 Cyflawni'n cwestiynau dwylo'r cwestiynau, a'r ddyglu'r cyfrifysgwysnag eich bodi'r ddyglu'r cyfrifysgwysnag, a'r ddyglu'r cyfrifysgwysnag. Cymru. Cymru pan fyddai'n gwneud, mae'n unrhyw unrhyw gweithredu oedd yn y gael i'r brifysgwysnag yw ein ffwrdd COVID. Yn mynd i ddod 10 miliwn gwaith ymlaen i'r gweithredu i'r ddylch i'r Prifysgwysnag, I want to thank all the front-line staff, the armed forces and the volunteers who have made that happen. At this critical moment, we need to continue the success of the vaccine programme to tackle this new variant. Earlier this week, the JCVI updated their guidance, meaning that people can get their booster jag three months after their second jag rather than six months later. Last night, it emerged that people who are now eligible for the vaccine were actually being turned away. First Minister, how is this allowed to happen? Has it now been resolved so that no one else is refused a vaccine that they are entitled to? Let me take the opportunity again today to thank vaccinators and vaccination teams across the country. Scotland currently has the fastest vaccination programme anywhere in the UK on first doses, second doses, third doses and, crucially, on booster doses. That is not a credit to this Government, that is a credit to those working so hard in every corner of the country every single day. The Government has a heavy responsibility to make sure that the pace of the programme doesn't just continue but accelerates and, as I said on Tuesday, we are very focused on that. Let me explain the issue yesterday. I am very sorry to anyone who was turned away from a vaccine clinic yesterday. When advice changes, and the JCVI advice changed on Monday, because this is a clinical procedure, there is a process of updating protocols and materials to make sure that everything is being done in line with clinical protocol. In the normal course of events, that is a process that would take around a week. That has happened now already and we have taken steps to ensure that that information has been cascaded down to vaccination clinics everywhere across Scotland. It is important that people who had that experience should do that. Let me stress that it was a small number of people who can go on to the website and re-book their appointment now if they are within what is now that three months, or if they are over that three month period. The vaccination programme continues to go well, as I have said candidly on a number of occasions, particularly when advice changes very quickly. There may be glitches in the system, like we saw yesterday. We try to avoid that happening, but when it does happen, we take steps to rectify that as quickly as possible. It is also fair to say that I saw on social media this morning a prominent journalist in England narrating exactly the same experience at a vaccine clinic in England. Those are issues that we are all dealing with right now, but we are all making sure that we are working hard to continue the excellent progress of this vaccination programme. Let me remind people that Scotland currently has the fastest vaccination programme anywhere in the UK. First Minister had time to check Twitter to see what was happening in England, rather than trying to solve the problems here in Scotland. Because, while her apology is very welcome and her backbenchers are shouting it's solved, her and the Deputy First Minister are going along the same lines that this was all an issue yesterday. However, we are still hearing this morning of people turning up on Thursday morning to get the vaccine that they had booked and they were turned away, turned away despite having an appointment. We have looked at the latest available updates from all health boards because the First Minister confirmed that it had been cascaded to all clinics. However, the situation is evolving as I came into the chamber, yet five health boards seem to be implementing the guidance as of now. Five are saying that they plan to implement the new guidance soon, and four health boards are yet to provide an update at all. The First Minister has just said that this has all been resolved, but as of this moment it doesn't look that way. Does it, First Minister? In terms of the comment about it being resolved, the guidance was issued by the chief medical officer yesterday. It is the case that all health boards have that guidance, and all health boards are expected to implement that guidance. My advice to people across Scotland is that if they are under the new JCVI advice, eligible for a booster vaccination, they should book that booster vaccination and health boards will implement the new guidance. I repeat the point not to make an excuse about this, but it is an important point of context. Vaccination, the most vital thing that we are doing right now, is a clinical process and a clinical procedure. It has to be backed up by protocols. When advice changes, those protocols have to change. That is a process that normally takes a lot longer than this. It has been done more quickly, rightly and properly because of the urgency of the vaccination programme. That is a process that health boards are now implementing to make sure that they are giving effect to that changed guidance. I absolutely accept that for anybody, and it was a small number of people who are finding themselves in this position, that is really frustrating. I am sorry that they are having that experience. Please go on and reboot. You will be vaccinated in line with the new advice. This is the biggest vaccination programme that has ever been undertaken. That is not just true of Scotland. That is true in every country administering these vaccines right now. It is being administered right now alongside the flu vaccination programme. This is an enormous logistical exercise. I have never stood here and said that every single aspect of this would go absolutely smoothly all of the time. When problems arise, we rectify those and we rectify them quickly. However, I make no apology for yet again taking a step back from all of this and recognising the enormous achievement that this vaccination programme