I remind everyone that social distancing measures are in place in the chamber and across the campus. I ask everyone to take particular care when they are entering or exiting the chamber.
I start by expressing my gratitude to all those who are working so hard to keep us safe during the pandemic, not least those who work in our front-line health and care services. The roll-out of the vaccines, in particular, is a remarkable effort in every corner of these islands, and the daily vaccine numbers show that the race between the virus and the vaccine is starting to be won.
However, it would be a mistake to see that race as an end game in a battle against a severe acute respiratory syndrome virus that is constantly mutating and probing our weaknesses. As Professor Sridhar put it recently, the vaccine is
“not a strategy in ... itself and relying on it alone is highly, highly risky”.
A well-functioning test, trace and isolate system must form the foundation of our approach to dealing with this and future pandemics.
At last week’s COVID-19 Committee meeting, the national clinical director stated:
“It looks as though we will have to live with Covid in some form for years to come, probably with routine vaccination over time.”—[
, 28 January 2021; c 11.]
If that is to be the case, developing a strong self-isolation package now will serve us well into the future.
Such a system will be successful only if people are actually isolating, and studies have consistently shown that many are struggling to. United Kingdom-wide research that was published by University College London on 13 January shows that 38 per cent of respondents were not isolating for the recommended number of days, and 13 per cent were not isolating at all. That is extremely concerning, and it emphasises the barriers that many people face when attempting to isolate. The same research shows that those from higher-income households are far less likely to not isolate at all. With one in three not fully isolating when requested, we need to do much more to support people.
There are concerning signs that the Scottish Government’s £500 self-isolation support grant is not getting to everyone who needs it. I warmly welcome the First Minister’s announcement yesterday that the grant will be extended to those earning the accredited living wage and below. That was another step in the right direction, which came after conditions were slightly widened last year to include those who meet criteria for the receipt of universal credit.
However, statistics from November show that just 1,200 of almost 4,000 applications for the grant were accepted—only 30 per cent. The Scottish Government suggested that that might be because of a high number of speculative applications, but we urgently need more clarity on that as the criteria have been widened again. Can the cabinet secretary guarantee that applicants are not being wrongly refused? After years of complaints from councils that the administration costs for the Scottish welfare fund are not being met by Government, are councils being fully supported to administer the grant? Even if speculative applications are the main reason for such a high rate of rejections, does that in itself not indicate that there might be significant unmet need?
The grant is means tested, and means-tested social security payments almost always have a lower uptake than universal ones. Has the Scottish Government estimated how many people are entitled to the grant but have not claimed it? If not, why not?
Countries with a far better track record of managing Covid are not scrimping on support. New Zealand offers the equivalent of about £315 a week, regardless of income. Similar amounts are paid on the same basis in Taiwan, Singapore and South Korea, whereas Finland guarantees 100 per cent of the person’s lost income, again regardless of individual circumstances.
Last month, it emerged that a universal payment is the preferred option of England’s Department for Health and Social Care. I strongly encourage the Scottish Government to consider making the grant universal or, at the very least, increasing eligibility further.
In the words of Dr Çevik, who is a member of the new and emerging respiratory virus threats advisory group,
“You can’t just expect people to sit at home with no money, no income, and then get £500 two weeks later, or four months later. The majority of people with Covid have mild symptoms and they will continue going to work if the alternative is that they lose their income.”
As the motion states, there are practical barriers to self-isolation. The self-isolation advice on NHS Inform advises those isolating to
“Separate yourself from other people in your home and keep the door closed. If you can’t stay in a separate room, try to stay 2 metres away from the other people ... If you can, use a separate bathroom from the rest of the household.”
That is easy if you live in a four-bedroom house with plenty of space, but it will prove difficult for many—not just those in temporary unsuitable accommodation but people in multigenerational households and small flats. Hotel accommodation must be offered to everyone who cannot practically follow the self-isolation guidelines in their own home.
“will accommodation such as hotel rooms be offered free to those who need them?”
The First Minister replied:
“The short answer to that question is yes.” —[
, 27 May 2020; c 10.]
However, a freedom of information request that was submitted by the Greens has revealed that, of the 20 councils that have responded so far, only three have provided hotel accommodation for self-isolation—to a total of seven people. That begs the question whether councils are receiving the support that they need to offer isolation accommodation and whether that is being publicised widely enough.
In New York City, a supported isolation package, which includes voluntary, free-of-charge stays at hotels with transport provided, food, medication, pet care and social care, is offered. Other countries that have had considerable success in tackling the virus have introduced similar packages. In South Korea, quarantined individuals are provided with daily necessities and sanitary kits. In Taiwan, individuals are offered financial compensation and support services, including daily follow-up calls, medical care, household services, accommodation and meal delivery.
I note the reference in the Scottish Government’s amendment to the national assistance helpline and the local self-isolation assistance service. I would very much welcome more reporting from Government on the reach and effectiveness of those services, which I know council staff are working hard to deliver in partnership with the third sector. However, given the accommodation figures that I have quoted, I am sure that the cabinet secretary will understand my concern that we need to do everything that we can to proactively support people to isolate.
The Scottish Greens have repeatedly called for an elimination strategy for the virus. I think that that is still achievable, despite the widespread community transmission that has taken place. The challenge will be keeping the virus pinned down. That can happen only through a robust contact tracing system, a supported isolation package, and a very dynamic vaccination programme. If we let any of those elements slip, we will fail, and we cannot afford to fail ever again.
That the Parliament welcomes the COVID-19 vaccination programme and extends its thanks to all NHS workers and others delivering it; understands that an effective test, trace and isolate regime will be needed now and in the future; considers that there are many barriers to adhering to self-isolation, including financial concerns, insecure employment, unsuitable accommodation and caring responsibilities; believes that proactive support is needed to reach the most vulnerable people and to enable compliance with self-isolation, and calls on the Scottish and the UK governments to make the Self-Isolation Support Grant universal and offer a supported isolation package that will provide accommodation, food, and any other essential services that might be required to allow people to self-isolate, free of charge.
I thank the Scottish Greens for bringing this very important debate to the chamber.
Alongside the vaccination programme and the testing programme, compliance with self-isolation is vital to ensuring that the transmission of Covid-19 is reduced.
