 The bank staff are very often the nurses employed by the national health service. The next item of business is a statement by Alex Neil on an update on ebola. The cabinet secretary will take questions at the end of a statement and, therefore, there should be no interventions or interruptions. Thank you very much indeed. I am grateful for the opportunity to update Parliament today ymwneud o'r bobl, rydyn ni wedi bod i gan gael thatigau o cwestiynau chenול yn y cwmrodd ond ond ar gyfer y lle i'r oes arall ac yn ymwneud, rydyn ni'n gydagau i'r wrthbwrn ddechrau ar gyfer y gelfwyr a'r gwestiynau yn ymgyrch, ond mae'r blwysig o bobl yn West Africa yn ei thryd o geisig o fewn i'r llaw o'r gwahanol mwyaf oherwydd y famp yn Llywodraeth Cymru.ologies yn West Africa erbyn hyn datblygawn. What we're saying is nothing short of a public health disaster in the affected countries. The World Health Organization publishes weekly updates on cases and deaths. The latest information from 25 October is that there have been a total of 10,141 cases of Ebola with 4,922 deaths. Historically, the disease has been confined to rural and more disperse communities in central Africa where it cannot easily take hold, but the outbreak in West Africa is affecting urban communities with large densely packed populations, areas where people move about regularly and countries to varying degrees with challenges around health infrastructure and leadership. Once Ebola had a fingerhold in this part of the continent earlier this year, it did begin to spread very rapidly. There is no sign yet that the epidemic is under control, but Scotland will play our full part in contributing to the international effort, along with our friends in the rest of the UK and elsewhere, to bring it under control in West Africa. Already, I am aware of more than 50 professionals from NHS Scotland who have already offered to help and, in some cases, are in situ in West Africa. It is likely that more support will be needed, and I have written to the NHS chief executives on 16 October to reiterate their support for volunteers and to particularly identify the need for more nurses and lab technicians. I would like to extend my sincere thanks to the Scottish aid workers operating in the region and the many healthcare workers and other staff who have expressed their willingness to volunteer in West Africa. Clearly, we need to know that any of our volunteers travelling to West Africa will be safe, and in partnership with Health Protection Scotland I am reassured that robust arrangements are in place to do that. We know who is going to West Africa, and we know that they will be trained well before they go and when they arrive. We are confident that they will be looked after when they are there, and we know that they will be monitored and supported when they return. Within Scotland, we are lucky enough to have the resources and infrastructure in the public health expertise and experience to put us in a good position to deal with any serious infectious diseases, but we are not complacent. There has been an increase in concern about Ebola in the last few weeks, prompted by the reports of transmissions of the disease to healthcare staff in Spain and the United States. However, it is important that we understand the reality of the risk. The fear of Ebola can be more infectious than the virus itself. The risk of a case arriving in Scotland is very low. There are no direct flights to Scotland from the affected countries, and robust exit screening is now in place in the three affected countries. Entrance screening is in place at Heathrow and Gatwick, as well as in key European hubs such as Paris and Brussels. Even if a case does appear within Scotland or the UK, it is very unlikely that we will see any transmission of the virus. The disease can only be caught through blood and other body fluids, and affected individuals will be unwell and have a fever and other symptoms that are not infectious, which will lead them to healthcare well before they are likely to pass the virus to other people. Indeed, the greatest risk of Ebola is to healthcare workers, because they are more likely to come into contact with body fluids when treating a patient, so we must keep the risks in perspective, but we must also be ready to respond, and that is why we have been working with the NHS to ensure that they are prepared and ready. My colleague Michael Matheson, the Minister for Public Health, has led this work since early summer, when he met experts from Health Protection Scotland. Following that, we established a viral hemorrhagic fever's national group, chaired by Health Protection Scotland, to ensure that all the necessary arrangements and contingency plans are in place. That group met for the first time in August, and since last week, the group has started meeting on a weekly basis. Given the importance of ensuring that we can quickly identify and diagnose possible cases of Ebola, we have provided funding to NHS Lothian to introduce a national testing service for viral hemorrhagic fevers in Scotland. That service, which will be in place from 1 December, means that blood samples will no longer need to be sent to the south of England for testing, and we will have the results more quickly. We are also working closely with the infectious disease clinical community to ensure that facilities and resources are in place to rapidly respond to a potential case. Our main infectious disease units in Glasgow and Lanarkshire in the west, Edinburgh in the east and Aberdeen in the north are ready to operate as regional centres of expertise, providing advice to other local hospitals or clinicians as needed and managing possible cases. Our many other infectious disease specialists in wards around Scotland are also ready to respond if needed. I am confident that we are ready to safely manage any possible case should one emerge. Indeed, we have already shown that our health boards, working with the Scottish Ambulance Service and others, can safely manage those types of infections. We have safely managed a case of primary and congo hemorrhagic