Health Protection (Coronavirus) (Requirements) (Scotland) Amendment Regulations 2021 (SSI 2021/299)
The next item of business is an evidence-taking session on the latest ministerial statement, the Coronavirus (Extension and Expiry) (Scotland) Act 2021 reports to the Scottish Parliament, and subordinate legislation.
I welcome to the meeting John Swinney, Deputy First Minister and Cabinet Secretary for Covid Recovery, and, from the Scottish Government, Elizabeth Blair, team leader, Covid co-ordination, governance and decision making; and Professor Jason Leitch, national clinical director. Thank you for attending this morning.
Deputy First Minister, do you wish to make any remarks before we move to questions?
Thank you, convener. I would like to make a brief opening statement in advance of the committee’s questions.
I welcome this opportunity to update the committee on the measures that are being taken to ensure the necessary parliamentary oversight of the on-going response to the pandemic with regard to the updates that the First Minister recently gave to Parliament and the report that I highlighted to the committee on my previous appearance.
As the First Minister set out in her statement to Parliament on Tuesday, we have not made any change to the current Covid regulations, although work is continuing on preparing legislation for Covid certification. The figures that the First Minister set out clearly indicate that the surge in cases that we saw in the summer has caused a sharp rise in the number of people in hospital and is also leading to a significant number of deaths.
However, there are signs that the surge has been levelling off and that the number of cases may even be falling slightly. Although the number of cases in older age groups—that is, people above the age of 45—is still rising slightly, the rate at which cases have grown in all those age groups has slowed during the past week. That context helps to explain why the Cabinet decided not to impose any further restrictions. I am grateful to everyone—all organisations, businesses and individuals—who has taken extra care in recent weeks to try to stop the current spike in infection. Cabinet secretaries are continuing to engage with representatives from business, the public sector and wider civic society to reinforce those messages.
As the university and college term begins, we have been working closely with universities, colleges and the wider sector to make the return as safe as possible, and we continue to work with local authorities to make schools, childcare centres and early learning premises as safe as possible, too. We will continue to require secondary school pupils to wear face coverings as well as maintaining other current mitigations in schools at least until the October holidays. As was set out earlier in the week by the Government, we will amend some of our guidance on contact tracing in schools to ensure that everyone has a clear understanding of the process.
On vaccinations for young people, the First Minister announced that the chief medical officers have taken a broad view of the benefits and risks of vaccination and have recommended that 12 to 15-year-olds be offered one dose of the Pfizer vaccine. Their advice has since been broadly endorsed by the Royal College of Paediatrics and Child Health. The Government will implement that recommendation as soon as possible and will shortly provide further information to health boards as well as, of course, to parents, carers and young people.
The First Minister also set out our approach to booster vaccinations, which will be offered to all adults over 50, to front-line health and care workers, to younger adults with certain health conditions or with health conditions that put them at higher risk and to adult household contacts of people with suppressed immune systems.
The final point about vaccination that I want to highlight—I know that members have heard from stakeholders on this point this morning—relates to Covid certification. Last week, Parliament voted in favour of the proposal to require eligible people to show proof of vaccination before they enter certain specified venues such as nightclubs or attend certain large-scale events. We are now working with businesses, events organisers and sports governing bodies to finalise the detail of that proposal and to publish sector-specific guidance. We believe that this is a proportionate measure that can reduce transmission in some settings, can encourage take-up of the vaccine and might help certain events and venues to continue to operate even when Covid rates are high.
I will move on to matters of legislation. I explained at my previous appearance before the committee that the Scottish Government’s report on the Coronavirus (Extension and Expiry) (Scotland) Act 2021 was to be laid before Parliament on Friday 3 September. That report fulfils our requirement in sections 5 and 7 of the 2021 act to lay a one-off report before the Scottish Parliament one month after the act received royal assent. It gives effect to duties in the act for Scottish ministers to report on the response to the Covid-19 pandemic, including measures relating to the holding of marriage ceremonies and civil partnerships, support for businesses and a range of other policy areas including social security support available to carers, support available to persons who are required to self-isolate for a reason relating to coronavirus, social care services and fiscal fines.
There is also a statutory instrument to discuss, but we will come to that later in the agenda. I am happy to answer the committee’s questions.
