1. Over the past 10 months and even before that, Governments across the world made mistakes in their planning for and handling of the pandemic, but today’s report by Audit Scotland identifies a lack of preparedness, on the part of the Scottish Government, stretching back more than a decade. Specifically, it charges that Scottish National Party ministers failed to implement key recommendations that were made after pandemic planning exercises in 2015, 2016 and 2018. Reports on exercises Silver Swan, Cygnus and Iris made 52 specific recommendations. How many of those recommendations had been implemented by the Scottish Government by March 2020?

The Audit Scotland report this morning is important, as are all Audit Scotland reports, and the Government will, as we always do, pay very close attention to it. However, one of the paramount points that the report makes is this:

“The Scottish Government and NHS in Scotland responded quickly to the rapidly developing pandemic”.

On the three pandemic preparedness exercises—Silver Swan in 2015, Cygnus in 2016 and Iris in 2018—I do not have the full list of the 52 recommendations in front of me, but I am happy to arrange for that information to be provided. As a result of those exercises, a range of national and local pandemic guidance and plans were updated to take account of the lessons from those exercises.

One of the key points, which is perhaps not captured fully in the Audit Scotland report, is that what we found ourselves dealing with in February and March last year was not a flu pandemic, so no amount of preparedness for a flu pandemic would have been sufficient in the face of the situation that we encountered. Regardless of how well prepared we had been for flu, it quickly became clear quite that we were dealing with something of a completely different nature.

In fact, in reflecting on the past 10 months—this will be a matter for proper scrutiny, in the fullness of time—I think that the more valid criticism of the Scottish Government, and of Governments across the western world, is that in the early stages of the pandemic we perhaps relied too much on flu preparations and had not done enough to prepare for the experience of severe acute respiratory syndrome-type outbreaks. That is one of the key lessons that Governments, certainly those in the western world, will have to learn. We will add that to the lessons that the Audit Scotland report has for us.

Let me end my answer where I started. According to Audit Scotland,

“The Scottish Government and NHS in Scotland responded quickly to the rapidly developing pandemic”.

It was no surprise that the First Minister did not want to give a number for how many of the 52 recommendations have been implemented, because the Audit Scotland report highlights a catalogue of missed opportunities on the part of the Scottish Government, including failure to ensure proper supply and use of personal protective equipment. It makes it clear that the PPE stockpile

“was not enough to fully meet the demands of the NHS.”

After the 2016 exercise, a working group identified access to PPE as a “priority action” to be completed by March 2018. Exercise Iris, which took place two years before the onset of the Covid pandemic, again warned that the Government needed to up its game on PPE. We simply should not have had national health service staff being forced to work without adequate protection, reusing masks and having to beg for donations because PPE was not in place.

Why did the Scottish Government not act on the repeated warnings that it received in the three reports, when doing so would have meant that doctors, nurses and carers were properly protected?

The First Minister:

I do not accept Ruth Davidson’s characterisation and I do not believe that it bears scrutiny. Scotland has never, not once, throughout the entire pandemic run out of PPE. Not only that, but we were, in fact, in a position at an earlier stage of the pandemic to offer mutual aid to other parts of the United Kingdom.

We found two things. [

Interruption

.] I say to the Conservatives that these are serious issues that deserve proper responses and consideration. First, we found that we had to rapidly improve, which we did, the distribution mechanisms for PPE to make sure that it got to the front line quickly. We did that with the NHS.

We set up a portal so that anybody who had concerns could quickly raise them and have them addressed.

Of course, in addition to the arrangements for the NHS, we quickly put in place new arrangements to top up the PPE supplies that were available to our care homes across the country.

Some detailed consideration was also required by experts, not politicians, of the particular PPE needs, given—to go back to my earlier point, which cannot just be glossed over—that we were dealing not with a flu pandemic, but with a completely different beast that required, in some respects, a different response.

We took all those steps and we continue to ensure that we have good and robust supplies of the right PPE. Of course we have, into the bargain, also developed a domestic supply chain for PPE. We have not done that by giving contracts to our political chums, as some other Governments have done. Before the pandemic, there was effectively zero Scottish PPE manufacturing; we were wholly reliant on imports. Over the winter period, nearly half of all PPE that has been used in Scotland has been supplied from Scotland.

I would be the last person to try to deny that there are lots of lessons for us to learn. We have to do that properly as we go through, as well as when we come out of, the pandemic. However, I think that the steps that we have taken are the right ones, and we will continue to make sure that the NHS and wider society are properly equipped.

The First Minister stands there telling us that there was no issue with PPE last year. Perhaps she wants to tell that to Scotland’s nurses, half of whom told the Royal College of Nursing that they had been forced to reuse single-use protection.

