 That concludes topical questions. The next item of business is a statement by Humza Yousaf on Covid-19 update. The cabinet secretary will take questions at the end of his statement, and so there should be no interventions or interruptions. I call on Humza Yousaf, cabinet secretary. Thank you very much, Presiding Officer. I will be providing the update to Parliament today on the latest Covid-19 situation. Given the update, I will provide an assessment of the current course of the pandemic, an update on the pressures on the NHS looking ahead to the winter, a report on the progress that we are making in delivering the vaccination programme, and an update to the changes to the rules around international travel. Of course, I will also be giving an update on the risks of transmission in around COP26. First, I will report on the most recent statistics. 2010 positive cases were reported yesterday, and 13.5 per cent of all tests conducted were positive. 932 people are currently in hospital with Covid at one more than yesterday. 63 people are receiving intensive care, that is five fewer than yesterday. Sadly, further 26 deaths have been reported over the past 24 hours. That takes the total number of deaths registered under this definition to 9,189. I want to send my condolences to everyone who has lost a loved one. More positively, the vaccination programme continues to make good progress. I can confirm that 4,320,370 people have received a first dose, 3,910,253 people have had both doses, and 36,759 have received that third primary vaccination. In total, 88 per cent of the over 18 population is now fully vaccinated with two doses. That includes 96 per cent of the over 40, 77 per cent of those 30 to 39 years old, and 68 per cent of those who are aged 18 to 29. In addition, 76 per cent of 16 and 17-year-olds and 55 per cent of 12 to 15-year-olds have had a first dose. For most people in those age groups, of course, only a single dose is recommended at this stage. Cases remain much lower than the previous peak around the start of September, but the decline in new cases has halted in recent weeks, and at around 2,500 new cases per day, it is still at a level well above previous lows. There are early signs that case numbers may increase again hereafter, so the situation remains precarious. As you would expect, the Scottish Government continues to explore all options for how it will respond to the evolving pandemic. We will not hesitate to strengthen the protective measures in place if it proves necessary to do so. The uncertainty and risk that we face as winter progresses means now is certainly not the time to relax our approach. We all need to redouble our efforts to adhere to the protective measures in place and follow the appropriate guidance. Over the past week, cabinet secretaries have been engaging closely with business and sectoral organisations right across the country as part of our continuing conversations to encourage compliance with the existing measures and the existing guidance. Our appeal to everyone is to wear face coverings when required, ventilate indoor spaces wherever possible, wash your hands and surfaces regularly, use lateral flow device tests regularly, book a PCR test if one of those shows up to be positive, or if you have symptoms of Covid or, indeed, if you are identified as a close contact of someone positive. Please continue to give your contact details when visiting pubs and restaurants, ensure your Covid certificate if you are visiting a venue where that is required. The Covid certification scheme was introduced on 1 October and has been enforceable by law since 18 October. I am grateful for businesses who have worked so hard to comply with the scheme. Critically, please continue to work from home wherever possible. That continues to be an exceptionally important way of reducing transmission. I know that they are not easy, but it is vital that those efforts continue in order to help us to control the transmission of the virus. The entire health and care system is currently under considerable pressure right across the country. Hospitals are at or close to capacity. The social care system is also under enormous pressure. I am reporting an increase in the number of people requiring care packages. We see that a continued high number of cases means that the NHS remains under more pressure than at any time during its 73-year history. As of today, Covid-related hospital occupancy, the number of patients in hospital with Covid at any given time, is 932 compared to 917 a week ago. Hospital admissions also remain high. There were 632 people with Covid being admitted to hospital in the latest week, and admissions to ICU have increased over the past month. That means that NHS staff are dealing with significant numbers of Covid patients alongside other patient care, while also preparing for and responding to wider winter pressures and dealing with the backlog of care that has been built up in the earlier stages of the pandemic. Essentially, our health and social care services have been dealing with demand, usually only experienced in winter, for many months already. Facing those challenges, health and care staff in the front line continue to give their all to keep us safe. I want to take this opportunity to reiterate my appreciation and gratitude for their enduring efforts. Pressures are, however, likely to intensify during the winter. Bonfire night is this week, and we expect that protests and demonstrations will continue to take place during COP26. Scotland, rightly, has a strong tradition of peaceful protests and demonstrations. However, I want to take this opportunity to encourage everyone to think very carefully about their behaviours and their impact on services, as well as the risk of spreading the virus to others. Of course, people should seek urgent medical help when needed. However, if a health-related matter is not critical or life-threatening, the advice of clinicians remains to call NHS 24 or contact your GP, pharmacy or local out-of-hours service. Moreover, we know that people meeting indoors more often as it gets colder, there are opportunities for Covid to circulate. We are also approaching the winter flu season, which could put further pressure on the NHS. Therefore, working closely with health boards as they deal with those pressures, I have today announced an additional package of winter support, backed by a further £10 million to bring a range of measures to get A&E patients to the right care as quickly as possible. That includes deploying physiotherapists and occupational therapists at A&E units to help triage and treat patients who would otherwise wait to see nursing staff. That will prevent people from being admitted to hospital unnecessarily. The new funding will provide more specialists such as social care workers and allied health professionals on hospital rotas, and extended opening hours for pharmacy and diagnostic services such as scanning and ultrasound to speed up referrals. It will also help to support extra staff for peak public holidays. That is more than