 The cabinet secretary will take questions at the end of his statement, so there should be no interventions or interruptions. I call on Hamza Yousaf for around 10 minutes, cabinet secretary. I'm pleased to announce that the Scottish Government has today published our autumn and winter vaccination strategy. I'm sure that members will agree with me that the Covid-19 vaccination programme has been a resounding success. The NHS and, indeed, many, many others have mobilised at breakneck speed to match supply, thereby protecting the most vulnerable in our society at a scale that has never been experienced in living memory. It's easy to forget that it was only nine months ago that we started receiving relatively small volumes of vaccine. We have now administered an incredible 8 million vaccine doses across Scotland, which demonstrates the incredible ability of our NHS and, again, our wider partners to respond in unprecedented circumstances. 92 per cent of all people aged 18 and over have had a first dose of a Covid vaccine and 86 per cent have had a second dose. That is a remarkable achievement, and I want to put on record my sincere thanks to everyone involved in this, frankly, Herkuleian effort. Vaccinations continue to play a critical role in helping to protect the people of Scotland and support our wider global effort in reducing the harm caused by Covid-19. As part of our commitment to openness and transparency, we have sought to keep Parliament and the public informed of our plans and our progress. Our autumn and winter vaccination strategy is part of this very commitment, and it illustrates that we have exceeded our expectations and set out in the original plans to vaccinate 80 per cent of the eligible population. More than that, the strategy outlines our vision and our commitment to continue to offer a vaccine to anyone eligible until at least spring next year. Finally, we set out how we will deliver Covid vaccinations alongside our biggest ever annual flu programme to help to protect as many lives as possible this winter. I am pleased that this morning Audit Scotland published its independent report on Scotland's Covid vaccination programme. It is an overwhelmingly positive report. The report highlights the remarkable success of the programme and how we have ensured good collaboration and joint working right across the board while developing new digital tools at an extraordinary pace. I hope that members will get a chance to look through this insightful report. The Audit Scotland report also highlights that the programme has been, and I am quoting, effective in reducing the number of people getting severely ill and dying from Covid-19, delivering a variety of ways to make it easier for more people to access them and the level of vaccine wastage has been low. I know that there is often much political and media commentary—understandably so, of course—when Audit Scotland produced challenging reports. I hope that there will also be attention paid to reports like this one, stating where excellent progress has been made in relation to the vaccination programme. As we look ahead to the autumn and winter months, it is vital that we build on our achievements and continue to deliver Covid vaccinations as well as seasonal flu vaccinations to all those who are eligible in Scotland. A key feature of the Covid-19 vaccination programme has been the evolving clinical advice, which has required the programme to pivot, often at quite short notice, to include new groups of people or change the vaccines that we have used. That has included, for example, extending our offer to 12 to 15-year-olds following advice from the JCVI and then the four UK chief medical officers. I thank our vaccinators for the care and sensitivity with which they are helping particularly younger people and their parents and carers to engage with the vaccination programme. It is important to reinforce that choice remains central to our approach. A great deal of emphasis has been placed on access to quality information, supported by discussions at vaccination centres to address any questions or concerns that young people may have. That was one of the key considerations that informed our own delivery and why we deliberately started vaccinations for young people within community settings to enable them to be accompanied by a parent or carer and have those really important discussions. We are also now administering a third primary dose of Covid vaccinations to those who are severely immunosuppressed. We have begun a programme of booster doses for those who are most at risk from severe disease. Booster doses are given at least six months after the second dose. This year, more than ever, we must ensure that those in the higher-risk age groups are protected against other seasonal respiratory illnesses such as flu. Our immunity may be even lower than usual due to lower levels of flu circulating last year as a result of the crucial public health measures that were in place at that time to protect the population from Covid. Therefore, earlier this month, we launched Scotland's biggest ever flu vaccination programme with expanded eligibility criteria to include everyone over 50 health and social care workers, including independent contractors such as GPs, dental and optometry staff, nurses, teachers and support staff, prison staff and prison population. I urge us all to come together to thank all those who have been involved in the vaccination programme and to those who will support it as we move forward. From those who work tirelessly in our NHS across local government to those in the army that have helped out and continued to help out to the many volunteers who have stepped forward at this crucial time. I am also grateful to the many faith, third sector and community groups who have contributed so much to supporting our efforts to deliver an inclusive national programme. We could not have achieved this remarkable success without your help, so today I want to express my thanks to everyone who has stepped forward to be vaccinated and the vaccinators. The overwhelming response from the people of Scotland has been inspiring. The vaccines are highly