Thank you, Deputy First Minister. I will begin the questioning. From discussions with local clubs and the late-night sector—and, indeed, from the previous evidence session—it has become evident that, when the system gets up and running, it will need to work for businesses and the general public. However, people who have been vaccinated outwith Scotland and, indeed, overseas might find it difficult to access the scheme. I have also been made aware of a large backlog in second vaccinations being updated on the national health service portal. With that in mind, and given that the scheme is due to be rolled out in less than two weeks, is there any flexibility with the hard-start date or could a more phased approach be considered to iron out any teething issues?
It is vital that the scheme that we put in place is able to work effectively, and we are addressing the issues that you have fairly raised as part of the development of the necessary technology to enable that.
The basic position for implementing the scheme is very strong, as are the availability of the data in vaccination records and the relationship of those records to individuals. The demonstrations that I have seen of the technology give me a very high level of confidence about the platform on which we are operating. Of course, there will be occasions when the data do not correspond exactly and we have to work with the suppliers and technology companies that we are working with to address those issues as expeditiously as we can. We addressed those matters with Mr Mason at a previous meeting.
As for implementation, the Government takes the view that the scheme needs to be up and running on 1 October because of its necessity in contributing towards the efforts to suppress the virus. That is the rationale behind our urgency in this matter, but in our briefing document on the proposals we indicate that implementation will be founded on the application of “reasonable measures” to put that into effect. Obviously, our guidance will endeavour to address that point, too.
I am not sure whether Jason Leitch wishes to add anything to what I have said about the specific issue of vaccination records.
The first thing to celebrate is that the vast majority of the population are vaccinated, so passports are more possible, and the vast majority of the records are good. When we launched QR codes, two weeks ago, 200,000 people downloaded their vaccination records on that day. The fundamentals are working, but the convener is right. My inbox includes two particular scenarios—as, I am sure, does hers: “I was vaccinated overseas, so how does that work?” and “I was vaccinated in the UK in two different countries, so how does that work?”
We have mechanisms in place to solve those issues. Yesterday, my colleague faced exactly that scenario, but it was fixed after one call. Other people have a slight challenge because, for instance, their maiden names are on their identification but their married names are on their vaccination records We are fixing those issues on an individual basis as fast as we can. The fundamental tech is intact and is working, but we have to catch up with some of those slightly more complex cases.
I will follow up on the convener’s point. I have been contacted by individuals who have season tickets for football clubs in Scotland but who live in England or Northern Ireland. In just two weeks’ time, they will have to produce vaccination certification. I understand that there is not currently a system that would permit them to access their football clubs. Is that issue being resolved? Will it be resolved in time?
The work is under way to do that. As Professor Leitch has said, individual circumstances might need a level of manual intervention to resolve the issue for individuals. At this stage, if people are in the situation that Mr Fraser has highlighted, whereby they have had a vaccine in a different jurisdiction and need to resolve the implications of that for their vaccination certification, I encourage them to engage in the practical mechanisms to resolve those issues. Obviously, as time goes on, we will be able refine further the systems in the common travel area so that they all speak to each other effectively, which will avoid the degree of manual intervention that we have highlighted. I reassure people that the steps that are required to resolve those issues are able to be taken.
Thank you for that. Let me press you on that point. Individuals have contacted me to say that they have been on the Scottish Government website, where the information says, “Work is being done to resolve this issue,” but they have told me that there is no signposting to the exact steps that they need to take to resolve the issue. Can you provide some clarity?
They would do that through the NHS Inform helpline, but perhaps Jason Leitch can provide some detail.
A number of scenarios cross over here. The fundamental scenario is non-Scottish residents, some of whom are overseas, who have season tickets for Scottish games or who want to come to a Scottish music festival. That is not about Scots who have been vaccinated in different places; that is about, for example, people coming on ferries from Northern Ireland to go to Rangers-Celtic games.
We will have to recognise overseas vaccinations up to a point. There are some technical challenges about where people were vaccinated and which vaccine was used, but, in the common travel area, the vaccination records will be transferable. Those individuals will need vaccination evidence from their country and, at this stage, that will probably be a paper copy, which will be acceptable. Eventually, as the Deputy First Minister said, the common travel area will have one transferable vaccination record, and the World Health Organization is working on one for the world, so it will get easier. The EU has a green tick system that is spreading wider—Italy, France and Spain are using that system. I anticipate that, eventually, all those systems will talk to one another, but, just now, they do not. Therefore, people from Belfast who come to Ibrox or Celtic Park will have to bring a paper record of their vaccination.