above the £300 million package of measures, which is largely focused on social care and supporting the reduction of delayed discharges to create more capacity in our acute and community hospitals. We are working closely with boards in health and social care partnerships to support and implement improvements. A discharge without delay improvement programme is now rolling out right across Scotland. It aims to improve flow through the hospital, reduce the level of delayed discharges. Work has recently started with five health board pathfinder sites, including NHS Lovian, prior to that national roll-out. All health board areas continue to work closely with their health and social care partnership to develop alternative care pathways that support hospital discharges, including the use of interim care options. Vaccination remains one of our most effective public health interventions against the pandemic. The first phase of the programme delivered more than £8 million of Covid-19 vaccinations in 10 months. With Covid boosters, flu vaccines and jabs for new groups added, we will now need to deliver roughly the same number of vaccines, £7.5 million, over the autumn and winter period alone. That has been a mammoth undertaking, which started ahead of JCVI providing advice on boosters. Our approach has sought to reduce the need for people to attend multiple appointments by maximising the availability of scheduled appointments and ensuring the efficient vaccination of people against both Covid-19 and seasonal flu. That is a huge job for our NHS. We have asked people, the people of Scotland, to help us where possible by coming to appointments and rescheduling where necessary. It is important to bear in mind that by the time that JCVI offered advice on the booster programme, there was already a large number of people eligible for their vaccines. Nonetheless, we started delivering boosters a week after receiving that advice and have been continually ramping up activity since then to ensure that we deliver a consistently high number of vaccinations. I am delighted that, since 6 September, we have delivered over 2 million vaccines, which has included almost three quarters of a million Covid-19 boosters. To illustrate the sheer volume being delivered, members will note that, in the week ending 24 October, almost 488,000 vaccinations were administered. That is more than we have achieved in any week since the programme began back in December last year. We are therefore confident that we will continue to be on track and will offer vaccines to what was JCVI groups 1 to 5, covering those who are aged over 70 years, those who are clinically extremely vulnerable, a front-line health and social care workers by the end of this month, and the remaining groups, including everybody over 50, by early next year. Every part of the UK is working at pace through the priority groups. Letters are now being sent to those who are aged between 60 to 69 and people with underlying health conditions, inviting them to appointments at the local community clinic, which has been running from late October right the way throughout November. Our approach will continue to prioritise those who are most vulnerable by protecting those appointments for those key groups. We also intend to move towards a system that enables online self-booking, this portal for adults aged 50 to 59, and those aged over 16 who are unpaid carers. Household contacts of the immunosuppressed will open from mid-November, allowing those groups to book booster appointments online. We know that the autumn and winter programme is both the biggest and the most complex that has ever been. That is why a guide has been included in the NHS informed website to help individuals to understand whether they are eligible for flu or a booster, or indeed both, and how and when they will be invited. We continue to ensure that our delivery model is person-centred and meets the needs of local communities, tailing our approach by learning from what works. As the First Minister outlined last week, we are also urgently exploring how we can quickly increase capacity, for example by establishing additional clinics, particularly at evenings and weekends. Given the record volumes of vaccines already being delivered, we need to augment our dedicated workforce. That is why we are supporting NHS boards to identify, recruit and train additional staff, including healthcare students in those in primary care, such as GPs, GP practice staff, dentists and pharmacists. I also take this opportunity to thank our armed forces for agreeing to support our vaccine effort by complementing our current workforce. By being vaccinated and boosted, we can protect each other and help our NHS through what will be another exceptionally busy winter period—in fact, the most busy winter period, I suspect—in the NHS's existence. That will allow us to ensure that there is a sustainable service in place for the future. I will now update on recent changes to arrangements for international travel. The final seven countries have been removed from the international travel red list, meaning that travellers to the UK from those destinations will no longer have to stay in a hotel to quarantine for 10 days on arrival. The decision was made on a four nations basis and took effect from 4am on 1 November. It affects arrivals from Colombia, the Dominican Republic, Ecuador, Haiti, Panama, Peru and Venezuela. The red list policy nonetheless remains in place, but at this particular time, with the delta variant dominant across the world, we do not consider that any countries meet the very high-risk threshold to be on that list. The situation will be closely monitored and regularly reviewed, and if the situation demands it, we will not hesitate to re-impose restrictions on international travel to safeguard the health of our citizens and protect Scotland's recovery. Some managed quarantine capacity will stay in place in Scotland in order to react to any change and risk assessment that would see a country added quite suddenly to the red list. That is a further sign of the success of the Scottish Government's vaccination programme and will enable the travel and tourism sectors to take another step back towards normal operation. In addition, vaccine certificates from a further 35 countries and territories will now be recognised to allow quarantine-free travel to Scotland. Going forward, that list will be reviewed on a regular basis. The United Kingdom Government unilaterally announced on 15 October that fully vaccinated travellers returning from non-red list countries will be able to take an LFD test with a photo verification instead of a PCR test for their day 2 test from 24 October. For practical reasons, as the First Minister has previously outlined, we have aligned with those changes that came into force from 4am on 31 October. Wales also confirmed that they would align from 31 October, and I understand that Northern Ireland is still to confirm. Travellers have been able to book those tests from the list of private providers in the Gov.uk site