effective at preventing severe disease and getting fully vaccinated remains the best way to be protected against the virus. I urge anyone who is eligible and not yet received a Covid vaccination to book an appointment or indeed attend a drop-in clinic at the earliest opportunity. For anyone who is hesitant because they need more reassurance or indeed information, our vaccination teams will be happy to discuss the benefits with you. We have continuously adapted our vaccination programme and incorporated lessons learned into our planning and delivery, regularly seeking feedback both from those directly and those that are indirectly involved in the programme. Vaccination along with testing remains our best route out of the pandemic and its crucial people do come forward. As a result of the positive impact of the vaccination programme, the rate of increase in Covid-19 cases has been less among those who are fully vaccinated compared with partially or indeed unvaccinated people, demonstrating the protection that is offered by vaccination. Many members know the statistic, but it is always worth repeating that, at the start of the year, around 12 per cent of cases were ending up in hospital. That figure is now down to around about 2 per cent. Across all age groups, the rate of hospital admission has been higher in unvaccinated people compared to vaccinated individuals. Most younger adults will have received their second Covid vaccine dose in late summer or early autumn, but there are currently over 170,000 adults—under 40—who have had their first dose but have yet to come forward for their second. Getting your second dose, if eligible, will give you longer lasting protection from the virus, and all help will play a part in keeping your friends, family, community and, of course, yourself safe. My plea to those who have not attended their appointment for a second dose, do not leave the job after. Please attend a drop-in clinic or arrange an appointment for the second dose of your vaccine. We have undertaken a range of national activity, as well as a range of targeted communications and engagement to encourage people who have not had their second dose for any reason to complete their vaccination. That includes a personal letter from our chief medical officer. We continue to work with colleges and universities to maximise vaccine uptake among students who are not fully vaccinated. Clear communications are a key part to encouraging uptake. We are working across social media channels to inform students of the benefits of getting vaccinated. Academic institutions are also being encouraged to work with student representatives to encourage uptake. Following advice from the JCVI and the four UK chief medical officers, all children aged 12 to 15 are now being offered a dose of the Covid vaccine. Health boards have begun to offer vaccinations to as many children as possible. Dropping clinics open for 12 to 15-year-olds to attend with their parents or carers last week. This week, eligible children and young people will be offered an appointment either at school or a community clinic. Most young people in this age group will receive a blue envelope with a scheduled appointment time and the national information leaflet. That will be for a community clinic in the health board area. There are some regions that are not undertaking the blue envelope or community clinic model. Those are NHS borders, Dumfries and Galloway, some parts of NHS Island and some island boards. In those cases, a school delivery model began earlier this week with the leaflet letter and consent form going home in school bags in those aforementioned health boards. I would encourage parents, carers and young people to read the material provided and reach an informed decision. I am pleased to report the role that has also begun of our seasonal flu programme and is progressing well. We launched our childhood and school vaccination programme on 6 September. Primary and secondary school pupils started receiving their flu vaccine from that date and, from 20 September, NHS boards began to vaccinate residents in care homes. The health and social care workers online portal for booking appointments also went live on 21 September. As members will be aware, we have prioritised those at the highest clinical risk and pregnant women. I will end, because I am already over time, by saying that we are working closely with NHS Scotland partners, local authorities and healthcare partnerships to proactively manage current system pressures. There are system pressures in terms of the workforce. We have been clear that the conditions are likely to remain challenging. I will make a statement to Parliament next week to set out immediate actions that the Scottish Government can do to assist to mitigate some of those pressures on our health service. Based on the success and good practice of the Covid programme, we will continue to improve, build and adapt the vital resources to deliver future vaccination programmes. We thank all those who have been involved in making our vaccination programme an incredible success. I look forward to taking questions from members. Thank you very much indeed, cabinet secretary. The cabinet secretary will now take questions on the issues raised in his statement. I intend to allow around 20 minutes for questions at which point we will need to move on to next business. I would encourage all members who wish to ask a question to press their request-to-speak buttons now or as soon as possible. I call on Dr Sandish Gouldhani. I would like to thank the cabinet secretary for advance sight of the statement. I want to say to anyone watching at home who is eligible for the Covid vaccination or the flu vaccination to please get it because it will save lives. I have had both of my Covid vaccinations and I will be getting my flu vaccination. Tess White has a disabled constituent who will have to travel from Inverburby to Stonehaven to get his vaccination, which will take him an hour door to door. Will the cabinet secretary set out a maximum travel time for patients, especially in rural areas? Will the cabinet secretary explain why he is going to give us a