now make sure that we take account of the effects of Covid. For example, the commitment to have counsellors in schools will be delivered by next month, and we continue to take forward plans for a community wellbeing service that will be more accessible, in a preventative sense, to young people who require it.

Let me come on to child and adolescent mental health services, because those are central to my question. The Scottish Children’s Services Coalition also warned last week that the Covid-19 restrictions have negatively impacted on young people who were struggling already with anxiety and depression. It goes so far as to warn of a “lost generation”. Services are still not equipped to deal with the demand that there is.

It is now two years on from the damning Audit Scotland report into rejected CAMHS referrals, which made 29 critical recommendations to overhaul the system. The fact is that only seven of those recommendations have been actioned to date. Two years ago, when that report first came out, I asked the First Minister whether she would reform the system of referrals, but it remains largely unreformed and unchanged. Figures from over the lockdown period show a 55 per cent drop in CAMHS referrals. They show that more than 1,100 young people have been waiting more than a year for treatment. They also show that, between April and June this year, more than 900 referrals to CAMHS were again rejected. That was supposed to have changed.

Will the First Minister accept that her Government has failed to implement the recommendations of the 2018 Audit Scotland report on rejected referrals to CAMHS? Will she accept that the Government is letting down a whole generation of young people? On world suicide prevention day, will she finally, once and for all, put an end to rejected referrals?

The First Minister:

I accept that there is much more to do. I will write to Richard Leonard with an update on the progress on and implementation of the recommendations in the report that he refers to because they are important. Some of the work that was under way had been disrupted by Covid—I will come to that—but it remains vital that we take that work forward.

It is correct to say that there has been a drop in referrals, although—and I do not have the figures in front of me—I know that referrals have started to increase again. The drop was largely because of the inability to have face-to-face services during the Covid pandemic. Many health boards—and I know that NHS Greater Glasgow and Clyde has done particular work on this—have used the unfortunate necessity of reduced referrals to catch up on some patients who have been waiting longer. That work has been during the pandemic period.

In the past couple of years, we have continued to invest heavily in CAMHS, and there are more people working in CAMHS. However, fundamentally, we require to reform and put more emphasis on prevention and early Intervention and less on specialist services, so that those services are there for those who need them. That work is under way and it will pick up again as—I hope—we come out of the Covid situation. I also referred to the counsellors in schools and the wellbeing service. All of that is about the vital work that we need to do to ensure that the investment that we are putting in delivers for the young people who need those services.

Finally, Richard Leonard referred to a quote about a “lost generation”, and I understand the fears that lie behind that. All of us—me in particular—have an absolute duty to do everything that we can, not just in mental health but across a range of things, to make sure that that phrase does not come to pass and that this generation of young people do not bear the long-term legacy of Covid. That is a duty and a responsibility that I take very seriously.