fever in Glasgow in 2012. We have 14 isolation rooms available to manage patients with Ebola in the three regional infectious disease units in Scotland and access to many more specialist facilities across the UK. An important strand of our work is ensuring that everybody across the national health service in Scotland and any other relevant professionals have all the information that they need as well. I am grateful to Health Protection Scotland and the other professionals involved for all the work that they have done in the past few months to update the many different pieces of guidance and technical advice in relation to Ebola. This information is all available in the Health Protection Scotland website, and I encourage all health professionals to ensure that they are familiar with the content there. It is very likely that any questions that they may have will already have been answered on the website. I have already mentioned the entry screening in place in the UK and European hubs. I am in regular contact with my ministerial contacts in the rest of the UK in both the Scotland office and the Department of Health, and we will keep under review the need for any additional entry screening, including in Scotland. I am not yet convinced that that is proportionate or necessary, but I am ready to implement screening if there are assessment changes. We also have to make sure that our international partners across Europe are keeping under review the question of screening and other public health measures. Discussions are already taking place at a European level in all these matters. We are also working with the oil and gas industry to ensure that any of our oil and gas workers coming or going to affected countries will have access to the same type and quality of monitoring arrangements that are in place for medical volunteers. That international joined-up approach is vital if we are to successfully tackle this outbreak. Across the world, countries need to pull together, and we in Scotland are keen to play our part. Earlier this year, the Government donated £0.5 million to the World Health Organization's Ebola response. That was not a one-off gesture. Last week, I announced an additional donation of £300,000 worth of medical equipment and supplies to West Africa from Scotland. That includes over 100,000 respirators and 1 million disposable aprons, which will be distributed to charities running clinics in Sierra Leone. I will continue to ensure that we offer every assistance that we can to the international effort. The best way for us to protect the public health in Scotland is to support the efforts under way in West Africa. In conclusion, I hope that I have provided the sufficient reassurance that we are monitoring the situation closely and that we take the public health of Scotland very seriously. The Government's Resilience Committee's score, chaired by the First Minister, has already met three times on the matter. That has provided an opportunity for us to engage with the Scottish experts and to ensure direct government oversight of our preparedness. We will continue to be vigilant and alert, and we will maintain our links with other parts of the UK to ensure a joined-up approach. The public should be reassured that the risk of Ebola coming to Scotland is still very low, but if it does arrive here, the national health service is ready to respond, and public health will be protected. Cabinet Secretary will now take questions on issues that have raised in his statement. I intend to allow around 20 minutes for questions after which we move on to the next side of business. It would be helpful if members who wish to ask a question of the cabinet secretary were to press the request to speak but now. I call Neil Findlay. I thank the cabinet secretary for his comprehensive statement and his response to my earlier letter appealing for MSPs to be kept updated on Ebola and any impact on Scotland or Scots. Can I pay tribute to the 50 NHS professionals working in the affected region and to the NGOs and their volunteers? They are doing tremendous work in a very difficult situation. Can I ask the cabinet secretary about the level of training that is being provided to staff on dealing with the disease prior to them entering the affected area, and indeed leaving for the affected area? What support will be provided to them when they are and on their return? What support and co-operation is being given to Scottish African charities working here and with people in Sierra Leone to help to prevent the spread of the disease and deal with the consequences of it? Today, I met representatives of some of those Scottish African charities and they asked me if I could put forward a request to the minister for a meeting with them so that they could discuss ways in which they could work together with the Scottish Government in order to help to deal with the situation on the ground and some of the consequences of that, including things such as education. I would really appreciate if the minister could take me up on that offer. Cabinet Secretary for Health and Sport, I and my colleagues Michael Matheson and Whomza Yousaf are planning to meet with the NGOs involved and indeed with other organisations whose support we require. Although some of them may not be NGOs working in Africa, some of them may be organisations that nevertheless can help with the supply and material that has now received a request from Oxfam for additional support, as well as the DFED list, which we are working our way through. We would be more than happy and we are planning to meet the NGOs and indeed others as well. That has to be a joint effort. It is not just about the Scottish Government, it is about all the people who can make a contribution. Of the staff who have gone, first of all, the number of staff that I have the latest is 59 staff who volunteered from Scotland, 31 of them are doctors, 17 are nurses, 7 are paramedics, 3 are lab technicians and 1 is of an unknown skill but nevertheless volunteered. Prior to assignment in West Africa, those healthcare workers participate in a three-stage