from around 5pm on Friday in advance of their arrival into Scotland. Those tests cost between £20 to £30 per test compared to the £55 to £65 for a PCR test, making it cheaper for those returning from international travel. If an individual receives a positive result, they are of course required to follow that up with a confirmatory PCR test that can be booked again on the Gov.uk site, or indeed by calling 119. As we will all be very aware, the 26th conference of the parties is under way in Glasgow. We are working tirelessly to ensure that it is delivered safely and successfully. The next fortnight is a critical moment for Scotland and indeed for the world. As we look to see hard commitments on reducing emissions on climate finance and on promoting international and intergenerational fairness, that supports those most vulnerable to the impacts of climate change. The Scottish Government has been working closely with the UK Government and partners in Scotland, including Glasgow City Council, Transport Scotland, NHS Scotland, Police Scotland and the UN to ensure the successful delivery of the COP26 summit. Covid-19 continues to present significant challenges to staging this unique event. The scale and worldwide draw of COP26 poses the risk of spread of Covid-19 both within the delegates and, of course, to or from the local population of Scotland and the UK. A comprehensive and exceptional package of mitigation measures has been put in place to ensure that the event can be delivered safely, helping to protect the welfare of everyone involved in the wider community. In addition to vaccination, measures include a robust testing regime, contact tracing, hygiene measures and ventilation. Health boards have planned and prepared for this event and various arrangements, including additional staff, are in place to support delegates and other visitors while maintaining and protecting key health services. The UK Government, as the event organisers, has put measures in place to manage access to the blue zone, once inside the site itself. Managing queues is the UN's responsibility. We are leasing, alongside the UK Government and Glasgow City Council, to encourage the UN to put in place additional measures to avoid queues such as were seen in media reports yesterday and to a lesser extent today. Of course, while public health measures can mitigate the spread of Covid-19 to an extent, there remains a risk that COP26 could increase the spread of the virus. That is why Covid-19 continues to be closely monitored by all relevant agencies and why the Scottish Government will be closely involved in operational decisions during the event. Vaccination is allowing us to live with far fewer restrictions and mitigations than at earlier stages in the pandemic. Case numbers are much lower than in August and early September, but they are still high. As we head into winter, there are some factors that could drive them up further. Hundreds of people each week are still being admitted to hospital with Covid. As I have already said, our NHS is under intense pressure. However much we all wish otherwise that the virus has not gone away, Covid remains a real threat. We all need to play our part in helping to keep the virus under control. For that reason, I will close again with a reminder of the three things that we can all do to help to protect each other. First, please get vaccinated. If you are eligible and have not yet done so, that includes going for a booster jab when you are invited for that. It is also never too late to get vaccinated. It remains the single most important thing that any of us can do. Secondly, please test regularly with the lateral flow device. Those can be ordered through the NHS informed website or collected from a local test site or indeed the community pharmacy. If you test positive or identified as a close contact or have symptoms of the virus, please self-isolate and book a PCR test. Thirdly, please comply with the mitigation still in place. Where face coverings in indoor public places such as shops, public transport and when we are moving about in hospitality settings, wash hands and surfaces thoroughly, meet outdoors if you can. I know that that will be increasingly difficult as we get into the depths of winter, but outdoor environments are safer. When meeting indoors, open windows and do anything that you can to improve ventilation. Try where possible to keep a safe distance from people in other households. Those precautions do make a difference. They will protect you and the people around you and help to ease the burden on our NHS. I thank you once again to everybody for all of your efforts. The cabinet secretary will now take questions on the issues raised in his statement. I intend to allow around 40 minutes for questions, after which we will move on to the next item of business. It would be helpful if members who wish to ask a question were to press their request to speak buttons. Today's statement comes against a backdrop of spiralling crisis in our Scotland's NHS. Any waiting times are the worst on record. Cancer diagnosis at stage 1 is the lowest since 2012. Covid is part of the problem, yes, but it cannot be used as the excuse. Less operations are now going ahead than when the country was in lockdown in March. Our front-line staff deserve far better than lumping all the blame on Covid. We are burning out and need more help. So why has this happened? Why is our NHS in crisis? The problem is that this health secretary is always a step behind, always announcing funding after the problem starts. The British Armed Forces support is fantastic, but the government asked for it too late, and it's great that the government listened to my ideas on long Covid, but they could have listened to those proposals in June. The extra funding is welcome, but it's been announced in dribs and drabs, not part of a fully-fledged and comprehensive plan. We warned when both the NHS recovery plan and winter plan were published that they barely scratched the surface. If we had a proper NHS recovery plan, if we had a proper winter plan, if this health secretary anticipated any issue ahead of time, Scotland's NHS wouldn't be in crisis. Our front-line staff wouldn't be overwhelmed to the point that we are now. Even today, the health secretary announced an extra £10 million to get spiralling A&E departments under control, but only after weeks of the worst A&E waiting times on record, the money was announced today to get the health secretary through this statement, not to get our NHS through the hardest winter on record. It's a PR first approach that we've come to expect from this health secretary. It's all soundbites, not strategy. It's an approach that might be applauded in ministerial ivory towers, but not on our hospital wards, not in our GP surgeries. Photo ops come first when what our NHS really needs is a plan that sees problems and fixes. I have only one question. Does the health secretary seriously believe that the knee-jerk plans outlined by your Government to support Scotland's NHS are good enough? I hate to break