is. I do not say that to get any credit for the Government. The credit belongs 100 per cent to those who have designed this programme and to those who are, as we speak right now, delivering it in every part of Scotland. The fastest vaccination programme in the UK, 27,000 lives already, according to a WHO study that was saved in Scotland. This is a success story. I take very seriously my responsibility to make sure that it continues to be a success story so that we get as many people vaccinated. We are vaccinated with boosters as far and as fast as we can. That is an obligation and a duty that this Government takes seriously every single day. Let's look at how seriously the Government has taken this issue. How this has unfolded is because of the communication from the First Minister's Government has been a mess. On Monday, the chief medical officer told everyone who is eligible to book an appointment and get vaccinated as soon as possible. On Tuesday, the national clinical director told people on Twitter that if they turn up for a booster, they would get it. On Tuesday, the First Minister came to this chamber, stood at that podium and called on the public to schedule booster appointments based on the new three-month timescale. She is now speaking about clinical processes and procedures, yet her words at the time were, I say to everyone who is in a similar position to me, try now, bring forward your booster appointment. That was Tuesday, yet we know that proper procedures had not been put in place so people ended up being turned away. Surely that should all have been sorted before the First Minister told people to bring forward their appointments. The advice that we gave is the advice that I give again today and a very small number of people, a minority of people, and to each and every one of them I understand that that is no comfort, and that is why I am saying that I am sorry that they had that experience. However, a small number of people in that timescale, when the protocols and the guidance were being updated, wrongly got turned away from the clinics. I know that some of those people personally got their vaccinations over the past couple of days within that updated guidance. That is one of those situations in a massive programme where the advice changed very quickly and very substantially, where, yes, I concede that a small number of people had an experience that they should not have had. We are rectifying that, that is being rectified and the advice remains. If you are eligible for your vaccination within the new guidance, go on and book your appointment. The guidance has been updated and people will be vaccinated. That is the position, and it is also the position that the success of this programme cannot be denied. We are currently vaccinated with booster vaccinations, and this is yesterday's figure, over 35 per cent of the over 12 population, ahead of England, ahead of Wales, ahead of Northern Ireland. We are not complacent about that. We are not resting on our laurels, but this vaccination programme is a success because of those right now working so hard across the country. Douglas Ross and any other member is right to raise issues where things go wrong or do not go as right as we want them to. However, some of the language that I have heard applied to the vaccination programme over the past 24 hours does a real disservice to those who are working so hard every day right now to get these jags into people's arms. So please, let's not lose sight of the success that these people are delivering for all of us right now in this fight against Covid. Douglas Ross knows that the First Minister is really struggling with her answers when she accepts that the question is correct. I am delighted that my questions are appropriate to the First Minister, but what we have heard from every single one of her answers is that she stood here on Tuesday and told people get the vaccine booster appointment now. She told people to do it now on Tuesday, but it is clear that, at that point, the First Minister and her Government had not done the groundwork with health boards prior to her announcement. It led to confusion when the public needed clarity so that we could accelerate this booster roll-out. Yesterday, a spokesperson for the Scottish Government insisted that we will confirm our approach to the vaccine deployment very soon. However, we should already have a detailed plan right now, and that could have stopped this mess happening. The SNP Scottish Government needs to show the same urgency to rolling out the booster vaccines, as was the case in delivering the first and second doses. There is a backlog of close to 2 million people across Scotland waiting for their jag. I do not know why SNP members do not want to hear this. It is happening in all of our constituents. Colleagues, excuse me, Mr Ross. Can we afford members the courtesy of listening to their questions and responses carefully? The sight of SNP MSPs laughing and shouting down comments from all of our constituents is, I think, very, very telling. Because there is a backlog of close to 2 million people in Scotland waiting to get their jag. On those benches, we have been calling for the reopening of mass vaccination centres. If not of the scale of the PNG live or the hydro, at least major clinics in town halls and buildings across Scotland. It is surely about time for the First Minister and her Government to back our calls so that we can roll out the booster vaccines as quickly as possible, and guarantee that no-one else gets turned away from having these vital jags. The small number of people who got turned away, I have set out the reasons for that. The action that has been taken was in the process of being taken, not just in Scotland but in other parts of the UK, to update guidance. The fact is that, in Douglas Ross, you can go and check this in the public record. The number of people over the past three days who got their booster vaccination, many of them, within that updated guidance is the vast majority. I accept readily because I know how important it is that we keep the pace and pick up the pace of