training programme. Five days of training undertaken in a facility in the UK, three days of training in the relevant facility on arrival in West Africa, which in our case will be Sierra Leone because part of the international agreement is that the UK Government will lead the effort internationally in Sierra Leone, other Governments such as the United States are leading the effort, for example in Liberia. So we obviously have agreed with the UK Government that we will focus our efforts in support of them in Sierra Leone, which we are doing. The arrangements in terms of monitoring their healthcare in situ are under the auspices of Public Health England. It has been agreed by the four Administrations in the UK that the lead agency in co-ordinating this and the conduit for all of this will be Public Health England. They have offered to register any aid worker from the UK wherever they are based and they are doing as they are doing with NHS volunteers from across the UK. They register the aid worker before they leave, they track them when they are there, they perform a risk assessment on the returners regards exposure to Ebola and they set up a monitoring system as well. I believe that there is a total of 12 beds allocated within Sierra Leone which is ring fence for any health worker working in the area, not just UK health workers working in the area who happens to contact Ebola. I am happy to send any member more details because I do have volumes of details on how these arrangements are, but I can assure the chamber both in terms of the training and in terms of looking after the health and wellbeing of the volunteers when they are in the countries. We now have a very comprehensive package which is a similar package to that for the rest of the UK. I welcome the statement bringing us up to date with action being taken to combat the Ebola outbreak and I thank the cabinet secretary for an advanced copy of the statement. I would also add my thanks to all the healthcare professionals who have volunteered to go and help in affected areas. The cabinet secretary will be aware of recent comments made by Dr Debbie Shardar, a senior lecturer in global health policy at Edinburgh University, that my home city of Aberdeen is, if Ebola comes to Scotland, likely to be an area at risk given its airport and concentration of population with international connections. As Aberdeen Royal Infirmary is one of the four centres in Scotland with a dedicated infection diseases unit, will he ensure that it receives adequate resources and support should there be a case of Ebola in the northeast? Also as a northeast member, I clearly welcome his comments that he is working closely with the oil and gas industry to protect workers in that industry. Is he fully confident that the necessary precautions are in place for those engaged in countries overseas affected by the virus when they return to the UK? Furthermore, will workers returning from such countries be prohibited from going on to installations within the North Sea until it can be certain that they have not been infected with the virus? I am happy to reassure the member and a whole host of points there. First of all, I will deal with the last point first. We have agreed with the oil and gas sector that no worker returning from one of those countries will go back in an oil rig in less than 21 days of arriving in the country. The reason for the 21 days is that that is the incubation period for Ebola. I can very quickly take you through the processes that each oil worker will go through, coming from West Africa to the UK, because that is obviously where the main risk might be. Obviously, within Scotland, Aberdeen in terms of oil workers would be the area that would be most likely to be affected. First of all, there is an exit screening process, so before anybody leaves any of those countries, they go through a full screening process. If they show any signs of the disease whatsoever, clinical judgments are made and, to date, with one exception, all those who are suspected of Ebola have been treated in the country and not travelled. Again, that is under very much the control of the UK Government and is in agreement both with the countries that are affected as well as part of the practice that is being adopted internationally. If any oil worker is suspected of having Ebola, the likelihood is that the clinical decision will be made to keep them in country and to deal with them there and to ensure that they get the same treatment in the country that they would get if they were at home in the UK. To date, only one case—which was not an oil worker, as you know—came to London and the chap said that he was a nurse, and he successfully recovered from Ebola. Once the oil worker goes through exit screening and, assuming that they have not been identified as possibly having Ebola, they then get on the flight. There are a number of connecting flights through Casablanca, Brussels and two of the main ones, Paris. I think of the three main routes from West Africa into the UK. Obviously, those flights then go into the primarily Heathrow and a small number go into Gatwick. In a small number of cases, they go to St Pancras, where there is also a screening process. When anyone arriving at Heathrow or Gatwick at St Pancras has been to one of those countries, they will go through an entry screening process. If they have a temperature at all, or if there is any worry at all, particularly, but even if they have recently been in the country, there is then a tracking process, so they are followed up and monitored for the period up to the 21 dates. Particularly with oil workers, we are working very closely with Oil and Gas UK with the industry because there are two companies who are operating in the North Sea and in the region, although most of the oil in that region is actually in Nigeria, which is now Ebola-free. Again, the risk should be absolutely minimal, but just in case, we are working very closely with the oil companies, particularly the two that have installations both in the North Sea and in West Africa. We are working very