it to Dr Gohani, but it's all soundbites, not strategy, a soundbite. He would do well to steer away from what are remarkably personal attacks, which I'm used to from him and his party, and concentrate on the issues, because personal attacks aren't going to get us, frankly, everywhere. What I would say to Dr Gohani is that he's not going to get me, nor the First Minister, standing here saying that the A&E performance is what we would expect. I have consistently said that, for anybody who suffers as a result of the A&E performance, as a result of the pressures that we're facing, not getting the service that I would expect them to do, I don't just regret that, but I apologise for any suffering that has been caused as a result. If you were to listen to Dr Gohani, there would be a suggestion that there was not a pandemic, or that, somehow, you could just magic away the effects of a pandemic. You have 18 months of a direct and indirect effects on our NHS because of the pandemic, which has not just resulted in pressures here in Scotland, of course which there are, but those are pressures that are shared in health systems not just across the UK, but right across Europe and the world. Our A&E performance, as I continue to say, is not where I want it to be. Dr Gohani did not mention the monthly statistics that came out today, which, again, show our performance is not where we would want it to be, but is the highest in the entire UK. Almost 10 points ahead of A&E services in England, almost 16 per cent ahead of A&E performance in Wales. That is not of any comfort to somebody who has to wait 12 hours in an A&E department in Scotland. It is simply a demonstration of the fact that those problems are shared right across the UK and would indicate that there is a problem not just unique to Scotland but across the entire UK. We have not sat around. We have invested an additional £40 million to our Scottish Ambulance Service, an additional £300 million for our winter programme. The First Minister announced an additional £482 million in relation to the Covid pressures that we are facing. I have announced an additional £10 million in July. We announced an additional £12 million to help health boards with the pressures that we are facing. I will continue to work hard with local health boards to do everything that we possibly can, to leave no stone unturned, to make sure that every single tool that we have in our armoury is deployed in the fight against this virus and for what will be an extremely challenging winter. I will leave Dr Gohani to do the personal attacks from a sedentary position. Jackie Baillie, our thoughts and condolences are with those who have lost a loved one. Week after week, the First Minister or the health secretary assures us that there is a plan to support the NHS, that winter planning is under way, but the facts do not lie. This week, A&E waiting times are the worst ever recorded. Thousands more people are waiting hours for help, and staff are reporting that the people that they are seeing are sicker than before. Restoring capacity in the NHS is key, but that cannot happen if Covid is left to circulate at dangerously high levels. The seven-day case rate last week was double what it was this time last year, and the vaccine programme is nowhere near the pace that it needs to be. At the end of last week, there were almost 900,000 people who had received their second dose over six months ago but had still not received a booster jack. 218,000 people are still waiting for their second dose of the vaccine. There are fewer vaccination centres and fewer vaccinators. Elderly people are queuing in the cold for hours on end. Apparently, in Edinburgh, drop-in vaccination clinics have been suspended because of COP26, which is happening 50 miles away along the MA in Glasgow. What modelling has been done of the expected spike in Covid cases following COP26? Can he publish the actual numbers and what arrangements are in place to stop our hospitals from being completely overwhelmed as a result? When will there be some much-needed urgency about the delivery of second and booster doses to the hundreds of thousands of people for whom protection is waning and who are still overdue their jacks? I thank Ms Bailey for a number of important questions, and I will try to cover them all if I can. On her characterisation of the current situation of the pandemic, on getting the Covid numbers under control, I would agree with her that we are absolutely, wholeheartedly working day and night to do what we can to control transmission. It would be helpful if we did get the support of Ms Bailey in some of those initiatives, such as the certification scheme, for example, which I know her colleagues in Wales do support. However, I know that we all share that endeavour to try to control Covid-19 transmission. What I cannot do is agree with Ms Bailey's characterisation of the vaccination programme being sluggish. It is not sluggish. I can hear that it is from a sedentary position. Opposition is desperate to malign our vaccination programme. There are more than 8 million vaccinations. The highest total percentage of a population vaccinated anywhere in the UK is here in Scotland. We have been praised for the pace at which we have managed to vaccinate 12 to 15-year-olds, to the extent that other Governments have rightly copied the model that we have done. I just announced in my statement that last week, in the week, up to 24 October, we had a record number of vaccines flew and booster. Never in a vaccination programme in the history of this country have we ever delivered almost 500,000 vaccinations, and that is to quote Ms Bailey sluggish. I think that that is a mischaracterisation. On some of the problems and issues that she did face, when you deliver 500,000 vaccines in the space of seven days, there can be issues, and I am always happy if members write to me about any problems that they are facing. There have been some localised problems. I note some of the problems that Ms Bailey has raised previously. I would also say to her and to others the best thing that people, if they do get constituent inquiries about when their booster or flu is eligible, when they can expect their appointment, the best thing that people can do is go on the NHS informed website where there is a guide available online. You can click what age you are, your eligibility criteria and it will tell you when to expect a letter or indeed when the online portal is likely to open, which will be mid-November for those who are 50 to 59 and unpaid carers aged 16. In terms of modelling, yes, we do have modelling and forecasting. We would do that regularly, but there are already a number of unknowns, given the fact that this is the first time that we have hosted an event of this significance in the midst of a global pandemic, so we are keeping close to our clinicians in that regard. We are, of course, using that modelling to work on our winter plans for the weeks and months ahead. The core of that plan is to invest in social care and to try to discharge as many people