this vaccination programme. That is why we consider the health secretary speaking to health boards on a daily basis right now. Many of them are putting on extra clinics already. There are large-scale vaccination clinics in many parts of the country. Douglas Ross seems to think that we are getting this somehow terribly wrong and uniquely wrong. Let me just share with people. We are all trying to work through the numbers of people who are eligible for vaccination as quickly as possible and as soon as possible after the JCVI gave us advice. Many people were already eligible by the time the JCVI gave us their original advice. Let me just set out for the public here. This is publicly available information. On first doses of the over 12 population, 90.9 per cent in Scotland vaccinated in England, 88.5 per cent. Second doses in Scotland, 82.6 per cent vaccinated in England, 80.4 per cent. On boosters in Scotland, 36 per cent of the over 12 population vaccinated in England, 32.2 per cent. So are we going as fast as we need to go? We've got to pick up that pace further. But actually, is the approach that we are taking in Scotland right now the most successful anywhere in the UK? Yes, and isn't it about time? Douglas Ross, if he won't give the Government, and I'm not asking him to give the Government any credit, not just in rhetoric but in reality, gave these vaccinators working so hard right across the country the credit they deserve. Question number two, Anna Sarwar. Yesterday, Kimberley Darek, who lost her daughter Millie four years ago, and Louise Lawrence, who lost her husband Andrew a year ago, said, Enough is enough, the Government needs to decide whose side it is on, patients, families and staff, or a failed health board leadership. Shamefully, the Government chose the wrong side. When there is a serious infection, exactly it's not a game, Mr Gray. Whenever there is a serious infection, an urgent alert is sent to the health secretary. It is called a high act red warning. In the closing seconds of the debate yesterday, the health secretary said he had received three high act red notices from the Queen Elizabeth University hospital since he became health secretary. After weeks of asking these questions, can the First Minister tell us what infections these three red warnings were for, what date they were received and what action the Government took? First Minister. I'm going to come back to that because I certainly can provide information on that. I want to, Presiding Officer, my apologies if I take a bit of time in this answer because these issues are really important to patients and their families across the country. Firstly, to Kimberley Darek and Louise Lawrence, I absolutely understand the questions that they have and their determination to get answers. I want to get them the answers to questions that they have and, in their position, I would be doing the same as the family member of somebody who had lost their lives. But Anna Sarwar has raised a number of concerns about the Queen Elizabeth. I just want to briefly go through those concerns and, in the process of doing that, I will answer the question that Anna Sarwar has asked. Firstly, the suggestion that the Queen Elizabeth University hospital is somehow unsafe and that there is a higher risk of infection there than anywhere else. Evidence does not bear that out, whether that is hospital standardised mortality ratios or published reporting of hospital-acquired infection. The Queen Elizabeth actually performs better than the national average and better than many other hospitals. Also, and this is an important point, Scotland as a whole has a lower prevalence of the European average. Secondly, there is a systemic problem in the Queen Elizabeth causing infections. That is a suggestion that has always been taken seriously. That is why the independent review was commissioned, why the case note review was commissioned, why the oversight board was established and why there is now a public inquiry and criminal investigations into some of those cases. Anna Sarwar derys all of that process, but much of it is the process that he demanded. More importantly, all of that process has led to improvements on the ground. We take all of that seriously, but the very difficult fact is that, despite best efforts to minimise the risk, no hospital anywhere in the world can eradicate completely the risk of infection in very sick patients. Individual cases—I cannot go into the detail of them, Presiding Officer, but after FMQ's last week, I asked the health board to do an internal review and they have advised me that, based on the work that they have done so far, there is no child with Aspergillus who had that noted on their death certificate as a direct or contributory cause of death. We are not resting on that. Health and Care Improvement Scotland has been asked to carry out a wider review. On the issue of the Hyatt assessments, it is important to recognise what they signify. When one of those notices comes to government, I think that Anna Sarwar gave the impression last week that that signified a death in a hospital. That signifies at least two or more cases of infection that are linked in some way. In the adult Queen Elizabeth hospital, red and amber ones come to government. There were two red and one amber from 25 November last year to 1 December this year. The dates of those were 12 January this year, 7 May this year and 23 June this year. I do not have the information on what infections but I can get that and provide it. The point that I want to end on goes to my first point about the suggestion that the Queen Elizabeth is somehow an unsafe hospital. There were those three alerts in relation to the Queen Elizabeth. In the same time frame, 45 were notified across Scotland as a whole. Let me just give some context around that. The Queen Elizabeth represents over 11 per cent of all adult acute beds in Scotland, but less than 7 per cent of these Hyatt notifications. We take all of those concerns very seriously, but I think that it is also important that we do not have politicians coming to this chamber and trying to