Thank you. It is very helpful to get that on the record.
A short time ago, we heard evidence from Neil Doncaster, who raised a number of practical issues around implementation, one of which was the practicality of stewarding at football grounds. As everybody knows, there are issues in the labour market at the moment. Recruiting the number of stewards that would be required to make the system credible is a real challenge for clubs, notwithstanding the cost implications. Has the Scottish Government reached a view on whether spot checks will be deemed sufficient? What other practical engagement is there, and what guidance is being given to clubs about how the system can be set up within the next two weeks?
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The point that Mr Fraser raises—which Neil Doncaster expressed this morning—is entirely reasonable. We are aware of the labour market challenges, which are visible to all of us, and the challenges around the availability of stewards are well documented. I do not in any way, shape or form dispute that point—I accept it, hence the rationale in the Government’s paper that we published last week, in which we indicated that there was a necessity for organisers to take reasonable measures and that there was likely to be a proportionate approach in different settings such as a crowd of 200 versus a crowd of 60,000. We envisage that there will have to be different approaches, and we are working through the issues in detail with football authorities in order to have that proportionate approach—principally because they will be the ones with the big crowds that will be affected, although other events and sectors will also be affected.
We are trying to encourage a climate in which vaccination uptake is understood to be a significant protection for the country against the spread of the virus. Even though there may not be a check of absolutely everybody who attends a football game, the more that we can do, the more we can make these events safer and less likely to be places in which the virus is transmitted and the more we contribute to the suppression of the virus.
We are actively involved in discussions with the football authorities and other players on these questions, and a proportionate approach is likely to be taken, as we highlighted in last week’s paper. As we also indicated, guidance supporting that information will be available to relevant parties.
That is very helpful.
I have one more question. It is on the slightly different issue of vaccination certification, and it came from a constituent who emailed me this week. He said that he downloaded his record of vaccination and was able to change every element on the certificate. In fact, he sent me a copy of his download, in which he had changed all the information. He was even able to remove large sections of the QR code. Is that an issue? How robust is the security around this? Although I hope that only a small minority of the population would ever seek to amend their vaccination certificate, how robust are the mechanisms to make sure that it does not become a widespread problem?
I accept that it is possible for somebody to change names and text in a PDF document. However, if one was to change one’s QR code, one would not get into the football match, because the QR code would not work—it would not scan or be valid. Somebody might want to play around with the shading or detail of the QR code but it would be pointless, as it would not get them into the game because it would not work. That question therefore mystifies me a little bit. The QR code—which is the element that has to be absolutely robust—cannot be tampered with to give it a different effect.
If the committee does not mind, I will go round members in reverse order this time.
Good morning, cabinet secretary and Professor Leitch. I will ask a question that I also asked during the previous evidence session. Given that venues may be committing an offence if they do not “take all reasonable measures”, what involvement did the industry that is affected have in developing what constitutes “reasonable measures”? Gavin Stevenson suggested that the Scottish Licensed Trade Association was not consulted at all on the matter. To make it work properly, all the sectors will have to understand what constitutes a reasonable measure in a wide variety of potential venues.
There are two elements to that question; the first is about engagement and the second is about what reasonable measures are. On engagement, I appreciate that this is being done quickly, but a lot of stuff around Covid has had to be done quickly because of the nature of the situation that we face. The rationale for us acting quickly in that respect is twofold.
First, we face a very high level of cases. The point has been made to Parliament that, if we had had case numbers a year ago of the type that we have now—although they are slightly lower than they have been—we would have been in lockdown. Thankfully, the vaccine provides us with a huge amount of protection against that, but we still have very high levels of case load, which flows through into levels of hospitalisation that are resulting in well-documented pressures on the national health service and all its constituent parts. There is a need to act swiftly to suppress the virus. That is the nature of the urgency around engagement.