as we safely can out of hospitals and into care and community settings. Now that is going to take some time because of the reasons why I have outlined in previous to the Parliament that it takes time to recruit, for example, 1,000 band 2s to 4s, but, as we get into that winter and flu season in particular, I am confident that we will be able to make progress in that regard. Alex Cole-Hamilton Thank you very much, Presiding Officer. Presiding Officer, this isn't safe. Waiting times like the ones that were announced this morning are actively putting people in danger, and sometimes, as has happened already, they could prove fatal. We also learned this morning that a quarter of a million operations have been lost to the Covid pandemic already, meaning that the ripple effect of this health crisis right now could rumble on for many years to come. That is not the fault of staff who have been handed this crisis by an SNP Government that has seen manifest failures in things like workforce planning and resourcing. I ask the cabinet secretary if he will today commission an independent review into all unnecessary deaths that have been caused as a result of this waiting times crisis. Cabinet Secretary, I just provide some context to some of what Alex Cole-Hamilton has said. He is right, of course, to say that the pandemic has undoubtedly, through its direct and indirect consequences, resulted in so much of this pressure. In terms of staffing, this Government has a good record on staffing. We have record numbers, in fact, of staff in our NHS, not only record numbers. They are the best paid in the entire UK. In terms of our record of investment, we also have record investment for our NHS, and we will continue to invest in that. Of course, budget negotiations, no doubt with other parties, will begin in earnest if they have not already, as we get towards the 9th of December, and the Scottish Government's budget at the end of this year. In terms of issues that he mentions around a public inquiry, investigation or review, we have, as the Scottish Government said, a public inquiry into all matters related to Covid-19. We are working on the remit of that. If he thinks that this is an issue that should be part of that remit, the Deputy First Minister, who is leading on those matters, will look forward to discussions or correspondence from Alex Cole-Hamilton in that regard. In fact, the Deputy First Minister and I are meeting with families and those that are representing families who have been bereaved by Covid and who indeed had families moved into care homes in relation to Covid later on this afternoon. Audrena Cult, to be followed by Jeremy Balfour. To ask the Scottish Government for an update on whether NovaVac's trial participants living in Scotland will be offered a full course of an approved vaccine. Cabinet Secretary for Health and Sport, I thank the member for raising the question. I know that it was a question that was also raised by Douglas Lumsden MSP last week as well, having discussed the matter again with the UK Government, the Secretary of State, as well as with my officials up here. I can absolutely confirm that discussions between clinical trial teams and JCVI experts, clinical trial participants who have had NovaVac's or Valneva's or Medecago's, are the non-MHRA-authorised vaccines. The non-authorised vaccines in relation to the MHRA approval can discuss the possibility of getting additional doses of a deployed vaccine with a principal investigator. Principal investigators will then discuss that on an individual basis, and, if agreed, arrange for the deployed vaccine to be administered. In short, they can receive the vaccination again if that is appropriate and agreed with their principal investigator. There have been some people who have corresponded with me and the First Minister who have suggested that we can look at an approach that may be more proactive than that, of which we are currently considering. Obviously, it is a fundamental right to be able to worship clearly without the intervention by the state. It is not a fundamental right to go to a crowded nightclub or bar, and yet, currently here in Scotland, you are able to attend a rugby match with 60,000 people, sing and shout, you are able to go to a dancer or to a club that is crowded and shout and sing. Meanwhile, religious communities partaking in communal worship are forced to wear masks. What is the scientific basis for the disparity that exists, given that it is far more important that people are able to worship freely when they attend a sports event or nightclub, and when will the double standard be rectified? Because we recognise that fundamental right for people to come together to worship, is one of the reasons why we have never applied the certification scheme to places of worship, because we recognise the importance of that. The other events that the member mentions have a certification scheme, so we mentioned a large-scale football match or rugby match, a large-scale concert, a late-night venue, etc. All of those events would come under the eligibility criteria of a certification scheme, so there would be that added additional element of protection. In terms of his specific question in and around face coverings, we do review regularly and are required to do so by law all the protective measures that are currently in place, such as the mandatory requirement for wearing of face coverings in most indoor settings, including, as the member rightly says, places of worship. That measure will continue to be monitored, and it will continue to be kept very much under review. After a recent review during which there was very careful consideration of all the current evidence, as well as all of the options available, ministers determined that the regulations on face coverings remain proportionate and should not change that at present. At this stage of the pandemic, many of the more intrusive restrictions have been lifted, but the virus and the harms that it causes have not gone away. While vaccination has significantly weakened the link between cases and serious health harms, it is not completely broken. It is therefore important that places of worship alongside many other indoor settings continue their good practice to reduce the spread of the virus. We are grateful to faith and belief communities for the important role in protecting their congregation and enabling everyone, particularly those at higher risk, to access worship safely. However, I take the member's point, and I promise him and give him an absolute guarantee that those measures are kept under review on a very regular basis. Rona Mackay, to be followed by Paul Sweeney. The removal of the final seven countries from the international travel red list has welcomed news for the travel industry, and Scots are looking to be reunited with their families. Can the cabinet secretary expand on what work is underway across the four nations to ensure that we continue to monitor the development of the virus as the last thing we need is a new strain on doing the success of the vaccination