suggest and to erode confidence in the quality of care that is provided by dedicated clinicians in the Queen Elizabeth hospital every single day. I think that it's worth noting that we had a debate in this Parliament yesterday where the health secretary had the opportunity to bring these facts to the Parliament and didn't. The First Minister didn't bother even turning up to the debate and didn't even bother voting in the debate yesterday. I think that it's also important to note that what we're talking about is process, but where is the accountability and responsibility that comes with those processes as well? To this day, not a single person has been held accountable. I'm pleased that the First Minister referenced the need for the Hyatt warning to not crucially just be about deaths but be about infections. I'm agreeing with you, First Minister, but I think that you need to understand what's happening in this health board because clearly either you're not being told the truth or you are hiding the truth, and I prefer to believe the first. I think that the health board is not telling you the truth, and I think that that's really, really serious. Jeane Freeman recognised that in the last Parliament, as we're talking about infections not deaths. When those infections happen, they should be notified so that the Government can take the necessary action. Let me give you an example. While the First Minister hides behind process and a public inquiry that could take three more years, patients are still getting infections and lives are still being lost. I have raised cases of Aspergillus and Stenotrophilmonus in this Parliament. Those cases should trigger Hyatt red warnings. Yesterday, I spoke to a mother who, in recent weeks, tragically lost her six-month-old baby. The child was an intensive care unit at the Children's Hospital at the Queen Elizabeth University campus. She shared the death certificate with me. Listed as a cause of death is Sureshia, another deadly bacteria linked to water and the hospital environment. From the indication from the First Minister, that didn't trigger a Hyatt red warning. Sureshia, a deadly bacteria linked to water and the hospital environment. That mother asked me to raise this case today, but in her words, I have no confidence in this health board. I have no confidence that action will be taken. It is inevitable that it will happen again and other patients will be affected. Another child's death, another grieving family, what is it going to take before action is taken? I think that I will make three points here and making them very genuinely because these are such important issues and my deepest condolences are with the mother that Anna Sarwar has referenced here today. The Hyatt system is about the Government being alerted to cases of infection. When that doesn't get triggered, that doesn't mean that no action is taken on individual cases of infection. The reason the Hyatt system triggers an alert to government on the basis of two or more linked infections is because that is indicative not of individual isolated cases of infection, and I will come back to that in a second, but of a potential infection outbreak that should trigger a higher level of response. The reason I will come back to isolated cases of infection is because it is such a hard fact, particularly if you are the parent or the relative of somebody who has died of an infection or got an infection in hospital even if that did not contribute to the person's death. It feels like my grandmother got an infection in hospital many years ago before her death. Basically, the reality here for every hospital across the world is that despite the best efforts and the highest quality of care, it is not possible to prevent every case of infection in very sick patients with compromised immune systems, so that is why that system is in place. Of course we review systems like that all of the time. Secondly, on process, I am not hiding behind anything, I am certainly not hiding behind process. The processes that are in place are important, and I repeat the point that I made earlier on, and I said we are called for many of these processes, including the public inquiry. We are not waiting until that concludes to do anything, so if we look at the recommendations of the independent review of the fabric and maintenance of the hospital that was commissioned by the Government, or if we look at the recommendations from the oversight board, I think that in the first case 98 per cent of those recommendations have been implemented, in the second I think that it is 88 per cent. There has been significant investment in the affected wards, in specialist ventilation, in water systems for example, so there is action being taken all of the time. I come back to the point that I made earlier on, every case of infection is serious. The Queen Elizabeth actually, when we look at all of the evidence here, has a lower incidence of infection than many other hospitals, and of course it is a big hospital providing very specialist care. Lastly, Presiding Officer, I know that I am taking time on this, but it is so important. This issue of a cover-up, and this was an issue raised and addressed in the letter that 23 senior clinicians wrote yesterday. I know from my experience as health secretary, from my experience as First Minister, from my experience as a citizen, and at times a user of the health service. I know how seriously clinicians take their duty of candour and honesty to patients. The Government takes that so seriously that we change the law to make duty of candour a legal obligation. I have confidence in clinicians. If the allegation is, as it appears to be, that health boards, or in this case, the Greater Glasgow and Clyde health board, are pressurising or bullying or telling clinicians not to be honest with patients, then my message, not to Anna Sarwar, but directly to every clinician across Greater Glasgow and Clyde, across the country, is that if they feel there in that position, they should raise that in any way that they see fit and they should come to me directly, because that is not acceptable