The second point in relation to engagement is that we have had a range of discussions. The First Minister and I were involved in a session the other day with a variety of stakeholders, and representatives of hospitality sectors were involved. I cannot recall off the top of my head whether Mr Stevenson was involved as there was a large number of participants. Jason Leitch and the finance secretary have had similar discussions with other sectors, and our officials are involved in dialogue to understand the practical issues. We are actively involved in those discussions in order to make sure that we hear the practical issues so that we can shape the guidance to ensure that there is a clear understanding of what is envisaged in the process.
That brings me to what reasonable measures are. Clearly, we can help organisations only by providing the necessary context, detail and information that allows them to form their view about reasonable measures. Having listened to the evidence that the stakeholders on the first panel provided, I note that there is willingness to do that and to be engaged in the implementation of such a scheme. They appealed for an understanding that there may be steps that they have to take to get more reasonable measures in place, and I certainly give an assurance that the Government is listening to that message and argument as we formulate the guidance.
The issue is not only that they have to form an opinion on the definition of reasonable measures, but that they have to implement it within two weeks. You will understand the concern that there is potential for offences to be committed.
I understand that, but all those organisations will to some extent, at an organised event or venue, be carrying out some form of checking of individuals who are coming in, whether that is through ticket checks, purchases or whatever. We are asking that another element be introduced—which, with the assistance of technology, should not add a significant burden to the process—in order to provide an extra layer of public safety and security regarding the spread of the virus. We will provide the necessary guidance that will set out what we consider to be reasonable measures to undertake such an endeavour, and in formulating that we will continue to have discussions with the relevant sectors.
As I discussed with Neil Doncaster, vaccination passport checks will be implemented by all clubs, even small ones, because there is potential for crowd size to be taken beyond 10,000 people when bigger clubs visit. You will recognise that there are varying abilities to finance that. One of Neil Doncaster’s suggestions was that initially, in phase 1, as the technology is being introduced, it would be more practical to instigate spot checks. Has the Government considered that?
I appreciate that crowd sizes vary significantly around the country, but some venues simply cannot accommodate more than 10,000 supporters. It does not matter how many supporters Rangers or Celtic bring along, because only a certain number of people can get into the ground. There are limiting factors. Before I came here today, the Minister for Parliamentary Business was telling me that St Mirren can accommodate only 8,000.
Spot checks are a valid issue. As I indicated in my answer to Mr Fraser a moment ago, in the paper that we published last Thursday, the Government envisages a proportionate approach in larger crowd settings. There is undoubtedly the possibility of that approach being taken.
I think that you need to have a word with your colleague, because the rule for the premier league is that all clubs need to have a 10,000 capacity all-seated stadium before they can—[Interruption.] Is that not the case any more? There you go. I have learned something new today. I thank the cabinet secretary for that.
There you are.
I have one more question. Earlier, the representative from the hospitality industry indicated that there is a potential inequality because people will choose venues based on whether they will need to produce a vaccination passport. Nights out often involve multiple venue visits. Do you recognise that there is a potential inequality regarding where people will choose to have a night out?
I recognise that point, which is material to the definition of a nightclub and which relates to a point that representatives of the nightclub sector have put to me. If we look at venue A, which, for argument’s sake, we will say closes at midnight, and venue B, which closes at 3 o’clock, we can see that there are two very different propositions, even if both venues involve music, dancing and the availability of alcohol. If someone has been out since the early evening, going to a venue that closes at midnight could make for a long night, but if they are out until 3 o’clock in the morning, it is a very different proposition. However, there might not be an awful lot to distinguish the two venues, and that is one of the issues that we are wrestling with.
We are discussing that with the sector to make sure that we do not create a situation where there is disadvantage because of the way in which the definition is constructed. We are looking at that issue very carefully in order to try to resolve it.
I heard what the Deputy First Minister said about a proportionate approach. It will have to be proportionate because, with the timescales that you have given, I am not sure that it could be anything else.
I have a few questions, one of which is on vaccine take-up. Professor Leitch says that it is really good, but what is the up-to-date position on it? What work is being done? Have you identified where there are specific problems? What analysis has been done where there is not the same level of vaccine take-up? For example, it has been suggested that there is lower take-up among people from lower socioeconomic backgrounds and young people in general, although the take-up figures that were given recently for people returning to St Andrews university were way above anything that I had expected, so that is not true of all young people. There is also a suggestion that there is lower take-up among people from certain ethnic backgrounds and communities, and refugees and asylum seekers.