I recognise that self-isolation is difficult practically, financially or emotionally for many people. Despite that hardship, the vast majority of people comply when they are asked to do so. It is important that we are clear about the facts. A recent University College London study on compliance with self-isolation across all four nations set out that 62 per cent of people developing symptoms complied with the isolation period and 80 per cent of people who had been in contact with someone who had tested positive complied with the guidance. Although the latest research shows that the rates of compliance are much higher than figures that are often quoted, including in the chamber, we still have more to do, of course.
We will continue to build on the substantial support that is available to people who are self-isolating to ensure that, if someone needs help to self-isolate, they can access that.
In 2020, the Scottish Government commenced a number of support services to ensure that vital support is available should people need it. Those services include the self-isolation assistance service, which is a proactive triage call service that is delivered by local authorities. Everyone who is contacted via test and protect is offered a call from their local authority to discuss all the support that is available—both the financial support and the wider support package. Indeed, that service can also be accessed by anyone by phoning the national assistance helpline. Those services provide essential medication, access to food and groceries, and access to local services. Many local authorities also offer wellbeing services, such as newspaper delivery, befriending and dog-walking services.
Local authority staff have made 91,000 calls to assess the needs of people who are self-isolating, and more than 26,000 support referrals were made to help those in need through those services from October to January. I thank all the local authority staff who are delivering that vital support, and I confirm that the Scottish Government will meet the additional administration costs for that, once they are agreed by the Convention of Scottish Local Authorities.
I have heard some fantastic examples of support being provided. A local authority staff member arranged the delivery of breast milk from a new mother to the hospital. A call handler supported a single mother so that her daughter could celebrate her birthday with a cake, a card and a present. A single person who received food delivered to them was also given the support that they needed to re-establish their electricity supply.
In recognising that local authorities best understand the needs of the people in their area, I am also keen to ensure that we enable the sharing of best practice in delivering those services. To that end, we are reviewing the existing support services with local authorities to consider how to standardise the offer nationally. Where local authorities identify opportunities or demand for a particular type of support, we will work to look at unlocking the existing resources to deliver that support to more people across the country.
For many people, though, the financial support is most vital to ensuring that they can afford to comply with a request to self-isolate. The Trades Union Congress today described the UK Government’s statutory sick pay provision as “paltry” and called for a decent level of sick pay to be offered to those who are required to self-isolate. I very much echo that call. The UK’s position on statutory sick pay is far less generous than any other country’s.
The purpose of the self-isolation support grants from the Scottish Government is to help low-income workers who cannot go to work because they must self-isolate and who will lose income as a result. From 16 February, the reach of that grant will be extended to workers who are in receipt of council tax reduction. It will also become available to those with caring responsibilities for someone over the age of 16 who is asked to self-isolate, where the carer fulfils the other eligibility criteria. Workers who earn the real living wage of £9.50 or less will also be eligible for the grant. We will continue to work with the Convention of Scottish Local Authorities to develop clear guidance on those changes for local authorities and for people who have been asked to self-isolate from 2 February onwards.
I also recognise that there is more to do to ensure that people who are self-isolating are aware of the support that is available to them should they need it. To that end, we will undertake a further national media campaign to promote the available support. Public Health Scotland officials have also revised communication materials that are used as part of the contact tracing service to be even more explicit that, if someone needs support, it is there for them.
If we wish to beat the virus, we must all play our part, whether that is self-isolating, going for a test or complying with restrictions. I am grateful to the many employers who have supported their employees who need to self-isolate. I am mindful of the many challenges that businesses face at this time.
However, it is clear that too many people feel unable to stay at home and self-isolate when required, because of a fear of their employer not allowing them to be absent while self-isolating. People who are required to self-isolate but who attend their place of work present a serious public health risk. Encouraging staff to attend work during their isolation period puts that business at risk of temporary closure due to an outbreak. It puts the lives of other employees and their risk as well. By the end of February, all people who are contact traced will be asked whether they would like a notification from Public Health Scotland to confirm that they are required to self-isolate and the dates of their self-isolation period. That notification will make clear to the employer that the person should not be attending the workplace, and it will ensure that people who are self-isolating are supported to stay at home. [
My apologies. I hope that that gives a flavour of the support that is available from the Scottish Government. We are pleased to support Pauline McNeill’s amendment. We cannot support Rachael Hamilton’s amendment, as we have already extended the eligibility for self-isolation grants.
I move, as an amendment to S5M-24029, to leave out from “test, trace and isolate” to end and insert:
“Test and Protect system and self-isolation are necessary to stop transmission of COVID-19; notes that recent UCL research shows that 62% of symptomatic people and 80% of close contacts comply fully with isolation guidance, and expresses thanks to all those who do so; further notes the importance of employers acting responsibly and supporting employees to self-isolate; agrees that there are barriers to adhering to self-isolation, including the UK Government’s low rates of Statutory Sick Pay; acknowledges that eligibility for the Scottish Government’s £500 Self-Isolation Support Grant will be extended to workers who earn less than the Real Living Wage, are in receipt of Council Tax Reduction, or have responsibilities for someone over 16 who needs to isolate; notes the Scottish Government's intention to increase awareness of the support available to those self-isolating, which includes the grant, the National Assistance Helpline and the Local Self-Isolation Assistance Service; expresses thanks to local authorities for delivering this support to their communities, and calls on the UK Government to make adjustments to Statutory Sick Pay and the Job Retention Scheme to provide increased and consistent support to people who need to self-isolate.”
In opening the debate on behalf of the Scottish Conservatives, I echo the thanks that are expressed in the Greens’ motion to our hard-working national health service staff and others, and notably our fantastic armed forces personnel and volunteers, who have been instrumental in the roll-out of the Covid-19 vaccine across Scotland and the UK.
I am not supportive of the Greens’ solutions, but I am pleased to have been given the opportunity to discuss the subject. We are all aware that self-isolation is crucial to prevent spread of the deadly virus. We have to break the cycle of transmission, especially in community settings, and use a package of measures to get on top of the virus. As we learn of new variants, compliance must be improved and barriers to self-isolation must be broken down.
We know that compliance varies hugely. Some studies say that it is at 62 per cent, which was quoted by Shirley-Anne Somerville, but others say that it is 18 per cent. Regardless of that, changing behaviour is key. In the week of 24 January, 4,249 people arrived in Scotland and were expected to quarantine in case they were incubating the virus, compared with 9,868 people living in Scotland who actually tested positive. Dr Müge Çevik, who is a virology expert at the University of St Andrews, says that compliance is our “weakest link”.