programme? I think that this is a very important point raised by Rona Mackay and the First Minister mentioned when we announced the change and the alignment with the UK Government that we were doing so for practical reasons, but she retained a concern in and around importation of new variants of concern of the virus. What I would say is that we have these conversations regularly at a four nations basis. I meet with my other health minister counterparts on usually a weekly basis. What I would say is that this is also a global effort, and therefore it is really important that that this engagement also takes place internationally. We are seeking to explore what further we can do to ensure protection against any known or indeed at this stage unknown variants of interest. What I would say to the member is that if we continue to test ourselves regularly as well, that is an important part of the protective measures that we have in place. However, I can give an absolute assurance to Rona Mackay that those discussions about importation of any variant of concern are discussions that take place on a regular basis across all four nations. Paul Sweeney to be followed by Siobhan Brown. Thank you, Presiding Officer. My constituent fell ill with Covid in March 2020. It is now November 2021, and my constituent continues to suffer from long Covid, with no long-term care plan for his recovery, as promised by a Scottish Government report published in September this year. He is living from sick line to sick line. When will the Scottish Government give the appropriate resource and guidance to the NHS care providers to help people with long Covid, such as my constituent? First of all, I am very sorry to hear about the suffering of Paul Sweeney's constituent. I have had constituent that has come to me with long Covid. In fact, one of my surgeries just last Friday before last. I recognise much of what Paul Sweeney is saying, but I have met a number of long Covid patients, such as Pamela, who I met in Eastwood health centre a number of weeks ago, who was telling me about just how good the holistic service she had clearly received. That is why I announced during that visit £10 million of additional funding for our health boards and other partners in relation to support with long Covid. I am meeting later this month with a range of organisations that advocate on behalf of those with long Covid so that we can refine some of the finer details of how that further £10 million can be spent. If Paul Sweeney would like to present to me the details of his constituent and I take him at good faith when he is saying that there is a lack of support for that constituent, I am happy to see how we can ensure that constituent gets the appropriate support that they require. Thank you, Presiding Officer. Following reports of menstrual disorders amongst a small number of people following the vaccine, I am concerned that that might act as a deterrent on the uptake of vaccines or booster jobs when the time comes. Whilst the benefits of the vaccine far outweigh the risks, what assurance can the cabinet secretary give that the MHRA is continuing to monitor these reports to guarantee that there is confidence in the vaccine and ensure continued success of the vaccine roll-out? Thank you, Siobhan Brown, for that question. I think I got the gist of it. Forgive me, I could not quite hear the very beginning of it, but I would say that there is a process in place, an MHRA process, in place for when there are side effects that do take place in the course of a vaccination programme where they can be flagged up. There is a official process where they are not just flagged up, but they are followed through and then they are discussed with clinicians, but what I would say is similar to what Siobhan Brown herself said, that the benefits of vaccination far outweigh those risks. If anybody is concerned about a particular risk, please go and speak to your vaccinator. Vaccinators are well-trained and equipped to deal with any inquiries that come their way, and arrangements can usually be made in place to accommodate you if we know that there are any particular health risks or concerns that you may have, but please get vaccinated. That is the single biggest thing that we can all do collectively to help us to control transmission of the virus. As the cabinet secretary will know, members of the armed forces have been stepping up across the country to answer calls to help with the ambulance crisis in the backlog in booster drugs. NHS Ayrshire Narin is among three health boards that have requested assistance. However, unlike other health boards, NHS Ayrshire Narin is the only health board to request the military help with general services on top of their additional duties. NHS Ayrshire Narin refused to comment as to why the military are needed and what they will be doing. Can the cabinet secretary shed any light in this situation, and can he assure me that NHS Ayrshire Narin is the only health board where military personnel are performing general duties rather than those that were agreed previously? The request from NHS Ayrshire Narin, as she probably knows, is now with military joint command. It would be inappropriate for me at this stage to give her the details of exactly the number of personnel and what duties she will be performing, partly because it is not my decision that is the decision for the armed forces and the armed services to determine once they have received that request, what I can promise, Ms Dowey, is that once we get confirmation from the armed forces about what additional capacity they are able to provide, I will ensure that that is made public, I will ensure that that is provided to the member. What I can give her an absolute assurance is that I speak on a regular basis to the chairs and chief executives of our health boards that include NHS Ayrshire Narin. I spoke to the interim chief executive yesterday on those very matters. Cabinet Secretary, a 72-year-old constituent with underlying health problems, six months having passed since her second vaccine had not received a booster appointment from NHS Lothian, so she phoned the helpline as advised. She made several calls, she was told that there would be a letter, there would not be a letter, that she had attended her appointment, her case was closed, that she wasn't on the system, the system was down, so phoned back tomorrow and the next day she phoned she told that she wouldn't get an appointment. I'm not blaming the call handlers, so can I ask the cabinet secretary to confirm with NHS Lothian what training and support call handlers are receiving to ensure consistency and accuracy? I think that it's a very important point raised by Christine Grahame and I referenced the answer to Ms Bailey when she asked a very similar question, which is that there's undoubtedly been localised problems and some of those problems have been in and around NHS Lothian, so me and my officials have spoken to NHS Lothian. We are confident that most, if not all of those issues, should now have been resolved. The advice