Where do we have such issues? Is the Government doing targeting and asking why there is lower take-up in certain areas and communities? It would be useful to get a response to that question and to see something in writing that sets out the approach.
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Those are all significant issues. I will talk through some of the points on vaccine uptake and the headline direction and I will perhaps rely on Professor Leitch to add specific details. I will go on to address some of the points that Mr Rowley has legitimately raised about particular groups and the efforts that are taken to try to increase uptake.
Uptake of the vaccine has been very high. The uptake level in a routine flu vaccine programme pre-Covid, for example, would be of the order of perhaps 65 to 70 per cent. In the over-40s cohort, the level of double vaccination is significantly in excess of 65 per cent; indeed, it is over 80 per cent now.
It depends on which way we cut it. The worst figure for the 40 to 49s is 91 per cent. The figure for everybody who is over 40 is above 90 per cent.
Compared with the uptakes in normal vaccination programmes, that is a really high uptake for the over-40s. The figures for the 30-to-39 and 18-to-29 cohorts have been at lower levels. Professor Leitch can give the specifics on where those figures are now.
We must remember that vaccinations for the 18 to 29s have not been as available because we did not start them until much later. The figures for that cohort are 76 per cent for first doses and 60 per cent for second doses, so three quarters have taken up the offer of vaccination and catching up. The figures for 30 to 39-year-olds are 83 per cent and 73 per cent respectively. The programme for 16 and 17-year-olds has been open for two weeks and 65 per cent have had a first dose, which is astonishing.
The general picture on vaccination is therefore encouraging. The numbers relating to 16 and 17-year-olds, which Professor Leitch has shared, are an indication of real enthusiasm to come forward. I pay tribute to the school community, which has done tremendous work to encourage young people, and to young people themselves, who have exercised tremendous leadership. For example, I saw senior pupils from all the Perth city schools, who were involved in a venture in my constituency at the Dewars ice rink vaccination centre, promoting that to their peers. That was very successful. That is probably the best communication that there can be to encourage uptake.
The general position is encouraging but, comparatively speaking, we have weaknesses among younger people—the under-30s—and we have challenges in some areas of the country that suffer from socioeconomic deprivation, and in black and minority ethnic communities. The Government has looked carefully with health boards at the practical deployment of services and vaccination opportunities in order to ensure that we try to counter those. Mr Rowley will be familiar with the situation in his locality. His health board will have been offering various drop-in opportunities at different places to try to address that.
A lot of the approach is focused on localities in which we know that there are weaknesses. However, we cannot oblige people to take up the opportunities in a voluntary vaccination programme. We can maximise the possibilities and availability, but we cannot oblige people.
I assure the committee of two things. The first is that we should be pleased by how much progress has been made. It is a tribute to the vaccinators around the country, who have worked incredibly hard. The second is that we are taking focused measures to boost uptake where we possibly can.
You have heard the numbers, so I will not go over them again. There are three groups that are more challenging than the average, although there are of course exceptions. They are the young, the socially deprived and some special cause groups consisting of people who are particularly vaccine sceptic. An example of the third group is the Polish community, because a lot of their information comes from Poland, which is the most vaccine-sceptic country in the world. We have to adjust our communication with and routes to access each of those populations. There are tactics and mechanisms to do that, and we need to do three things.
First, we must make the vaccine as accessible as possible. We must increase access by opening mobile vaccination units in, for example, the car parks of further education colleges. My sister works at the City of Glasgow College. It had little influence over what happened, frankly, but it opened for a morning and in four hours it dealt with 200 people who were coming back to the institution.
Secondly, we must adapt our communication to suit the group that we are dealing with. A 52-year-old guy talking to 16-year-olds does not really work, but I can help the relevant Young Scot panel by giving it information, and those young people can help in the schools and further education colleges.
Thirdly, although we should not spend too long on this, we have to deal with misinformation. As we go down the age groups, misinformation becomes more of a problem because of social media and younger people’s access to that misinformation. All that we can do is to use trusted voices to get the correct information out. MSPs are part of that mechanism, and you can help us in that environment as we fight against that misinformation.