I want to make three main points in addressing the various issues that are covered in the Green Party’s motion, and to look for ways in which we can improve the current circumstances.
First, I say that this short debate cannot solve the problems that we are facing, and neither can yesterday’s announcement by the Scottish Government of extension of eligibility thresholds for self-isolation grants, although we welcomed it. The Scottish Government must look at why people are not self-isolating. We know that financial concerns, insecurity of employment, caring responsibilities and unsuitable accommodation are all reasons why people might choose not to self-isolate. As part of the measures to address concerns, changes to statutory sick pay were welcome.
We know that vulnerable communities, including black, Asian and minority ethnic groups, are less likely to self-isolate because of poorer housing, anti-vaccination theories and, possibly, their economic situation. We need a more bespoke intervention to suit those communities, rather than just taking a universal approach. Enforcement can be a key tool in supporting adherence, but it is essential that unintended consequences because of inequalities are carefully looked at so that people who do not have appropriate resources to support self-isolation are not unfairly penalised.
We know that some people break self-isolation because they have to go to the shops for food. Currently, students and low-income households in Scotland are supported by delivery of groceries through central provision, but other countries—for example, Denmark—offer designated quarantine accommodation that includes food and supplies for people who are self-isolating.
Secondly, we know that additional financial support is crucial, so we welcome the changes to statutory sick pay eligibility for people who cannot work because of coronavirus. However, we must look carefully at the Scottish welfare fund, which has not performed well during this time of great need. Of the £59.5 million of Scottish welfare fund that was available in 2020-21, by the end of September 2020, only £18.9 million of it, or 32 per cent of the cash that was available, had been spent. The self-isolation support grant is administered through the Scottish welfare fund.
At the tail end of last year, we heard in the Social Security Committee that many people had been unsuccessful in obtaining support. I share Mark Ruskell’s concern that only 2,000 people had received the self-isolation grant up to the end of November, when just under 7,000 people had applied for the grant. Richard Gass of Rights Advice Scotland spoke of the poor success rate and of how Glasgow City Council was receiving 250 applications per week but was turning down three quarters of them.
The guidance states that when someone does not meet the criteria for the self-isolation grant, they should be considered for a crisis grant, but we know that crisis grants are also not reaching those who need them. Back in March, Shirley-Anne Somerville sent a letter to advise local authorities that it should be possible for people to obtain the crisis grant more than three times a year, but the Child Poverty Action Group made it clear in committee that crisis grants are still being refused on the basis that someone has already had three grants, and their exceptional circumstances have been ignored.
We know that £22 million of additional funding has been earmarked for the Scottish welfare fund, so why are so many people being turned away? The problems that are being caused by distribution of the Scottish welfare fund need to be sorted out, especially for people who are self-isolating.
Thirdly, we know that there is a route out of the pandemic, but I do not believe that the Scottish National Party has grasped the urgency of the situation. On Sunday, we saw the lowest daily figure of just over 9,000 vaccines being administered, while other nations in the UK raced ahead. Our route map out of the pandemic relies on a strong track and trace system, increased testing and, crucially, efficient and rapid vaccination of our population. There must be more mass asymptomatic testing and support to get mass vaccination centres up to 20,000 vaccines a day, with the help of the British Army.
I certainly will. We cannot support the SNP amendment, given that it offers no measures that have not already been announced and only a tweak to improve self-isolation rates. I would like to work together, but I will have to move the amendment in my name.
I move amendment S5M-24029.3, to leave out from “and the UK governments” to end and insert:
“Government to ensure that the eligibility criteria for self-isolation support grants covers all those who most need support.”
Scottish Labour supports the Green motion because we agree with the basic principle that everyone should be able to afford to self-isolate.
The pandemic has already caused astronomical levels of hardship, but in tackling the virus, the current system still does not go far enough. Many low-paid workers struggle to afford to self-isolate, despite earning more than the real living wage. Many people face a choice between Covid compliance and financial devastation.
Transmission reduces only if people who have the virus self-isolate and if those who are identified as having been close to an infected person do likewise. However, many people are nervous about downloading the Protect Scotland app because they do not—mainly for financial reasons—want to be told to self-isolate if they have been near someone who has Covid. After a year of disrupted work, many people’s finances are under enormous strain and many feel that they cannot afford to self-isolate.
Dr Wanda Wyporska of the Equality Trust charity has said, as we have heard today, that people avoid testing for a range of reasons, from caring responsibilities to employment worries. She said:
“Some people have said they’re not going to take the test, because if they are told to isolate, they won’t be able to work” and will, therefore, not get any income. Initial data show that there is low take-up of Covid testing in deprived areas of the United Kingdom, along with higher levels of people testing positive. We need to take stock to discover whether that situation has changed at all, and we need to try to understand whether a pattern exists, so that we can work out what we must do to respond.
People on lower incomes have been hardest hit by the virus and by the collateral damage of restrictions. It is obvious that the test and trace approach will reduce transmission only if infectious people are able to isolate effectively. That is the biggest barrier.
Recent research by University College London found that only 43 per cent of people who develop Covid symptoms say that they had requested a test. What happened to the other 57 per cent? That is a finding of the biggest study to date, and its lead author, Dr Daisy Fancourt, said:
“The number of respondents who say they are not isolating for the recommended number of days is also deeply concerning. The increased adherence to self-isolation rules among those with a higher household income suggests that many of those not isolating are breaking guidelines due to financial concerns, and more support needs to be put in place to allow people to self-isolate without fear of losing out financially.”
Without proper support to help people to self-isolate, there is an economic divide between those who have the means to stay at home and those who do not. Even if people want to self-isolate, finances can prevent them from doing so. Working-class households are bearing the brunt of that divide. We hear that “We are all in it together”, but for many people, it does not feel as though that is the case. While some people are paddling, others are waist deep.
Less than one third of the population of Scotland have downloaded the Protect Scotland app. People who test positive for Covid-19 are given a randomly generated code to enter, which then alerts close contacts who also have the app that they should self-isolate. However, fewer than half of those who use the app and have tested positive have actually entered the code to alert others. Clearly, we have more work to do in that regard.
I know that, in England and Wales, an update to the contact tracing system has been added to enable people to apply for the £500 grant if they receive a self-isolation direction. I note what Shirley-Anne Somerville said about updates to the app, so it would be useful if, in winding up, ministers could clarify whether we have similar processes here in Scotland.