and would not be acceptable. Those are serious issues, but let's treat them seriously, as this Government does, but let's not erode confidence in a hospital providing a high quality of care. Ascending out photographs of mould without saying that they were from four and two years ago had been rectified, and of course the report that included those photographs in the first instance made clear that they did not affect patient care. That is what Anna Sarwar did yesterday. I think that that is crossing the line from raising legitimate issues to trying to undermine confidence in a hospital and in hard-working clinicians. Anna Sarwar. I listened to what the First Minister said and I'll address a couple of those points, but can I first of all say that she should listen to the words of Dr Christine Peters, who was one of the whistleblowers at the start of this crisis? What did Dr Christine Peters say? Do not gaslight the entire staff base of the Coon Elizabeth University hospital in order to protect the jobs of a few at the top. No one is questioning their confidence in their front-line staff. What we are questioning is the confidence in the leadership of this board. This fight is as much about the staff as it is about the families and the patients. I accept that we cannot stop every single hospital-acquired infection, but given what we know has happened at the Coon Elizabeth University hospital, that should show that there needs a grip on the situation. If it was me, I would be sent to the health board every single time there is a serious infection. I want to know about it so that we can make sure that we are taking the necessary action so that we do not make the same mistakes again, not trying to hide behind some process. That is exactly again what is happening in this case. Why are you not getting a grip off this health board so we know every single time there is a serious infection related to the water and the hospital environment so action can be taken? The problem here is not those asking the difficult questions, but those making the wrong decisions. The First Minister says that taking the steps of moving the health board into stage 5 is a step too far, but in 2018 she escalated NHS Tayside into emergency measures. She sacked the chief executive and the chair, and that was for financial mismanagement. In Greater Glasgow and Clyde, children have died and are still dying, yet not a single person has been held accountable. No more hiding behind process, no more blaming of staff, no more waiting for the findings of a public inquiry in the distant future. Families cannot wait that long. You made the wrong choice yesterday, and as we have heard today, there are still patients dying in the hospital after contracting infections. I shared a new case today. For the sake of the staff working tirelessly to save lives, for the sake of the families who have lost loved ones, for the patients in Glasgow and across Scotland and for the sake of all those who have had to share the heartbreaking stories, please listen, act and do the right thing. First Minister, I will try to cover all the points that were raised under three broad headings as briefly as possible. I am probably betraying my age here. I am never entirely sure what gaslighting exactly means in practice, but I am not blaming staff. I am not blaming staff. Nobody is blaming staff. The letter that was written to me and to the health secretary yesterday was from clinicians, clinical voices, head of medicine, medical directors, people who are part of the clinical community. The point is this. This is not blaming staff. This is recognising a reality. When individual patients or their families are communicated with, it is not a health board that communicates with them, it is clinicians. I have the utmost confidence in the way in which clinicians do that and the seriousness with which they take a duty of candour and honesty to patients. The point that I am making is that if any clinician considers that they are being pressurised to do something different, bullied into doing something different or told to do something different, they should not hesitate to bring that directly to me or to the health secretary. We will not tolerate that. The second point is about this process, hiding behind process. The public inquiry was something Anna Sarwar called for. It is right and proper that that happens. There is a criminal investigation on going into certain cases. However, if you take the independent review and the oversight board, important pieces of process that led to many recommendations that have been implemented to real investments in the water system and ventilation system at the hospital. I come back to this point because it will lead me into my last point. The Queen Elizabeth in saying this I am not minimising the seriousness of every infection, but the Queen Elizabeth hospital in terms of published statistics around infection, in terms of standardised mortality data, actually performs better than the national average. That says some of the actions that have been taken are working and clinicians in that hospital deliver a high quality of care across a very, very complex range of treatments. This comes to the final point, Presiding Officer, is the sack the board cried. This is really serious and I think there is a criminal investigation under way. Anna Sarwar is, from a sedentary position, asking me who is behaved criminally. That is what a criminal investigation is intended for, whether anybody has and if so who and in what way. That is a really irresponsible thing to shout across the chamber. The final point is this. If I thought for a minute that simply removing the health board would change anything on the ground in the Queen Elizabeth hospital, or if that was the problem and there weren't improvements because the improvements were being blocked by the health board, I would do that without hesitation. But removing a health board, given everything that I have said about the work that has been done, in the middle of a pandemic and a vaccination programme would not be the responsible thing to do. The responsible