further update in a week and not now on vital information about mitigating pressures, maximising capacity and supporting our system response, which is key to delivery? I thank Dr Ghani for his question and I thank him for the plea that he makes at the beginning coming from not just an opposition politician but somebody who is a practicing GP. I think that that is a really important call to make to people. On the details of Tess White's constituent, I would be happy if Ms White would like to forward me details of that disabled constituent. I think that health boards are working extremely hard to ensure that there are drop-in clinics available as close to people as possible. If that is not happening, I am more than happy to take it up with the relevant health board. So there are drop-in centres right across the country. I wouldn't expect somebody to have to travel an hour. That seems to me an excessively long journey for somebody to take. So if Ms White would like to forward me the details, I will do that. My statement, hopefully to Parliament, will be in less than a week. Of course, we have already taken action to try to mitigate some of the winter pressures that we are facing. That will be a further update to that. I thank the cabinet secretary for his advance copy of his statement. The demands on the NHS are currently at crisis point, so delivering the flu vaccination and Covid booster programme at pace will be critically important. Can the cabinet secretary commit to doing the flu programme at least before Christmas rather than by March to better protect the NHS? I also welcome the development of the long-term sustainable vaccination workforce, but that will of course take time. In the meantime, locum pharmacists do not appear to be used to the same extent as locum GPs or indeed nurses. Can the cabinet secretary commit to using locum pharmacists as well as commercial pharmacists to deliver the programme? Finally, the cabinet secretary will be aware that uptake is lower in disadvantaged areas and that the vaccination centres that were closed are now reopened in order that the vaccinations are delivered as locally as possible. In terms of the programme on-going, we are talking about 7.5 million vaccines over the course of autumn and winter, so in the space of a few months, we are going to try to deliver 7.5 million doses, which is just less than the 8 million doses that we have delivered in the past nine months. An incredible effort is needed. We are confident of meeting the timescales that we have set out in the strategy. Of course, if Ms Baillie, as she requests, if we can go any quicker than that, I promise her that we absolutely will. As she has referenced already in her second part of her question, the NHS is facing severe, severe pressures. Therefore, we have to be able to make sure that we are doing this in a way that is, of course, with pace, but also managing some of those really challenging pressures. Of course, I will look at the issue again of local pharmacists. It is an issue that my sister, who is a local pharmacist herself, has raised with me, I think, in my first week as health secretary. There is also a conversation that I had with the chief pharmacist, Alison Strath. I will take that issue away, because anything that we can do to maximise our workforce is a good idea. On the final point that Ms Baillie raises, yes, again, I will have, as you can imagine, very regular engagement with health boards. If there is more that they can do around opening up additional vaccine centres, then I am sure that that is an issue that I will raise with him, but I am sure that it is an issue that he is proactively looking at. However, it is not just about access, because I think that Ms Baillie would agree with me generally when it came to dose 1 and dose 2 of the vaccine. I think that it would be fair to say that there was very good coverage of local drop-in centres, generally across the country. We have to do more around communication, do what we can to work with the third sector, working with faith leaders, for example, working with our ethnic minority organisations, such as Bemis, who have been excellent, to try to outreach to those groups where uptake is lower. Any suggestions that anybody has on this chamber will be met with an open mind from me. I am going to ask the cabinet secretary to address the issue of rural people, not just for the Covid vaccine but more for the flu vaccination roll-out. What advice does he give to health boards that there are issues about people in rural areas accessing the centres, the urban centres, where the vaccination programme has been rolled out? I think that that is a fair point that was made by Gillian Martin. People can obviously find the clinics at a local to them following the NHS boards webpage. We also have a landing page on NHS inform that takes you to your health board area, which allows you to see the nearest drop-in clinic to you. I know that this is a particular issue in rural areas and what can seem like a relatively short distance, due to public transport links and so on and so forth. Again, particularly at weekends, it can be a much longer journey. I am more than happy to speak to the rural boards in particular about that issue. If there are cases—I make this as a very open offer—if there are cases, as Dr Ghani has already done on behalf of Tess White, if there are cases where the journey time seems unreasonable, I am more than happy for MSPs to write to me directly and I will be happy to raise those with the health board. Let me also put on record my thanks to all those in our health service who participated in delivering the vaccine programme. It has clearly saved lives and will continue to do so. Cabinet Secretary, today's Audit Scotland report states that the vaccine programme so far has been reliant on temporary staff and volunteers. It notes that work is currently taking place to establish the size of workforce that is needed. I notice that there is reference to this within the development plan. You have recognised the pressures. How many staff do you envisage will be required to sustain not only the Covid vaccine programme but the flu