closely, obviously, with the Grampian health board to make sure that all the facilities that are in place in Aberdeen absolutely minimise any chance of any oil worker, or indeed anyone else, contacting Ebola. I was very pleased to hear that the Scottish Government is working along with so many others, but what we are talking about is very much a reactive situation. There have been discussions about whether, in fact, the international community was caught a bit off guard on that. What I am interested in knowing about is that, with the recognition that it is always better to be preventative in such things in developing countries, what kind of on-going research, collaboratively and internationally, and what kind of on-going information and training programmes in countries that have been affected will be put in place or discussions taking place about that because there are many reasons, including some that are cultural, as well as health infrastructure, why those diseases cannot be contained quickly when they break out. There are many initiatives going on in the country. For example, one of the problems is the cultural opposition in those countries to cremation of dead bodies. Therefore, the burial of those dead bodies means that there is a particular risk from that kind of internment. Clearly, there are initiatives going on to try to deal with that to minimise any risk because of the cultural problems arising from wide-scale cremation. In terms of the wider picture, first of all, I did not mention the two points to make about vaccines. First of all, there are two vaccines that are about ready for distribution at the time of the year. Initially, it will be in small numbers, probably about 20,000 units in January, but it is leading to more than a million units by April. As people will be aware, there has been a global agreement to fast-track the approval process for those vaccines because if we had to wait for them to go through the normal processes, we would probably take years before we could actually use the vaccines. However, there has been global agreement, and the most advanced one is one being produced by GSK. However, there is also, I believe, a Canadian vaccine that is also about ready to go. Obviously, there will be some tests on those vaccines before they are finally used, particularly to look at side effects and so on. However, the good news is that there is now a high expectation that there will be a vaccine available at some point in the first half of 2015. It has also been agreed globally, I think, very sensibly that the top priority group, obviously, for vaccination will be the health workers working in these West African countries for obvious reasons. In terms of ZMAP, which is also a drug that received wide-scale publicity, the jury is out in terms of its effectiveness. In any case, there is currently no supply worldwide any more of ZMAP. The last supply was used up by a region patient two weeks ago, because it is based on growing plants, and the plants take some time to grow. However, there is a lot of effort going on internationally to look at the safety of the vaccines and make them widely available as early as possible, but also to look at possible cures for Ebola. In among all the bad news, there is a degree of optimism that, hopefully, by this time next year, we will have vaccines available, and they will be widespread and particularly available in West Africa. Can I join others in thanking the Cabinet Secretary for the Comprehensive Statement and the clarity with which the issue is being tackled? It is good that our service has already had experience of a Crimea congo hemorrhagic fever, but what risk assessment has been made of the demand of the 14 isolation rooms and associated equipment in a normal winter with the predictions that the outbreak could well last into 2016? The growth curve is not going to stop until at least the summer of next year. Can I also ask what training and equipment is being made available to ambulance workers? We are engaged in finalising a contingency plan for worst-case scenarios, so that if we end up in a situation where there is much higher demand and we end up with more than any case—particularly if we get more than one case—so that we can cope in Scotland. Obviously, the procedure that is in place at the moment is that anyone who has been identified as being infected by Ebola coming from West Africa, if the clinical decision—and it will be a clinical decision to transport them to the UK—go to the Royal Free hospital in London. Irrespective of where they live or where their destination is, if they have already been diagnosed with having Ebola, they will go to the Royal Free hospital in London under current arrangements. Once it is appropriate, it will then be transported to one of the infectious disease units in Scotland. We have put in place—already in place—a host of procedures and training, not specifically for Ebola but for hemorrhagic fevers. That was up quite considerably two years ago when we had the Crimean Congo case. My colleague Michael Matheson has been working on this with all the professionals since the start of the summer. Training and risk assessment, all that is built into the work that is on going right across the board. We have very little time left for questions on this important statement. I would appreciate short questions and short answers, cabinet secretary. Bob Doris, Fodd Boudge and Hulme. Can I commend the Scottish Government on its preparedness in relation to this matter? Can I just check that there are various areas where Ebola could, in theory, spread such as schools and higher education in Scotland, although, in theory, the chances are very limited? Have you been in contact with higher further education establishments and schools in Scotland to see what actions they would need to take to play their part? We have been in touch through local authorities with schools, with every college and with every university in Scotland. With particular attention, we have been in direct contact through the university or college with the 30 students who are studying in