thing for government to do is to work with the health board to continue to make the improvements, to continue to ensure that in the Queen Elizabeth hospital and in every hospital across the country, high quality care is provided. That is what we do every day. Before we move on to supplementary questions, I wish to make members aware that First Minister's questions will continue to date until 1255 approximately and I call Kenneth Gibson. Thank you, Presiding Officer. First Minister, the address on to Brodic ferry regularly has to berth overnight at Brodic due to the poor state of the address on harbour fenders. Leading to the cancellation of the 7am service to Arran, a sailing that carries goods, workers and contractors to the island. The next sailing arrives in Brodic at 10.40am, impacting on the working day. Basic maintenance has been neglected by pill ports privatised by previous Tory government, accompanied by the raked in millions in passenger fees over the years. Does the First Minister agree that some of those fees should be retained by CalMac until such times as offenders are repaired or replaced? I know that the payment of berthing dues is a matter between the ferry operator CalMac ferries and the harbour authority. It is the responsibility of the statutory harbour authority to ensure that harbours are well maintained and fit for purpose. We are investing heavily in ports and vessels to support and improve the ferry services as part of the wider infrastructure investment plan that we have outlined already. I will ask the Transport Minister to write to Kenny Gibson with some more detail about the investments and the work that we are doing. Transport Scotland is doing with stakeholders, including the Peel Ports Group, North Ayrshire Council and the Arran Ferry Group, to improve services and infrastructure, particularly on the Arran route. Ritchell Hamilton is the First Minister of Scotland, which includes the responsibility for the Scottish borders, not just the central belt. Outrageously, it took until Tuesday of this week for the First Minister to acknowledge the devastation caused by Storm or Arwen on Twitter. The First Minister must not think it acceptable that a frail and vulnerable 87-year-old constituent of mine has had to sleep in front of the fire, a coal fire, in a chair without power or heat this week. We all know that energy companies have serious questions to answer, but surely the First Minister must agree that the Scottish Government has a responsibility to act quickly in these life-threatening situations. I do, and the Scottish Government has been heavily engaged in this all week. The Scottish Government Resilience Committee has met on several occasions. I chaired the most recent of those meetings just yesterday. There have been extensive discussions on a daily, several times a day basis with the power companies. It is an opportunity to express my sympathies to everybody who has been impacted by Storm Arwen. The storm was almost unprecedented, certainly unprecedented in recent memory, in its severity, and the impact of the storm has been extreme. Many, many thousands of people have suffered a very difficult experience as a result of that, and some are still suffering that difficult experience. In terms of the power connection issues, at the start there were more than 200,000 customers off supply. As of this morning, and this is a moving picture, obviously there are around 3,300 still not reconnected to supply. The power companies are working intensively on that, and the estimate is that it may take until the end of this week to get absolutely everybody back on power supply. There is a lot of welfare support being provided and, again, the Government is working with resilience partnerships to ensure that that is happening as it should be. This has been a really difficult time. I think that there are lessons for all of us to learn. The Scottish Government will lead through our resilience arrangements, a lessons learned exercise once the impact has been addressed. One of the lessons is about communication. I know that the power companies have been working extensively and intensively to get people reconnected. The damage has been extreme, but I think that there are lessons that everybody can learn, and we will certainly ensure that that happens once, of course. Everybody is back on power and the immediate impacts have been addressed. For all of us who have lost a loved one in a care home during the pandemic, Anne's law will come too late, including for my constituent Anne Duke, the inspiration behind the campaign. Loneliness and isolation continue to impact the quality of life of many care home residents, despite the open with care policy on visiting. Can the First Minister reassure people that the Anne's law consultation report is still on track to be published this month? When will the Government deliver its promise on Anne's law? We are absolutely committed to introducing Anne's law. The public consultation on Anne's law closed on 5 November. Officials are currently working through the responses to consider the impact that they might have on how we go about implementing Anne's law. It is really important that we consider the views from the public properly, but we intend to publish the responses in the coming weeks and take forward our plans to implement this as soon as possible. Loneliness and isolation has been a particular issue for many people over the course of the pandemic and, in particular, for those in care homes. We continue to support a range of initiatives to help to address loneliness and isolation, but of course all of us can help to reduce the impact of Covid by following all of the protections in place so that we can continue to keep the pandemic under control and therefore support the greater and increasing return to normal life, which in itself will go a long way to helping address the root causes of some of the loneliness and isolation that people have suffered. Question 3, Alex Cole-Hamilton. To ask the First Minister when the Cabinet will next meet. First Minister, Alex Cole-Hamilton. I'm very grateful for that reply. This morning, the Office of National Statistics published figures to show that 99,000 Scots now suffer from long Covid. I asked the First Minister about this at the start of October. 