Misinformation is a big concern. I speak out against it, and was glad to hear the First Minister speak out against it last week. We need to be less namby-pamby with such people, and to confront the misinformation that they are spreading.
How are discussions about the current laws going with the retail and transport sectors? I have raised this point before; shop workers tell me that their managers do not see it being the role of shops to enforce anything to do with wearing face coverings. That means that we can go into some Scottish chain shops and see the staff wearing masks but fewer and fewer other people doing so. Do you agree that it is the case that, over time, as fewer people abide by the rules, the rules will become pretty pointless? I once mentioned Aldi’s green-light system to you. Other retailers have good systems in place and they approach people about wearing masks. However, some do not, so shop workers are being left vulnerable.
I agree 100 per cent about the importance of the matter, and I can reassure you that we are making efforts to pursue it.
The other day, I saw a social media message in which a clinician shared a photograph of himself dressed head to toe in personal protective equipment, wearing a heavy-duty clinical face mask. It looked unbearably uncomfortable. The message that he set alongside the picture was, essentially, “If all you’re moaning about is wearing a face mask to go to the shops, come and stand where I’ve been standing for a minute.” I think that that made the point perfectly. Wearing a face covering is the least that we can ask people to do to ensure that they are taking precautions to stop spread of the virus.
All the baseline measures—wearing a face covering, observing physical distancing where possible, coughing etiquette, hand-hygiene procedures and so on—will interrupt spread of the virus, so it is important that we reinforce the messages on them.
About three weeks ago, the Cabinet discussed the issue. General frustration was expressed that, after 9 August, there had been a sense that there could be relaxation of those baseline measures.
We therefore took a number of steps. We deputised cabinet secretaries to intensify stakeholder discussion—basically, to get on the phone to supermarkets, retailers, transport companies, universities and colleges. Members of the Cabinet did that, along with their officials, in order to have those conversations.
Then, two weeks ago, I convened a stakeholder discussion involving about 170 organisations, including representatives of the retail sector and all the supermarket chains, transport companies, education institutions, local authorities, business organisations and trade unions. The aim of that was to reinforce the importance of application of the baseline measures. Of course, in such a conversation involving a range of stakeholders, some will be pressing strong arguments that are supportive of what the Government is doing. For example, I was delighted with the degree to which the trade union representatives on the call reinforced the message. They are, understandably, concerned about the wellbeing of their members. It was a helpful call that strengthened the attitude to application of baseline measures.
On Tuesday, the First Minister and I convened a follow-up call that included much the same cast list. There was quite a bit of feedback from the retail sector that the messaging from the Government about turning up the heat on following baseline measures had helped in the retail environment. Ministers have undertaken specific communications to support retail workers and to encourage members of the public to be respectful of those workers by ensuring that they wear a face covering if they are asked to do so by a retail employee.
I hope that that reinforcement of the baseline measures is contributing in part to the tempering of the level of infection in society. As the First Minister reported to Parliament on Tuesday, we are in a better place than we were last week and the week before.
I assure Mr Rowley that we intend to have no let-up in encouraging and motivating organisations to follow the baseline measures. I think that most organisations accept the importance of that, because they can see that, if we do not do it, we might have to do other things that they will like even less.
This morning, the front pages of the Daily Record and The Scotsman carried horror stories about people not getting ambulances. They are real-life stories. How prepared are we for this winter? Even before Covid, the NHS struggled in winter—we all know that, and I have dealt with it in various forums. How prepared are we, given that we are in a pandemic and that people will be out and about so we can expect issues with things such as flu? Should the public be concerned about getting through the winter?
The winter preparations started some time ago in order to ensure that we are ready for the pressures that are inevitably put on the health service during autumn and winter. Frankly, that is why the Government is taking some of the steps that we are taking. I accept that they are not the most popular measures that we have ever taken, but they have to be taken in order to try to suppress the prevalence of the virus.
I do not have today’s numbers in front of me, but on Tuesday we had 1,064 people in hospital with Covid, which is a very high number of admissions to hospital because of Covid. The Cabinet regularly sees modelling of what might happen if we do not suppress levels of the virus. Those levels translate into levels of hospitalisation.
There might now be a different ratio. Back in the early part of the pandemic, about 13 per cent of people who had positive tests for Covid were hospitalised; now, it is about 2 per cent to 3 per cent. The difference is that the level of positive tests is much higher today than it was 12 months ago, which translates into more people, which puts more pressure on the national health service.