As far as I can establish, the Scottish welfare fund is very important when it comes to self-isolation. There are issues around lack of public awareness of the fund and inconsistency in awarding grants. Last year, the Poverty and Inequality Commission found that the fund was underutilised through the initial period of lockdown from April to June and, shockingly, it found that there had been a massive underspend of £1.1 million compared with the same period in 2019. We can see how desperate things have become for a lot of people. The latest figures show that less than a third of people who applied for a self-isolation grant had their applications approved.
I think that we all agree that asymptomatic testing is extremely important in tracking down the virus, so we must make it easier for people to self-isolate without undermining their financial situation. One in three people has coronavirus without displaying any symptoms; therefore, we also need to target testing at people who cannot work at home during lockdown.
In conclusion, I say that no one should pay a financial price for isolating from family, work and friends to stop the spread of the virus, if they cannot afford to do so. Therefore, Scottish Labour supports the principle of the Green motion, which is that there should be a universal right to be supported in order to self-isolate to stop the spread of the virus.
I move amendment S5M-24029.1, to insert after “future”:
“and is integral along with the vaccine roll-out in the fight against COVID-19; believes that this will require full use of Scotland’s testing capacity to deliver mass asymptomatic testing in communities across Scotland”.
I am grateful to the Green Party for making time for this important debate today. We have some differences of opinion on universality, but it is important that we make it clear that nobody should be disadvantaged if they are forced to self-isolate.
It is nearly a year since the first cases of Covid-19 were confirmed in Scotland. When I look back at that time, it seemed that the threat was very far away. It is strange to think that, just a year ago last week, I was asking the Cabinet Secretary for Health and Sport about repatriating British citizens from a Chinese city that I had barely heard of and, today, I learned that one of my closest friends has tested positive, after sitting at the bedside of her father, who died in an Edinburgh hospital of Covid on Friday. We had no idea just how much the pandemic would turn all our lives upside down.
Since then, coronavirus has dominated every aspect of the business of Parliament, which is right. Consideration of public health has to come first, but the impact has been felt in all portfolios and discussions—from justice to jobs and from education to the environment. We have not always agreed in the chamber on the right course of action, and sometimes that disagreement has been vehement, but that comes from a good place. It comes from passion and from having a duty of care for the people whom we were all sent here to represent.
The top line of the Green Party motion rightly refers to the Government’s vaccine roll-out. My frustration about that is a matter of public record. It is not the fault of clinicians; it is because of a centralised bottleneck. We are starting to see improvement, for which I am grateful, but I will restate the point that my leader, Willie Rennie, made at First Minister’s question time this afternoon. A vaccine hub has been established in one of the most deprived areas of my consistency, in Muirhouse, but everyone who lives within sight of it will be shipped to the Edinburgh international conference centre to get their vaccines. We really need to identify and remedy some of the administrative hurdles.
The motion also refers to the need for an “effective” test, trace and isolate programme. That need was urgent six months ago; the Government’s launch of test and protect proved to be many things, but “effective” was not one of them. That said, I welcome the plans that the First Minister laid out yesterday to widen asymptomatic testing in healthcare settings and to launch community testing across mainland areas. Some reassurance will be given to teaching staff—who are rightly anxious, given the prevalence and transmissibility of the new variant among young people—that they will have access to asymptomatic testing twice weekly.
These are unprecedented times, as is absolutely manifest in the workload from all our inboxes and mailbags. There have been queries about the restrictions, about interpreting guidance and rules and about many other aspects of Covid-related casework.
However, for me—and, I am sure, for other members—the greatest amount of time has been spent helping people who have had little or no support from the Government, because they have slipped through various cracks in the firmament. I do not blame the Government for that. It is very difficult to have a catch-all provision in these difficult times, but there are many such cases.
The toll that that has taken on people has been huge. The stress and emotional burden of being unable to pay for the basics, not knowing how rent will be paid next month and not knowing how they will keep up a decent standard of living have been unbearable for so many of my constituents, as they have for many of other members’ constituents. The virus is punishing enough without people having to choose between following rules and being able to feed their families, so we need to make it easier for people to self-isolate.
Thanks to the broad shoulders of the UK economy, people have been able to access the coronavirus job retention scheme, and I welcome the First Minister’s announcement yesterday that the £500 self-isolation payment will be available to everyone whose income level is below the real living wage.
As I close, I urge the Scottish Government to ensure that the new measures are robust and inclusive enough that no one who needs or is entitled to support will lose out. The Government will have the responsibility for ensuring that the support packages succeed where they have previously failed, because the livelihoods of all our constituents depend on them.
Let us not lose sight of the recovery. The biggest thanks that we can give to those who are working hard to keep us safe throughout the pandemic is to do everything that we can to fight the virus with a world-class test and trace system, adequate support packages for individuals and businesses, and a vaccination programme that will allow businesses to reopen, our economy to restart and schools to return.
A number of members have mentioned the real possibility, as articulated by Jason Leitch at the COVID-19 Committee last week, that Covid might be here to stay and that we might have to learn to live around it. That means that we need to make it safer and more convenient for people to observe the rules and to ensure that people are financially recompensed if they are required to do so. Achievement of that will require a spirit of partnership and co-operation inside and outside Parliament, with people working together in the interests of everyone, in all corners of Scotland.
I am grateful for the opportunity to make a few brief remarks in the debate. I join Mark Ruskell and colleagues from across the chamber in thanking our front-line health and social care workers, particularly those who are working, in some cases, around the clock to roll out the vaccine programme.
I agree with a huge amount of the Green Party’s motion and, instinctively, I favour universality in the delivery of benefits. I qualify what I am about to say with that statement. A challenge that we face in relation to the fiscal support that we offer in Scotland is that we have to operate within the limited resources that we have at our disposal. When we have to manage an unpredictable crisis, there is a strong case for ensuring that we target every resource at where it is most needed, but I certainly want to move towards universality if we know that that will be fiscally sustainable.
Mark Ruskell and Alex Cole-Hamilton made the important point about being cognisant that we will be living with Covid for the long term. We should ensure that the test and protect system is robust, because Covid will be with us for some time, and we should put in place measures to support people who have to self-isolate. Covid will not be a passing issue; it will occupy the attention of members for much of the next parliamentary session, just as it has occupied all of our attention over the past 12 months.