is, of course, to wait for your appointment letter. If that appointment letter hasn't come in your over 70, then, of course, contacting the vaccine helpline should assist you, but I know that there were some localised problems and issues in relation to NHS Lothian. What I would say is that we are administering record numbers of vaccines. Those problems will happen time to time, and it's right, of course, that members like Christine Grahame raised them here. Again, this is an offer to every single member. If there are challenges that are being experienced by your constituent, of course, as well as going through the local health board, if you wish to come to me directly, of course, I'm always happy for me and my officials to follow those matters up to. Gillian Mackay to be followed by Emma Harper. Figures published by Public Health Scotland today revealed that, during April to December 2020, the number of people being diagnosed with breast, colorectal and lung cancers were 19 per cent, 25 per cent and 9 per cent respectively lower than would have been expected. While diagnoses of breast and lung cancer have begun to return to pre-pandemic levels, colorectal cancer diagnoses are still well below what they were previously. It's clear that we must encourage people to come forward when they have worrying symptoms, but there is a risk that the well-publicised pressures on the health service may discourage them. What urgent action will the Scottish Government take not only to ensure that people who do have symptoms seek help, but that services are able to deliver a timely diagnosis when they do, cabinet secretary? I thank Gillian Mackay for a really important question. She'll be aware, of course, when it comes to colorectal cancers, they are some of our most challenging terms of the 62-day pathway. That's why we ensure that traditional funding goes towards cancer such as colorectal. In that respect, I spoke yesterday to the Scottish Cancer Coalition and again reaffirmed our commitment to provide further funding. There has been further funding towards the cancers that were mentioned, but particularly in relation to colorectal cancer. I'll write to the member with further details of that additional investment. As we are now quickly approaching winter, where many more people will be congregating indoors for Covid-19 and other viruses such as flu are more transmissible, can I ask the cabinet secretary for an assurance that there are adequate resources within the test and protect Scotland to be able to cope with increased demand? Can the cabinet secretary reiterate how important it is to continue to regularly self-test with the lateral flow tests, which are free of charge? As he said in my statement, testing yourself regularly is incredibly important. It's one of the most significant measures that you can take as an individual to help us to control transmission of the virus. There are good stocks and supplies of LFD tests. The First Minister's announcement yesterday of additional investment to help with Covid pressures included £120 million for test and protect, so there is adequate resource absolutely in place. Yes, I reiterate and reaffirm what Ms Harper has said that testing yourself regularly is incredibly important, so I encourage everybody to do it. Fiona Hyslop, to be followed by Colin Smith. Some of my constituents who have underlying health issues would normally get their flu vaccines during the autumn-winter period. As the appointments for the Covid-19 booster vaccine and the flu vaccine are now being combined, constituents have to wait until six months have passed since their second Covid-19 vaccine dose before getting the flu vaccine at the same time as a very welcome Covid-19 booster. I have some constituents who have contacted me as it will mean that individuals may be waiting until January for essential flu vaccines and for immuno-compromised individuals waiting until January may be too big a risk. Will there be an opportunity for such individuals concerned about flu to receive their flu vaccines separately in November and December? In short, yes. Of course, if there are circumstances where that is not happening, I am more than happy to look into that. It is important to say that many of those who are immunocompromised would have expected them to be called forward for their third dose, not to be conflated with the booster dose already, but if there are those who do not, I am keen to hear from those individuals. Appointments are being scheduled very much based on clinical need. That is why we have that JCVI priority. It is based on clinical need and indeed age. It will take until mid-January for everyone to be offered their vaccine, but those who are offered their vaccine in mid-January would not be at the highest clinical need level. In short, the situation and scenario that Ms Hislop is articulating, if there are those who are immunosuppress or immunocompromised and are not being offered their flu vaccine and are worried about waiting, of course they should contact the health board. However, if there are any constituents that she would like to raise directly with me, constituent cases that she would like to raise directly with me, I am more than happy to liaise with the health board. Colin Smyth, to be followed by John Mason. Public Health Scotland last week reported that Covid restrictions led to a massive three and a half million fewer dental treatments last year. Restrictions still significantly limit the capacity of dentists to provide as wider range of treatment. I am receiving an increasing number of constituent complaints that they cannot receive a certain treatment on NHS without an unbearable weight, but they are being told that they can get the same treatment, often from the same dentist, if they go privately with no weight. Does the cabinet secretary accept that this two-tier system will get worse if the Government ends emergency funding for the sector, as the need to maximise private treatment income, would increase further? I find the situation that Colin Smyth outlines an unacceptable one, I think, as we all do. Somebody is coming in to see a dentist and being told to wait weeks or months, and then only being told that they can see them the next day if they move on to a private plan. I do not see that as an acceptable situation, and I have raised such with representatives of the dental sector. On additional funding to the sector, we have recently announced some additional funding for the dental sector. That is why, and I know that the BDA does not necessarily agree with that as being the right way around, but I certainly believe that we need to tackle that backlog before we can get into issues of long-term reform of the sector. We are overhauling the complete dental sector, the dental fee structure. Of course, we may have to do all that. We will consult with the BDA and others, but it is really necessary to respond to the current backlogs that his constituents and my constituents are all facing. I am more than happy to provide the member if he wishes more detail of what funding