11:15In addition to that, the national health service is undertaking two other aspects of work. It is providing the normal emergency care that is necessary—Mr Rowley mentioned news articles about very alarming and totally unacceptable circumstances—and it is dealing with routine elective work, which had been slowed up or paused entirely because of Covid. Therefore, the national health service is under phenomenal pressure. What we can do in advance of the winter is suppress levels of Covid in order to reduce the number of hospitalisations and to relieve some of the pressure. That will work across all aspects of the health service, whether it is ambulance services, acute admissions or elective care.
There are huge pressures on the national health service. Winter preparations have been and continue to be made—we have more people available to work in our national health service—but there will be challenges resulting from the level of Covid in our society.
I am conscious of the time. John Mason is next.
My understanding is that quite a few countries have used vaccination certificates already, so I presume that we can learn from them. For example, I understand that Greece announced its scheme on 28 May and that there was a big uptake of vaccinations in June before the certificates came into operation in July. I do not know whether you saw the previous evidence session; in it, Mr Doncaster argued that we should be more like France, where vaccination certificates are required for entry everywhere, so that the scheme would be simple and understood by everyone. What have we learned from other countries’ experiences?
We have learned that vaccination certification can fuel vaccination uptake. In the short period since we announced that the introduction of vaccination certificates was likely, there has been an increase in uptake in certain groups, so we have learned from that. There is obviously a debate to be had about how extensively vaccination certificates should be applied. The Government is crystal clear in its view that we will never use them for eligibility for public services. That will just not be considered.
However, there is a legitimate argument, which we are not pursuing at this stage, for extending vaccination certificates across a wider range of facilities. We want to avoid that, but my response to that flows from my response to Mr Rowley a moment ago, which was that we must take all reasonable steps to suppress the virus, to protect the national health service and, ideally, to enable us to avoid further restrictions that could have a greater impact on society as a whole. We want to avoid that if possible.
I also ask Professor Leitch about other countries’ experiences.
I can partly deflect that question—which I have got very good at—to the politicians who actually have to make the choices.
The public health advice is fairly binary; it is not complex. Being vaccinated is better than being unvaccinated in pretty much every context—this room included. I would be more comfortable in this room if everybody in it were vaccinated. I imagine that John Mason would be, too. That would be true in nightclubs and in sports stadia, and it would be true in my house.
Therefore, it becomes a political judgment about what to do with the information and how we address the breadth and content of Covid vaccination certification. Countries are making different choices. Israel was first, with a green pass that included testing, previous infection and vaccination. Most recently, New York has introduced a version of that, as have other parts of Europe. Scottish politicians, on advice from public health advisers—remember that economic and social policy advisers are sitting beside them—made a choice to do what has been decided as the initial phase of Covid certification. There are arguments for going broader or for going narrower, and for changing the content or for keeping it the same. In the end, those are the judgments that are to be made.
However, the fundamental public health message is that people should get vaccinated. The certificate does two things. First, it makes the location safer. Secondly, it incentivises people to get vaccinated. From a public health perspective, then, it is a bit of a no-brainer. I understand that there is complexity in implementing it all, but that is an entirely different thing—it is not a public health issue.
On exemptions, a constituent of mine has a range of health problems but, as I understand it, her general practitioner and clinicians have not yet decided whether it is wise for her to get the vaccine. That is a purely medical decision, but where does that leave her? Do we press the clinicians to make the decision, or will she just be restricted in where she can go?
There are two issues to address in that question. First, the question whether the lady in question should be vaccinated is an exclusively clinical matter, so I will say nothing that would intrude on such decision making. These are, in some circumstances, very difficult judgments. It is estimated that fewer than one in 1,000 people—or 0.1 per cent—cannot be vaccinated for medical reasons. We are therefore talking about a very small number of people, which I think demonstrates the difficulty of the clinical judgment that has to be applied. As I have said, I would not seek to intrude on that.