one as well? I thank Ms Weber for the question, because it is an incredibly important one. She will know that the information on page 19 of the strategy deals with workforce. It gives detail of how many vaccinators we have to date and how many volunteer hours have also helped in that vaccination effort. I will not put a number on it just now, because it would depend on the diversity of that workforce. However, I would say to Ms Weber that no stone from this Government is being left unturned to ensure that we meet the ambitious targets that I have already referenced to Ms Bailey of our vaccination programme for the autumn winter. Can the cabinet secretary provide an update as to how Scots have been vaccinated outside of Scotland, including my constituent, who lives in Echelfechan, but works for NHS England where they were first vaccinated? How can they obtain proof of vaccination status? There are a number of things that can be done. First and foremost, I say to anybody who has been vaccinated outside of Scotland, for example, when it comes to the certification scheme that comes into force at 5am tomorrow, you can use, for example, the NHS England app, or indeed you can use certification proof from anywhere across the common travel area. For a number of those countries in the common travel area, we already have, for example, with England, a data exchange that is available. What we are doing from tomorrow is launching an online form for people to complete if they have been vaccinated in England, Wales or Northern Ireland, but live in Scotland. We ask that if an individual vaccination from another part of the UK is not showing, and there may well be times when there are errors and all members have contacted me about that, we would ask people to phone the Covid status helpline on 08081968565, and they aim to fix those issues within 14 days. I am at a loss to understand why the GCVI does not consider police officers amongst being a priority group. Given the incredible efforts that Police Scotland and Serving Police officers will make, Police in COP26, with up to 25,000 people attending, exposing them to considerable risks, is the Government planning on asking the GCVI to include police officers as being a priority for the booster vaccine as they should be? She asked questions with absolute sincerity, and I, as a former Justice Secretary, know the incredible efforts that our police officers, men and women, right across the country make. She is right to reference the fact that they will make an incredible impact in relation to arrangements around COP26. I would say to Pauline McNeill that it is right that the GCVI gives us that clinical expertise. It is also the case in my understanding that police officers have taken up, of course, in good numbers and very high numbers the offer of vaccination. We will continue to listen to the advice of the GCVI in relation to when and who should be prioritised in relation to vaccination and immunisation. I wonder what advice the cabinet secretary would give to somebody who is thinking of declining their third or booster jag because they would like to see that jag going to somebody in the developing world. Cabinet secretary? I would ask them not to delay. I can understand what might seem like good intentions on their behalf, but to give them some sort of assurance we are working with international partners and also working with the UK Government, Welsh Government and Northern Irish Government in relation to the COVAX scheme. I have had many good conversations with other health ministers right across the UK about what contribution Scotland can make to that global effort, but by not going for your booster dose or your third dose or indeed any of the first two doses, that is an automatic guarantee that that dose ends up somewhere in the developing world. Please be assured that we are working with international partners and domestic partners around the COVAX scheme and working with the World Health Organization, but please, if you are eligible for a vaccine for your first, second, third or indeed booster dose, then please step forward. On the SNP's shambolic plans for Covid certification, very little has been said so far about how fraud will be combated. So, in the absence of a photographic component, can the cabinet secretary tell me how the system actually proves that the person who presents the passport is, in fact, the same person to whom it was issued? As far as I can see, it doesn't, and from tomorrow the system will be wide open to fraud through impersonation. I do not agree, of course, with Craig Hoy's characterisation of the scheme and, in fact, the courts have made it clear in their judgment that they believe that we have taken the appropriate steps in relation to launching our scheme tomorrow. I do not agree with the characterisation of it being shambolic. Secondly, as a number of security features on the Covid certificate, the QR code itself cannot be altered. I find it slightly distressing that Craig Hoy is now suggesting that people should have to prove their ID and show their ID alongside any paper copyright of the vaccination status. That is not something that we are calling for. I would say to Mr Hoy, although I respect the fact that he disagrees, he should not be trying to create confusion or, indeed, giving inaccurate claims around a certification scheme. Cabinet secretary, we know that winter pressures on the NHS exist at all times, notwithstanding Covid in the mix for this year coming. Can you please emphasise to people how important it is that the flu jab is taken up in order to protect their NHS over the winter period? Yes, in short, it is absolutely vital. The information and advice that I have received from our own clinicians is where we can try to co-administer both the booster and the flu vaccine. However, in some cases, the timeline will not necessarily match up. Therefore, what we are not going to do is delay the flu vaccine. It is really important, given that we fear the worst around the flu vaccine because we think that people's immunity is lower to flu because there was not much flu circulating last year. It is really, really vital to