8 weeks and 20,000 new patients later and we are still nowhere. Where are the long Covid clinics? Where are the community nurses delivering support into the homes of sufferers? Where is the financial guidance and financial certainty for employees who just don't know what they're going to be paid at the end of each month, including in the Scottish Government? Long Covid sufferers need new hope. I said as much to the finance secretary in negotiations around the budget yesterday. Does the First Minister recognise the plight of long Covid sufferers? Her Government's response has so far been unequal to the challenge. Will she meet that with a significant and substantial response in next week's budget? I absolutely recognise the plight of those who are suffering long Covid. It's a dreadful condition. It's often a complex condition and clinicians and scientists are still working to understand exactly how that impacts on people. I don't accept that our response has not been equal to the scale of the challenge, but I do absolutely accept that our response and the response of all Governments will have to considerably scale up and adapt as we learn more about long Covid. We have published an approach paper, which sets out 16 different commitments to improve care and support for people with long Covid in Scotland. Those commitments are already backed by a £10 million long Covid support fund, so there is already financial commitment there. I fully expect that there will be a requirement for additional financial support, not just in this budget but perhaps for years to come as we continue to understand and respond to long Covid. I can't. I'm not going to pre-empt the budget next week, but the budget will include a significant increase in the funding of the national health service and, as part of the many obligations on the shoulders of the national health service, responding to the needs of those with long Covid is an important one. To ask the First Minister whether she will provide an update on the advances that the Scottish Government has made in relation to the British Sign Language national plan. The Scottish Government published the British Sign Language progress report on 27 October. It outlined progress being made towards implementing the BSL national plan. Outlines progress on a range of fronts including education, BSL English interpreting and public life. The report outlines how the Scottish Government has funded BSL partnership organisations to engage and support public bodies with their plans and notes important developments such as the decision that our next census will ask, can you use BSL for the first time? Significant progress has been made towards making the country more inclusive and supportive of BSL users. The language enjoys a higher profile than ever before in our public life and is even more visible in media and communications. That is a really important development. I thank the First Minister for her response. Tomorrow is international day of persons with disabilities and there has been tremendous strides in deaf and BSL visibility since the BSL Scotland Act 2015. I have even had feedback from the British Deaf Association that many across the UK were even tuning into the Scottish Government's Covid briefings. As the UK Government did not provide an interpreter service, and I am sure that we were all moved by the powerful performance on Strictly Come dancing when Rose Aileen Ellis, when she was dancing and the music stopped. It was an incredibly poignant moment. We still have more to do to open the doors for the deaf community. Can the First Minister give an indication of what work has been done in terms of the BSL national plan to ensure that the very welcome increasing demand for BSL training and education is met? I recognise that tomorrow is international day for persons with disabilities. That is an important reminder of our obligations to people living with disabilities to ensure that we are making our countries, our societies as inclusive as possible. It is also fair to say that I am going to take the opportunity to say that Karen Adam herself is a shining example of somebody using her public platform to raise the profile of BSL. I want to pay tribute to her for doing that. There is no doubt that those things matter. The really moving moments on Strictly Come dancing a couple of weeks ago when Rose took the opportunity of that platform to again raise awareness is something that will live in people's memories for a long, long time. Let me also take the opportunity to say thank you publicly to the BSL interpreters who have helped me to communicate with the country over this Covid pandemic. We owe them a huge debt of gratitude to making sure that our public messages reached as many people as possible. In terms of the specific question, we are working to expand opportunities around education. We are updating guidance on the appropriate qualifications for teachers of children and young people with sensory impairments, including BSL qualification. Through the inclusion of BSL in the one plus two languages policy, there are now more opportunities to learn BSL. The Government through the Scottish Funding Council is also continuing to invest in BSL education and training in higher education. To ask the First Minister what the Scottish Government's response is to reports that the use of anti-depressant medication among children has increased by more than 80 per cent over the last 10 years. We are committed to ensuring that all children and young people can access the right support for their mental health without stigma, including medication where this is clinically considered the most appropriate intervention. The numbers of children and young people being prescribed anti-depressant medication is low. Public Health Scotland data shows that in the 0 to 19 age category 1.8 per cent of children and young people were prescribed medication. Medication will