Secondly, on the implications of non-vaccination for a vaccination certification scheme, we have to ensure that the scheme does not disadvantage people in accessing venues if they choose, as an unvaccinated person, to do so. In other words, someone who is unvaccinated for entirely legitimate and proper clinically assessed medical reasons should not be disadvantaged if they want to see their favourite football club playing. Obviously that will have implications for other members of society, but there is a limited risk of exposure. Fundamentally, though, that is a judgment for the individual, so we have to ensure that the vaccination certification scheme in no way disadvantages or discriminates against them.
That was helpful. Professor Leitch, do you wish to add anything?
The one in 1,000 figure comes from global research and is about right, although we do not know whether it is higher or lower. The two big groups that are involved are people who are receiving end-of-life care and people who are receiving not all types of chemotherapy, but active chemotherapy for serious cancer. Those individuals are unlikely to be in big groups going to venues. Of course, it is not impossible that a person who is receiving end-of-life care will want to go and see their favourite football team, so we will have to make allowances for that.
However, clinical exemptions from vaccination are very rare. The procedure is so safe that, even for people who are sick, it is often the right thing to do. Clinicians will make those choices. We have given advice on what we will put in place and what that will look like. The scheme will have to allow for such clinical exemptions; I say again that they are rare.
On a different issue, I understand that the regulations are going to be introduced quite late on and will be subject to the made affirmative procedure. Would it be possible to bring them forward a little bit so that we can approve them before the end of September?
I will continue to consider that, but the necessity of having the regulations on the statute book by 1 October and having time for discussions and dialogue with stakeholders, and the required time for drafting and processing, suggest to me that it will be most likely that we will use the made affirmative procedure. However, as I have said, I will continue to consider the matter.
As an extension to that point, if hospital numbers were to fall dramatically over the next fortnight, would we just forget about certificates?
I do not think that we would, for the reasons that Mr Rowley suggested in his question about the challenges that we face over winter. In that scenario, we might be coming back round to the issue in three weeks’ time. To reinforce that point, I draw on the contents of the United Kingdom Government’s plan B, which includes vaccination certification; I think that it has an eye on the winter problems and the challenges that it will face.
Previous witnesses talked about the expense of apps and checking people as they go into venues. My experience—I think that people know this—as a Clyde Football Club supporter, is that my season ticket is on an app that is checked when I walk in. There is no problem—the staff use their own phones for doing that, and there does not seem to be an issue. What is your response to the point about the cost to businesses?
I agree very much with the point that you made about the technology, Mr Mason. It is routine technology that is widely available through free downloadable apps for individuals and for those who undertake checking. It has been designed to be within the firmament of the technology that we are all accustomed to using nowadays.
I apologise to other members who wanted to ask more questions, but we are really pushed for time. That concludes our consideration of the agenda item. I thank the Deputy First Minister and his officials for their time today.
We now move to consideration of the motion on the made affirmative instrument that was considered under the previous item. Deputy First Minister, would you like to make any more remarks on the Scottish statutory instrument before we vote on the motion?
I want to place on the record that the SSI amended the Health Protection (Coronavirus) (Requirements) (Scotland) Regulations 2021, which came into force on Monday 9 August 2021. The regulations that we are discussing, which came into force on 3 September, made a minor amendment to enable performers to perform or rehearse for a performance without face coverings in situations where distancing or partitioning are not possible. For clarity, that exemption will apply for as long as there is either a partition or a distance of at least 1m between performers and other people, including the audience, but that does not include people who are performing or rehearsing with the performers or assisting with the performance or rehearsal.
Thank you, Deputy First Minister. I note that no member wishes to speak on the motion.
Motion moved.
That the COVID-19 Recovery Committee recommends that the Health Protection (Coronavirus) (Requirements) (Scotland) Amendment Regulations 2021 (SSI 2021/299) be approved.—[John Swinney.]
Motion agreed to.
The committee will in due course publish a report to Parliament setting out our decision on the statutory instrument.
That concludes our consideration of the agenda item and our time with the Deputy First Minister. I thank him and his officials for their attendance.
The committee’s next meeting will be on 23 September, when we will continue to take evidence on vaccination certification. We will also take evidence from the Cabinet Secretary for Net Zero, Energy and Transport on the ministerial statement on Covid 19 and on subordinate legislation.
That concludes the public part of our meeting. I will allow the witnesses to leave before we continue in private session.
11:28 Meeting continued in private until 11:30.Air ais
Vaccination Certification