we have provided for the dental sector, and we will continue to provide investment and funding in order to clear those backlogs as quickly as we possibly can. John Mason, to be followed by Russell Finlay. Thank you. The cabinet secretary knows that there was a lot of scare mungering around before the vaccine certification scheme was introduced about two weeks ago. Can he give us any update about how it is going? Significantly, it is going very well. We have had over a million downloads of the app. We have had many downloads of the PDF and paper copies as well. He will have seen and read the feedback from those who have been attending football matches, which has been exceptionally positive. I know that there are those in the nighttime industry who are still opposed to the scheme. I suspect that his inbox is not full, as my inbox is not full of people who are unable to get into their local late-night venue or indeed their nightclub. That, to me, suggests that the scheme is working very well. Russell Finlay, to be followed by Gillian Martin. NHS workers across Scotland are bracing themselves to the winter ahead at Paisley's Royal Alexandra hospital. There is a reported chronic shortage of staff across all departments. The fear is that even more front-line mericks will be lost to sickness because of the extreme pressure of the working environment that they are in. Can the cabinet secretary tell RAH staff and the people of Renfrewshire if he is confident of protecting their services this winter? I am certainly confident that he will work with NHS Greater Glasgow with all the health boards right across the country to do what we can to protect their services. He is absolutely right to recognise that our NHS staff are extremely tired. They have been working exceptionally hard over the course of the past 20 odd months during the pandemic. What I would say to Mr Finlay is that we have increased our funding from £8 million to £12 million for wellbeing of staff. That includes provision of things such as, for example, free-hopped drinks and food available on the wards. Psychological interventions help with access to the national wellbeing hub and other wellbeing support. Wherever I can increase that funding for wellbeing, I absolutely would and will. However, Mr Finlay is also correct in suggesting that the best way to protect the wellbeing of those who work for us is to try to mitigate as best we possibly can against the worst effects of what will be an extremely challenging winter. However, even doing that, I have to be upfront and I have to be honest and say that even with all those interventions, this winter will be extremely challenging. I have been contacted by some of my constituents who have children eligible for the Covid vaccine because they have underlying health conditions and disabilities or because they live with someone who is shielding. There seems to be a bit of confusion that some of those young people have not received an appointment for a second vaccination and they have struggled to make an appointment for a second vaccination online. Can the cabinet secretary provide clarification as to whether the group should be receiving two doses and, if so, how best can they get appointments for it? If there are particular constituent cases that Ms Martin or any member would like me to look at at the local health board to look at, please do get in touch. However, in general, most 16 to 17-year-olds who do not have other underlying risk factors such as them themselves having an underlying medical condition or being a young unpaid carer, they are only eligible for a first dose, as per current JCVI advice. Forgive me, I do not think that I answered that question from Ms Bailey previously. We are awaiting further advice from JCVI on second doses for this group and also boosters for the rest of the population. We keep regularly in contact with the UK Government who are the recipients of that JCVI advice and, of course, we will consider that advice when it is issued. The cabinet secretary was told by the Government's own experts that pupils should not have to wear masks in schools, yet he disregarded the advice. The Government's own draft guidelines, published on 8 October, said the same, and he disregarded his own draft guidelines. Can the cabinet secretary tell the chamber what study has been done on the impact on children and young people's mental and physical health because of his decision to force pupils to wear masks all day, and what measurement must be satisfied for this directive to be removed? As a step-parent of a 12-year-old, I take full exception to the insinuations in Mr Kerr's question to suggest that the Government is wilfully ignoring medical advice is completely incorrect. In fact, the reason why we have retained the current regulations and baseline mitigations in place for face coverings within school is because of the advice that we have received from the chief medical officers—precisely because of the advice that has been received. Of course, when the advisory subgroup met and gave their recommendation, we were in a period of declining cases. Once we considered that advice, once we spoke to the appropriate stakeholders, including speaking to our own clinicians within Government, cases stopped declining and began to plateau. We have seen a recent rise. The protection is there to protect young people and those who work in schools as well. I can promise you that, not just as the Cabinet Secretary for Health and Social Care but as a parent of a 12-year-old who has just gone to high school, I do not wish those baseline mitigations to be in place for a second longer than they have to be. We will continue to take the advice—he may be shouting that we should ignore this advice, but we should continue to take the advice of the chief medical officer. I encourage Stephen Kerr to also listen to clinicians in this regard. As the flu vaccine is being delivered along with the third dose of the vaccine, what guidance is available for GP services to support them to direct patients who receive both doses of their vaccine abroad and therefore are not necessarily on the register for the flu vaccine roll-out? I was just thinking about that before I came down to the chamber. In short, there is advice on the NHS informed website, which takes you to the appropriate advice or link that you need to follow if you have been vaccinated with either one dose or both doses internationally and outside of the common travel area. Of course, we work closely with health boards who in turn work closely with GPs, and perhaps more appropriately in this setting, with vaccinators in a community setting around the guidelines of somebody approaches who has been vaccinated internationally either with one dose or indeed with two doses. I am confident that there is the appropriate information available. However, again, I reiterate what I have said in previous answers. If any member feels that there is a case where that is not being treated appropriately, I am more than happy for them to contact me with the details directly.