protect our NHS and to protect individuals and people themselves that they come forward and take up that offer of the flu vaccine as soon as their priority group is eligible. Several pharmaceutical companies are in advanced clinical trials on second-generation vaccines that particularly target vaccine escape in variations such as Delta. Can the cabinet secretary first reassure the chamber that current first-generation vaccines are highly effective at preventing serious illness? However, can he also indicate to the chamber how we will fold in those second-generation vaccines into the booster programme when they become available? I think that I will call Hamilton for a very good question. Yes, on this first point, of course, they are highly effective and there is plenty of data there in research to show the efficacy of the current vaccines. Again, this is a conversation that I have regularly across the four nations with other health ministers. What we do, of course, is to wait for not just the MHRA approval once the clinical trials have been completed. I think that we are expecting the results of the cough boost trial mid next month. Once we receive those results, it will be for the JCVI and others to give details of how those vaccines should be deployed. We are well plugged into that and hope to get the results of the cough boost trial mid next month. I will come back to the member with further detail. As the cabinet secretary will be aware, those who are vulnerable to flu, such as those with mild to moderate asthma and young children, were not in the original priority groups for the Covid vaccine. I am concerned that, as the flu and Covid booster vaccine programmes are run simultaneously, there is a risk that some may incorrectly assume that they are not eligible or do not need a flu vaccine. How will the Scottish Government ensure that those who are eligible for the flu vaccine are aware of that and attend to their appointment? That is an excellent question by Gillian Mackay, because there can be some confusion. There are a number of vaccines under way. We talked about a third dose, we talked about a booster dose, we talked about a flu vaccine and so on and so forth. She is absolutely right. We have already done work on that with communication colleagues to see how we can simplify the message and target it to those that we think are eligible and make sure that nobody is missed out. We are urgently working on that. We have done some work on that already, and she will have seen some of the communications, but I think that it can be made a bit sharper and a bit crisper, and therefore we are actively exploring that very issue as we speak. To ask the cabinet secretary when is the anticipated completion date for all Covid booster vaccines to have been administered. In some respects, it is an evergreen offer because she will be aware from my statement and from previous statements on the booster programme. Of course, the booster dose cannot be given until six months after the second dose, so we will continue to offer that as well as, I suppose, it is not possible in some respects to have a definitive completion date, but we aim to provide boosters to those who are eligible as close to the six months from receiving the second dose, but we will keep that programme rolling on and rolling on, much like we are doing for the primary doses of the vaccine. The pandemic has clearly shown the inequalities that our communities still face. One of them is, of course, internet access. The Scottish Government vaccination strategy is clear in its push for online bookings, but the cabinet secretary knows that many of our constituents still are unable to gain access either at home or at their local libraries. This is a real issue, particularly for older residents. Therefore, I ask the cabinet secretary how the Scottish Government intends to reach out to those with no internet access. Will the Government commit more resources for hard copy letters to be sent? I thank Mr Trowdry for the question. I also pay credit to him personally, because I know that he has been involved particularly in the ethnic minority community in Edinburgh through the work that he has done with Elric over a number of years to ensure that the vaccine uptake is high among those ethnic minority communities. I thank Mr Trowdry for his personal efforts in that regard. Let me give him an absolute assurance for those who do not register with the portal. There will be a deduplication process and letters will be sent out. We have the resource for that, but based on his question, I will go away to look to see if there is anything further that we can do for those who might be digitally excluded. Vaccination and testing are crucial tools in ensuring that our schools remain safe for staff and pupils. Teachers are eligible for the flu jab this year but are not being prioritised for the Covid booster jab. Will the cabinet secretary look again at this decision and also commit to not introducing charges for lateral flow tests? I have real concerns about changing or moving away from our universal offer of lateral flow tests, so that is absolutely not within this Government's purview at the moment at all. I know that it has been raised by the UK Government as part of their winter plan, but I have put on record to the UK Government that I think that it is a wholly inappropriate step to be taking. In fairness to the UK Government, I do not think that they are looking to do that immediately. On her first question again, much like I said to her colleague Pauline McNeill, we take advice from the experts on vaccine and immunisation, the JCVI. If they change the advice, we will listen to that. First, I will put on record my thanks to our teachers for the incredible work that they have done throughout the pandemic to make sure that our children's education is not disrupted. I would say to those teachers that please do step forward for your booster vaccine when you are eligible six months after the second dose that you have received. Thank you very much. That concludes questions on the statements and there will be a brief pause before we move to the next item of business.