Several members commented on the link between the prevalence of the virus and poverty, deprivation and low income. Members who have been forensically examining Public Health Scotland’s Covid maps daily will be aware that the areas in their constituencies or regions with the highest concentration of people who have tested positive are very often areas in which lower incomes are more prevalent and areas of increased multiple deprivation, so I completely agree with Mark Ruskell about the need to target those groups and ensure that support is available in order to achieve elimination.
Some members touched on the vaccination programme. The way in which that issue has been politicised is deeply regrettable. Across these islands, we have to be rooting for one another. The failure of one part of the UK is a failure for all of us in our fight against the virus. The Scottish Government has said that, initially, the focus has been on depth rather than breadth, to use the First Minister’s terms. However, the figures from yesterday and today show that the pace of vaccination is picking up considerably, and it is likely that that pace will accelerate. In the weeks preceding an election campaign, I understand the temptation to look for a wedge issue.
I would never doubt Mr Cole-Hamilton’s sincerity, for which I know he is reputed across the chamber. However, I question the motives of the UK Government, given that it is briefing about quantities of the vaccine while insisting that the Scottish Government does not put that information into the public domain. I raise the issue for a very straightforward reason: that creates uncertainty and worry among constituents. Countless constituents have got in touch with me after reading newspaper headlines on the back of Opposition party attacks. I phone to reassure them and, a day or two later, they have had their vaccine and everything is fine.
I encourage members to resist the temptation to create uncertainty. If they do raise the issue, they should temper their language and be cognisant that a lot of very vulnerable people are very worried. We have a responsibility not to needlessly spread fear.
Other members have begun with thanks, and I echo one line in the Government amendment and thank those who have done the right thing by self-isolating as necessary. However, I am certain that I am not the only member in the chamber who has, since the very beginning of the pandemic, heard from constituents who are self-isolating despite their severe anxieties about the consequences for themselves, their livelihoods and their families. We have a responsibility to recognise those anxieties and to address them.
I have heard from constituents who have been made to work by their employer, even despite having reported symptoms; told not to use the test and protect app; refused furlough; and told directly not to self-isolate—“Turn up for work, or you’ll lose your job.” Those are the kinds of threats that people have had. Never mind just the loss of pay during the self-isolation period; staff are told, “Turn up for work, or you won’t get any more shifts at all.” That is the type of coercion that some constituents have reported experiencing throughout the whole saga.
I worry that the fear of coercion or reprisals from employers will only grow as the vaccine programme rolls out. Irresponsible employers will feel strengthened in that regard, and some employees will feel under greater pressure to take risks with their own health and the public’s health. Most people want to do the right thing, but they face barriers—about money, but not only money.
I will mention some of the arguments from the Scottish Trades Union Congress. In my memory, the STUC has never taken a simplistic jobs, jobs, jobs or all-jobs-are-good-jobs approach. It recognises that quality of employment matters. Some jobs are secure, well rewarded and protected by legal workplace rights and good practice by employers. Work of that kind is great for people’s wellbeing, socially and physically as well as economically. Bad jobs do the opposite. As Rozanne Foyer told the Finance and Constitution Committee today in her evidence on the budget, the pandemic has shown us more clearly than ever “that bad work kills”, including by creating barriers to self-isolation where that is necessary.
As I said, some of those barriers are financial. They may result from precarious work; insecure incomes; a lack of employment rights; and the low level of, or a lack of eligibility for, statutory sick pay. It is therefore absurd to remove from the motion any reference to the UK Government. However, there are also challenges that are within the devolved competence of the Scottish Government, because barriers to self-isolation also exist in the form of living space, caring responsibilities, mental health and many more factors.
I very much welcome the First Minister’s acknowledgement that issues such as international travel should have been dealt with more firmly in the past. We are now moving to a system of managed hotel quarantine, which is overdue but welcome and necessary. Why should there be any less of a proactive approach to self-isolation for people who live here, who know that they may have been exposed to the virus and want to do the right thing, but who need a bit of help? We need a much more proactive approach from both Governments. I commend Mark Ruskell’s motion to the chamber.
I call Donald Cameron.
Excuse me, Mr Cameron, we seem to have an issue with your sound. Perhaps you could hold on for a moment.
Can you say hello to us, Mr Cameron? We are still not hearing you. I see that Willie Coffey is in the chamber, so I ask him to be the next contributor.
The financial support that is being provided to people who are self-isolating is really important, and I have no doubt that it is much welcomed.
As usual, our SNP Government is going further—as far as we can to help as many people as possible. Yesterday, as the cabinet secretary said, we extended the support to cover people on the real living wage or less. It now includes people who already depend on a council tax reduction and those with caring responsibilities, which I am really pleased to see. There is also an extension to the timescale for applying for the support, to try to help as many people as we can. All that means that we will be able to reach another 200,000 people in Scotland.
After the £500 grant was introduced in October, the Government was asked to include the parents of children who had to self-isolate, and we did so. We also reached out to support people who were not on universal credit but would qualify for it if they applied, so we can see that the Government is doing as much as possible to help and responding to circumstances as best it can. Can we do more to help more people? I hope that if we can, we will, but I am sure that the people of Scotland can see that the Government is stepping in to help the most vulnerable of our citizens who are having to-self isolate.
A development that is interesting to note is that the Protect Scotland app that many of us have on our mobile phones will shortly be updated, so that people who are notified to self-isolate through the app will get details of how to apply for the grant. As I understand it, the app will also give them a certificate to authenticate their claim when they make the application to their local council. That should help, too. It is a really helpful and useful application of information technology in these times. Well done, once again, to our software engineers for making it possible.
I want to say a few words slightly away from the debate about money and on isolation itself. When we get through this awful time, as I know that we will, I hope that the Government will look back and examine the impact that self-isolation has had on our people and continue to provide support in some form or other. Let us not forget our shielders, many of whom have in effect been living in isolation since the start of the pandemic, nearly a year ago now. I will share one or two examples of the impact of isolation on my family. It will probably be the same experience as for other members in the chamber and many families across Scotland.
My sister, Helen, is shielding and living at home with my niece, Kerri, who is both special needs and disabled. They have hardly been out of the house in 11 months. The impact on Kerri of not seeing any friends for such a long time is hard to imagine, and on Helen, too. She is trying to cope with her own vulnerability while protecting Kerri; that is impossible to comprehend.
My daughter, Niamh, despite being healthy, spent much of last year in self-imposed isolation while trying to complete her master’s degree at the University of Stirling, because her boyfriend, Seb, is extremely vulnerable to the virus and has been shielding for a full calendar year. To protect and help him, she decided to keep apart from her family in order to keep him safe.