Scotland who are from West Africa from the affected countries. We are in touch with them via their college or stroke university to make sure that they are very well aware of the risks and particularly to let us know if any of their friends or family are travelling to or from West Africa so that we can monitor their situation as well. We have categorised the highest risk categories of people. Oil and gas workers are obviously top of the list because of the volume of students and the indigenous population, which is also a smaller number. Again, we are in touch with those people. Every GP in Scotland has been made aware by the acting chief medical officer of what needs to be done if, in any way, Ebola is suspected, as well as the appropriate other outlets. We have covered every possible avenue. The acting chief medical officer will be reminding people on a regular basis until any potential threat from Ebola is completely eradicated. Jim Pugham, followed by Gil Paterson. I thank the cabinet secretary for advance sight of his statement and express my thanks to the NHS staff and others who have not without risk volunteered to go out to tackle Ebola. The minister stated that he does not believe that it would be proportionate or necessary to implement screening here in Scotland, and I would agree with him on that. However, could he explain to the chamber what criteria he will use in his on-going assessments, and what would need to happen before screening was considered necessary? I say that the point of entry screening is already being done in London. I think I am right in saying that 85 per cent of those who fly in indirectly from those West African countries come through. He threw, and the balance comes from Gatwick and Frew St Pancras in London. There is very comprehensive screening there. However, we are in regular touch, both with the Scotland office and with the department of health, in particular the public health minister, Jane Ellison. Obviously, they have been through an exercise down there as well to establish whether they are going to extend screening to regional airports in England. There is a set of criteria and an assessment methodology for doing that. We are working with them and we will keep that situation under review. At the moment, I think that I am right in saying that there is no additional screening in the regional airports in England yet, although there has been some consideration to it. However, there is very clear criteria and assessment. As I say, I and myself and Mr Matheson would be happy to send more details to the member because it would take me quite a while to go through all those criteria and those assessments. The cabinet secretary has said that guidance has been sent to health professionals to ensure that they are equipped to deal with the suspected cases. What information will be provided to pharmacists, particularly on recognising potential cases? The acting chief medical officer, as well as the chief pharmaceutical officer, is informing, through various sources, particularly the health boards, the pharmacy industry, as well, of anything that they need to be aware of so that everybody involved in medical care, healthcare of any type in Scotland, is fully aware of what the signs are, what the risks are and what the procedures are should they suspect anyone having Ebola. I thank the cabinet secretary for his very comprehensive statement. Can I agree with him when he says in that statement that the best way for us to protect the public health in Scotland is to support the efforts that are under way in West Africa? Having recently visited Cameroon and being screened on entry to that country, I can testify to the seriousness with which the countries in West Africa are taking this particular outbreak. I applaud the funding and supplies made available by the Scottish Government, but the task of fighting Ebola is falling to countries that struggle continually to provide a health service to their citizens in the normal course of events. I wonder whether the Scottish Government might be looking at ways of helping to provide assistance to those West African countries that are most affected to sustain the health services that the people within those countries need in their daily lives. As I said in my statement, we have already shipped out £300,000 worth of aprons and masks and so on, but it is not just what is in store in Larkhall for the NHS in Scotland that we are shipping. We are working to a list prepared by the Department for International Development. The priority at the moment is for stuff that is required to deal with Ebola in hospitals and clinics in the affected countries. Once we are broken the back of that, we will look at the longer-term situation where we can help. We have already sent half a million pounds through the World Health Organization, but rather than trying to reinvent the wheel, we are working through the established international organisations that are the World Health Organization. Obviously, we are working very closely with DFID and with Oxfam and others. We will respond to the Oxfam request very positively as well. Where a request comes in for longer-term assistance, then clearly Mr Yousaf and Mr Matheson together and myself will do what we can to provide anything that we possibly can to help those people because their health service is pretty primitive, quite frankly, in those affected countries. Indeed, I have asked Mr Matheson and Mr Yousaf, along with a small number of officials, the appropriate time to visit West Africa and identify any additional help that we can provide from Scotland. I agree with the member that we should be doing everything that we can not just to help them over this Ebola crisis but to provide as much help as we can to avoid it happening again and to help them to build up a better healthcare system in all their countries. I apologise to the two members that I was unable to recall. We move to the next side of business, which is a debate on motion number 11301 in the name of Nicola Sturgeon on Scotland's Evolution Commission, the Smith Commission. Members who