Tragically, Scotland’s care homes have seen more than a third of Scotland’s Covid deaths, with more than 3,000 people losing their lives in care homes since March last year. The advice that was handed to the First Minister in three separate reports is that more had to be done to protect social care. That should have been consulted on as far back as 2018. Instead, the consultation did not open until more than a year later. It closed in September 2019, six months before Scotland’s first wave of Covid. In those six months, the guidance was never updated; no updates were ever published. Crucially, that means that care homes were left to face the pandemic with guidance that was almost a decade old and was hopelessly out of date.

We know that the Scottish Government is now reviewing the guidance, but it is far too late for too many grieving families. Is it not just a fact that had the First Minister and her Government acted sooner and brought forward guidance, which was demanded before Covid struck, some lives in those care homes could have been saved?

The First Minister:

Again, I say no—I do not accept that. In my response to the previous question, I did not say that there were no issues with PPE, but took time to set out properly what the issues were. The issues were not what Ruth Davidson said they were; the issues were to do with distribution, making sure that we had the right types of PPE and then building the domestic supply chain. I know that that does not suit the soundbites that Ruth Davidson wants to hurl across the chamber. I spend each and every day dealing with the fine detail of the issues; that is what I try to share with the public.

It is simply not true to say that guidance was not issued to care homes; guidance was issued to them right at the start of the pandemic. We have taken steps to amend the guidance, as our knowledge and understanding of exactly what it is that we have been dealing with has developed. We will continue to do that.

I have been, and will continue to be, very candid. If we could turn back the clock and have then the knowledge that we have now about the nature of the pandemic that we are dealing with, we would have done certain things differently in care homes. I desperately wish that we could have that time again. However, we have made sure that, in relation to the guidance, the focus was on infection prevention and control in care homes, and on the use of testing, when our knowledge developed to allow that to change.

Our more recent focus was criticised—certainly, by implication—a couple of weeks ago by Ruth Davidson in her questions about vaccination. However, because we have focused on making sure not only that we offered the vaccine to every older person in a care home, but that we got the vaccine to every older person in a care home, we are now seeing a rapid reduction in deaths in care homes. I am not sure whether that will be exactly mirrored in all other parts of the UK. We will have to wait to see the figures.

There are lessons to learn every day, and I take that very seriously. I do not think that Ruth Davidson does anybody involved a favour by her mischaracterisation of some of the really difficult challenges that we have been dealing with, and which we continue to deal with.

I will read directly from Audit Scotland’s report so that there can be no “mischaracterisation”. The First Minister mentioned the guidance that was issued to care homes. Page 21 of the report says that

“Flu pandemic guidance published in 2012, designed for health and social care in England, was issued to health and social care in Scotland.”

Despite the Scottish Government’s having been told in 2018 that it had to update that guidance, it was not opened for consultation until 2019. Even by the time the consultation had closed, six months before Covid hit, the Scottish Government still had not published updated guidance. That represents two years of failure to tell social care accommodation and care home providers what they should be doing and how they should be doing it.

Throughout the pandemic, the First Minister has sought to build her reputation on how she has handled the virus. However, the truth is that her Government was less prepared than it should have been, as is set out in black and white in today’s Audit Scotland report. The Government made mistakes. Those mistakes cost the health of front-line workers and the lives of care home residents, and they built up over a decade of delay. The Auditor General’s report makes it plain that the First Minister’s Government was warned again and again. There were years during which she could have acted. What stopped her?

The First Minister:

I just do not think that that bears any serious scrutiny. Every single day over the past 10 months—for almost a year, now—I have sought to do nothing other than my best, and to ensure that the Government is also doing its best, to steer the country through the pandemic as safely as possible. That is still my focus each and every single day, no matter what attempts Ruth Davidson might make to change that.

All along, I have admitted mistakes. I will continue to ensure that the Government seeks to learn from mistakes as we go. For as long as I live, I will regret the toll that the virus has taken, particularly on the older members of our community and those who live in our care homes.

However, I also know that because of decisions that we have taken and—even more so—because of the efforts of health and social care workers across the country, we in Scotland can say that we have a lower number of cases than other parts of the UK have. We also have a proportionally lower number of deaths. No one should misunderstand my point: the number is still far too high, but the rate is lower than that for England and Wales.

Every single day, we continue to take steps to ensure that we reduce the impact of the virus. That is, right now, all that I seek to do every day, and what I will continue to seek to do.

Ruth Davidson wanted to quote from Audit Scotland’s report, so I will do the same. It says that

“Staff across the NHS and Scottish Government have worked hard, in challenging circumstances” and that

“The Scottish Government and NHS ... responded quickly”.

It also says that the actions that were taken prevented

“the NHS from becoming overwhelmed”.

What Audit Scotland describes as

“Initial difficulties in supplying and distributing”— which I mentioned in the context of PPE—were

“resolved and supply is now meeting demand.”

I can go on. The report also says:

“The Scottish Government worked to improve the support available for the health and social care workforce during the pandemic” and it goes on to cover the steps that we are now taking to rebuild and remobilise the health service.

I will continue to try to ensure that the Government learns lessons. However, each and every day, and for as long as it takes, I will stay focused on leading the country through the current circumstances as safely as possible.