Last but not least, my partner’s dad, Jimmy Muir, aged 93, was enjoying his life quietly at home at the start of the pandemic but he is now confined to a care home as a result of isolation and lack of mobility. They will all probably be really annoyed with me for mentioning them, but to say that I am proud of them all is an understatement.
The impact of self-isolation has been felt by many of our citizens, young and old, and it is much wider than we think. I am asking that we care enough to reach out to people, ask them about their experience to learn as much as we can about it and be prepared to keep offering help, if it is needed, as we recover from the pandemic. If we do that, on top of helping with grants wherever they are needed, we will have done some good and valuable work for the people of Scotland at this time of crisis.
Notwithstanding the Government’s action to widen the entitlement criteria, which was announced yesterday, I welcome today’s debate and agree that the self-isolation support grants should be universal and barrier free. Today’s motion recognises
“that there are many barriers to ... self-isolation, including financial concerns, insecure employment, unsuitable accommodation and caring responsibilities”.
That is what I want to focus on.
For the past three months, I have been consulting on a member’s bill to set up a Scottish employment injuries advisory council. There is a lot to resolve with the now-devolved benefit, but I believe that Covid-19 and its long-term effects should be regarded as an industrial disease when the illness is caught by someone in the workplace. Key workers such as NHS, social care, retail and transport workers all face a higher risk of getting Covid and getting it severely or coming into contact with someone who has it. They cannot work at home and some are lower paid than others.
I will take care workers as an example. On paper, the grant should work for them, but we know that life is not as simple as that. During the member’s bill process, I was told about care workers having faced and continuing to face barriers to self-isolation. The trade unions Unite and GMB told me that many have been wary of getting tested because they fear the loss of income if they have to self-isolate, as they would not get sick pay. They are low paid and many are on universal credit, but they also face stigma if they have been off work. Other workers, including construction workers, face financial and potential employment repercussions from pay lost and possibly jobs lost in an industry with a history of blacklisting. They, too, lose out from self-isolating or speaking up about the workplace not being Covid safe. In addition, if they are not on a means-tested benefit, they are not eligible for the grant.
When the alert call or text message to self-isolate comes, people have to drop everything instantly. It is a devastating irony that those who are most at risk have to do the most to get help. Baked into the entitlement criteria are a multitude of barriers and paperwork requirements to access the support. In what is supposed to be—and is—an emergency situation, before they can get any help, they must locate and submit proof of qualifying benefits and a recent bank statement, and they must get proof that they cannot work from home and that their earned income will fall. Instead of slashing the criteria, the Government has simply changed the thresholds.
Low-paid workers might also have a different experience from that of a professional or a homeworker when they receive that alert. We would all panic about having food in and medication in the cupboard, but many of us are lucky enough not to have to consider whether there is enough cash in the bank to go and get that shop in before the grant is paid or whether there is enough credit on the phone to claim the grant or set up an online account for an online shop with an unfamiliar supermarket.
The pandemic has accelerated the divisions in society and our workforce at a rapid rate. Key workers, furloughed workers and those working at home all have different experiences of being at risk of catching the virus, of having to self-isolate and of that risk being borne by their workplace. For the sake of those who are most likely to lose out by self-isolating, the Government must drastically think harder about how it can remove the barriers to their getting this vital support.
I hope that you can hear me, Deputy Presiding Officer.
The Covid-19 pandemic has been a horrific experience for many, and in different ways. First and foremost, many people have had to deal with the tragic deaths of family members and friends, while others have been at the front line of our NHS or in social care, dealing with the devastating impacts of the virus at first hand. Even for those who have not been directly affected by the infection itself, the virus has nevertheless had a debilitating and pernicious impact, especially when it comes to being unable to see family or friends.
The series of lockdowns that have been designed to keep us safe and protect our NHS have had a significant and profound impact on many people’s lives. In particular, they have had an unintended impact on the mental health of the nation, which is something that we must not just recognise but act on.
Indeed, both lockdown and periods of self-isolation will affect people in different ways, which is something that has scarcely been discussed during the course of the pandemic. I therefore commend Mark Ruskell for bringing this debate to the chamber, even if Conservative members cannot fully endorse the entirety of his motion. I note that it is an issue that Mark Ruskell has pursued tenaciously in the Covid-19 Committee, which I have the honour of convening.
It is plainly right that we support those who are most at risk from taking time off work to self-isolate, not just to ensure the efficacy of self-isolation as a means of preventing further spread of the virus, but because self-isolation, in and of itself, can lead to significant anxiety, as many members have pointed out, not to mention the practical consequences that it can have.
As the motion notes, self-isolation can have those unintended practical consequences and it can put people in precarious situations relating to their employment status and financial means, among other concerns. It is right, therefore, that both the UK and the Scottish Governments have similar schemes offering £500 to those who are most in need, so that they can self-isolate with some financial stability and security. The Scottish Conservatives have concerns, however, about how the scheme has been managed in Scotland, with less than a third of applications for the self-isolation grant having been approved by the SNP Government, according to the latest available data. Clearly, improvements need to be made in ensuring that such targeted support gets to those who need it most.
That scheme is not the only way in which people have been supported during the pandemic. It would be churlish not to recognise what the Scottish Government has done in that regard, but there are also schemes such as the UK Government’s furlough scheme and its self-employment income support scheme, which have provided valuable income to those who are unable to work during the pandemic. The UK Government has also sought to support some of the most vulnerable people through investing additional money in the universal credit programme and through easing the eligibility criteria for applications for universal credit.
Those are all positive interventions, but it is clear that more is needed to help those who are struggling with the pandemic and its effects. As I noted, there are real and legitimate concerns about the impact of self-isolation on people’s mental health, especially at this time of year. In November, the Scottish Association for Mental Health published a study that revealed
“that 50% say their mental health has been worse in the last few weeks than at the start of the coronavirus pandemic.”
Age Scotland has noted
“the impact of loneliness ... increasing the risk of stress, anxiety and depression, and doubling the risk of dementia.”
Clearly, we must ensure that those stressful factors related to self-isolation are mitigated as much as possible.
We agree with the general thrust of the motion, but we are of the view that the Scottish Government must do more to reduce the negative mental health impacts of self-isolation. It is clear that existing financial support schemes can play a part in achieving such aims, but only if such support is properly targeted to those who need it most.
This has been an excellent debate, with helpful and well-argued contributions from across the political divide. I, too, congratulate Mark Ruskell and the Scottish Green Party on their initiative in securing the debate.
The Covid-19 pandemic has placed tremendous strain and responsibility on all our hard-working front-line NHS and care workers. The vaccination programme, as well as being a triumph for British and international—[
.]—has required exceptional organisational and administrative expertise in its roll-out. As the motion recognises,
“an effective test, trace and isolate regime will be needed” not just immediately, but for some time into the future.
The key issue in the debate, as far as I am concerned, is the variety of barriers to self-isolation: money worries, insecure employment, suitable accommodation and caring responsibilities. To be clear, self-isolation is a key and crucial element of any Covid recovery strategy. If quarantine/self-isolation is not carried out effectively, for all the reasons that I have just highlighted, we are weakening one of the key pillars of the plan, which will, of course, put back Covid recovery and renewal and will extend lockdown restrictions for longer than they need to be. Earlier this week, in reply to a question from Bob Doris, the cabinet secretary outlined how the Scottish Government is supporting people to self-isolate. As we have heard, eligibility for the self-isolation support grant has now been extended to those who earn the real living wage or lower.
Members made extremely useful contributions to the debate. I will focus, first, on that of Mark Ruskell, who made the point that our vaccination programme is not a strategy in itself. He also quoted Professor Jason Leitch, who has said that we might have to live with Covid for some years to come. Of course, we will need a strong self-isolation strategy for that reason. Mr Ruskell also quoted academic research that suggested that 38 per cent of individuals were not isolating for the recommended number of days.
The cabinet secretary said that we have more to do, which is, of course, true. She said that, if people need help, they should be able to access it, and she flagged up the national assistance service and the helpline. She gave a good example of best practice when she spoke about the delivery of breast milk from a new mother. The key will be for us to share such best practice.
Rachael Hamilton thanked our front-line staff and mentioned the military, members of which have worked extremely effectively in the current crisis.
Pauline McNeill made the point that everyone should be able to afford to self-isolate. Many people have to make a choice between compliance with Covid rules versus financial destruction. Ms McNeill said that isolation must work effectively, otherwise our testing and tracing strategy will not be as effective as it could be. More support is needed, particularly for those who fall on the wrong side of the economic divide.
Alex Cole-Hamilton made an important point about welcoming the testing of asymptomatic people. He again mentioned the dilemma that disadvantaged families face, between following the rules and feeding their own families.
I am conscious of the time, Presiding Officer, so I will conclude my remarks. As many members have testified, we need to discuss the broader economic and social context of child poverty in Scotland. Even before Covid, our levels of such poverty and social isolation were high and were projected to rise.
I hope that members will support Labour’s amendment, which calls on the Scottish Government to make
“full use of Scotland’s testing capacity to deliver mass asymptomatic testing”.
We need to keep the virus pinned down. Vaccination is an important part of our strategy, but the test, trace and isolate approach should also be part of the mix. Together, we can defeat this foe and then rebuild our economy and communities.
I thank hard-working NHS staff who are doing all they can to keep us safe and protected during these unparalleled times. Now that the vaccination programme is under way they are once again working tirelessly to ensure that our population is protected.
The Scottish Greens are right to state that an effective test, trace and isolate regime will be needed now and in the future, particularly as we attempt to deal with the emergence of worrying new variants of the virus—a point made by Mark Ruskell. Donald Cameron also highlighted the mental health impacts with which many of our communities are struggling at this time.
The proactive provision of support will be needed if we are to reach our most vulnerable people and enable them to comply with self-isolation rules—a point well made by Shirley-Anne Somerville and Pauline McNeill. Ms McNeill also raised the issue that the app should be upgraded to improve access to support through it.
Scottish Conservatives believe that support should be offered proactively to all those who need it, including those on low incomes. However, we cannot agree that it should be offered universally. Many people, including all members in the chamber, would not see any loss of income as a result of either self-isolating or taking time off work following a positive test result. It would be far more effective to provide a comprehensive support scheme targeted towards those who need it, rather than a blanket approach that would cover everyone including those who do not need any support from the state to enable them to self-isolate.
Many members, including my colleague Rachael Hamilton as well as Alex Cole-Hamilton, mentioned the vaccination programme. I agree that an effective test, trace and isolate regime would complement the vaccine programme. In the past 24 hours we have started to hear positive news about the Oxford vaccine, in that a person’s ability to transmit the virus could be substantially reduced from 22 days after they receive their first jab. That is further evidence that the vaccination programme is our route out of the crisis and will be the most effective way to significantly reduce the number of people who are required to self-isolate.
More than ever, it is imperative that the SNP handles the vaccine roll-out successfully. I will be clear: I desperately want the Scottish Government to succeed in the vaccine roll-out. However, no degree of SNP spin can compensate for its mishandling of the programme. The fact is that hundreds of thousands of vaccine doses that are allocated to Scotland are sitting in storage, and no degree of SNP spin can explain why we have fallen so far behind the rest of the UK when it comes to administering the vaccine.
All four nations have equal access based on population share. There is no excuse. Last week, 2.4 million first doses of the vaccine were administered. Only 145,000 of those were in Scotland. Based on population share, that figure should have been 200,000.
Supporting all those who need support to self-isolate is critical. However, fixing the vaccine roll-out programme is the surest and fastest way to protect the most vulnerable in our society.
I thank members for their contributions to this very important debate. We all appreciate and share an understanding that compliance will continue to be critical for some time. Only by self-isolating when we develop symptoms, or are notified to do so, can we break the chain of transmission of the virus and save lives. We know that self-isolation is a significant challenge for people to undertake, and I have set out the extensive range of support that is available to people who are self-isolating and our intention to expand that.
Mark Ruskell was quite right to challenge the Government to think about the issue not just in the short term but for the long term, and I reassure him that we are committed to looking at the lessons that we need to learn for the future. However, I cannot agree with him on the aspect of his motion that is about a universal offer for everyone who self-isolates. According to our forecasting, that would cost £700 million for the next financial year, and, given the financial constraints that we are under, the Scottish Government believes that there are better ways to support people at this point.
I urge Rachael Hamilton not to use again the figure of 18 per cent compliance—which is woefully out of date—because that does a disservice not to the Government but to those who are making the difficult choice to self-isolate. Compliance is high, as I said in my opening remarks. If we do not give people the correct picture, and instead give them a false one, that will damage morale and compliance. We must, please, use the most up-to-date figures, not for the Government’s benefit but for the people out there who are listening to us and looking for leadership.
Many members have, quite rightly, asked about the number of people who have been turned down for a self-isolation support grant. In passing, I add that that replicates roughly what is happening in England. I note that a report in
The Guardian yesterday said that 70 per cent of people who apply are being refused. We are taking action to ensure that we extend eligibility, so perhaps more people will be eligible in future than have been in the past.
However, I also point to some other reasons why people are not eligible for a grant—for example, people who have applied had not been in work and have therefore not had a drop in income; people have not been self-isolating; and there have been speculative applications. We will look, and have been looking, very seriously at what we need to do on eligibility. That is why we have already made changes and we will continue to look at it.
Pauline McNeill talked about people who are frightened to come forward for a test because of a fear of self-isolating. She was quite right to highlight that. That is why we are already looking at what we need to do about putting in information about support when we are doing community testing, so that people are aware of what is out there. Again, I mentioned in my opening remarks the publicity campaigns that we will be doing in general.
I am sure that the cabinet secretary recognises that people face threats of consequences, and coercion, from employers, and have fears of such. Surely, as hospitality and retail reopen and as the vaccine rolls out, we need more than just information for employees; we need a way of ensuring a high level of good practice by employers. We need the stick, not just the carrot.
I was just coming on to the remarks that Patrick Harvie made earlier and to that point. He rightly raises the issues that some employees have been facing, and I know that he has previously spoken about those in the chamber. In my opening remarks, I mentioned some of the measures that we are looking to undertake. The member should be reassured that we are considering what more can be done. We are taking the issue very seriously, and I am happy to work with Patrick Harvie and others on the further details of that.
Patrick Harvie and others spoke about isolation accommodation. The Scottish Government and COSLA developed isolation accommodation guidance last summer. The feedback from those delivering the support is that, although the service has been on offer for people who need it, there is very limited demand for alternative accommodation. However, we keep the issue under review. For example, we are examining how we offer support to make sure that the information is detailed enough so that people understand the offer that is out there.
We have a strong universal support package that is available to everyone in Scotland and we are taking targeted action for people on low incomes that are less than the real living wage. We have a strong package but, as always, I am of course willing to work with members from across the chamber to see what more can be done. We will see the best results through a shared endeavour to tackle the virus and to support compliance.
I thank members for their contributions and warm words. I hope that the debate has put a strong spotlight on one aspect of our Covid response, and I look forward to further scrutiny of the issue not just in the chamber but in the COVID-19 Committee, under Donald Cameron’s convenership.
It is right that we scrutinise the issue, because we have never had a full picture of the effectiveness of self-isolation or of the services and support that we are putting in place to help people to self-isolate. The cabinet secretary rightly said that 68 per cent of people have managed to self-isolate. In some ways, we can welcome that figure and thank those people for their efforts. That has been very difficult, particularly for those who have had to shield for a long period. Willie Coffey’s heartfelt contribution showed just how hard it has been, particularly for carers, to go into self-isolation and to shield.
However, the flip-side of that is the figure that I mentioned: the 32 per cent who have been unable to self-isolate. As Pauline McNeill said, some people are paddling, but others are waist deep and are really struggling. There is an element of fear for people about self-isolation and what might happen in their workplace and if they lose income.
The Scottish Government’s support package has evolved. The local assistance service started by working just with those who were shielding but is now available to everybody who needs to self-isolate, alongside a national helpline. We need to see how effective that service is. I make no criticism of the incredible work of council officers who are delivering the helpline alongside strong third sector partners, but we need to ensure that there is consistency across the country and that the work of the local assistance service is getting through to the people who desperately need support.
I welcome the cabinet secretary’s commitment to ensure, in conversation with COSLA, that the administration costs of running the service are fully met. All of us who have contact with our local authority colleagues know just how hard council workers are having to work at the moment and the stresses and strains that they are under. That is an important point.
Something is not quite happening on the accommodation side. Earlier, I highlighted the incredibly low uptake of the accommodation offer. I understand that, in Edinburgh, the figures show that, recently, only 1 per cent of those who have been in touch with the local assistance service have gone on to get further support. That is difficult to understand, given the inequality that exists in the city and the needs of people who are living with poverty and disadvantage. I have my doubts about whether the service and the support packages that we are putting in place are getting through to the people who desperately need them. I hope that I am wrong, but we need to provide more scrutiny on that.
The cabinet secretary mentioned a national media campaign. That would be very welcome. I have constituents who are genuinely unsure about what type of support they can get. I know of virtually nobody who believes that they can get hotel accommodation through the existing arrangements. In theory, I think that people can, but it is not clear whether someone who lives in a two-bedroom flat that three or four people live in can get hotel accommodation. There is an issue with the messaging.
In addition, as has been mentioned, there are barriers to accessing the grant. Up to now, there has been only a 10-day window. Some people who have been ill have missed that window and have been turned down for the grant. The extension to 28 days makes a lot of sense. There is also an element of digital exclusion, as Mark Griffin mentioned and Citizens Advice Scotland has discussed. People who are self-isolating cannot get outside the house, so they will need a computer or an iPhone or whatever to send in the evidence that is needed in order to apply for the grant. Every time we impose such a requirement, we put up a barrier. Every time we do that, we make it harder.
I think that I have one minute left. The Presiding Officer has confirmed that. In that time, I want to talk about employers.
Mark Griffin and Patrick Harvie spoke about irresponsible employers. The STUC is right—bad work kills. It kills every day, but it kills even more in a pandemic. Bad employers are making implied threats to their workforce, which means that they are unable to do the right thing.
However, there are good employers. There is a very good employer near where I stay in Stirling called Recyke-a-bike, which is a social enterprise. It does not have as much income coming in as it would like to pay beyond statutory sick pay; it is also in a business in which the work cannot be done at home, which makes things difficult. Recyke-a-bike has called me repeatedly to ask for the eligibility criteria to be extended to beyond the real living wage so that more of its staff can be captured, they can get the support that they need and they do not need to choose between isolating and eating.
I welcome the fact that progress has been made this week. In effect, eligibility has been extended to another 200,000 people in Scotland, which is welcome progress, but a lot more than 200,000 people are in in-work poverty, and we need to focus on them. We need to put in place the most robust package possible in the world to ensure that they can do the right thing, isolate when they need to and be supported in doing that.