be one aspect of treatment alongside psychological therapy or other therapeutic interventions. It is not the only treatment option for children and young people who require support. We are continuing to improve access and invest in other services such as funding to ensure that every secondary school in Scotland has access to counselling and funding for community-based mental health and wellbeing services as part of our focus on early intervention and prevention. First Minister, infants under the age of four are being prescribed anti-depressants. The number of 5 to 14-year-olds on anti-depressant medication has risen massively in recent years and these are alarming statistics. This is a hidden mental health pandemic. We know early intervention and prevention are key. What action is the Scottish Government taking to extend community-based mental health services for children and young people, to support youth work services and to ensure that there is an adequate pipeline of qualified counsellors for schools? Those are really important issues and I think that we should all, as I know the member does, treat them really seriously. I think that this is a really important point and I am sure that the member will agree with me on this. Prescribing in this instance or in any instance is a clinical decision and it is important that prescribing decisions are taken by clinicians based on their judgment of what is in the interests of the patient. When it comes to the prescribing of anti-depressants, whether that is for children or for adults, it is really important that we do not talk about that in a way that stigmatises the use of anti-depressants because for some people that will be the correct intervention even if only for a period of time. Therefore, we need to remember that when we are having these discussions. What is really important, and I think that this lies behind Tess White's question and it is absolutely legitimate, is a situation where people are being prescribed anti-depressants because there is a lack of more appropriate alternatives. I think that that is where the responsibility on government is very serious, which is why the work that I referenced in my earlier answer, we are trying to shift the focus on child and adolescent mental health into a much more early intervention space. We are investing in councillors in schools, in early intervention mental health and wellbeing services in communities so that there are alternatives and where somebody is prescribed anti-depressants it is genuinely because that is the right intervention for them at that time. 6. Paul O'Kane To answer the First Minister what the Scottish Government's response is to the report towards a Scotland that cares a new national outcome on care for the national performance framework by the University of the West of Scotland supported by Oxfam Scotland, Carer Scotland, Scottish Care, the Scottish Women's Budget Group and One Payment Family Scotland. That is a timely report and we will consider it fully. The views of carers will be heard as part of the next review of the national performance framework, which is due to start next year. We are committed to creating a national care service to increase the quality of care and improve fair work in social care and are currently improving pay terms and conditions for social care workers. Carers make a highly significant and valuable contribution to our society and the wellbeing of the country. That is, for example, why we introduced the carers allowance supplement, providing over £230 twice a year on top of carers allowance to support around £91,000 unpaid carers. We provided an additional payment last year and we will do so again this month. We are also providing an additional £28.5 million for local carers support this financial year. Let me take the opportunity to put on record my thanks to carers all over the country and to recognise that this period of the pandemic has made what they already do and deal with even more difficult. I thank the First Minister for her answer. The past 20 months of the pandemic have highlighted the vital importance of all forms of care, whether paid or unpaid, yet those who look after someone overwhelmingly women remain badly undervalued and under rewarded with many living in poverty as a result. Does the First Minister agree that we must now make a long-lasting and deep commitment to change by locking in a new national outcome, focused on better valuing and investing in all forms of care and monitoring progress, and that would give a real focus and show how we value care and carers across Scotland? The national performance framework, before I address that specific, I absolutely agree that the pandemic has taught us lots of things, but it has particularly taught us the importance of care and the need to value and better value all those, whether on an unpaid or paid basis, all those who provide care across the country. I think that that is a very reasonable point to make. The framework will be reviewed next year and we will have the opportunity to consider a specific national outcome on care within the context of that wider review. The only other thing that I would add to that, of course, is that the national performance framework is intended to be a cross-cutting framework, so it is also important not to see anything in isolation that we capture all the different things that will impact on care within that. It is also really important that we value those who provide care, the national care service and the work to establish that will be very important. We need to pay those who work in our social care service more, and we need to, even though we do more to support unpaid carers than probably any Government in the UK, we have more yet to do, not just financially, but in terms of ensuring respite support and wider support for unpaid carers who do so much for their own loved ones but do so much to help the wellbeing of the country as well. To ask the First Minister what the Scottish Government's response is to the union connectivity review. We only saw the union connectivity review when it was published on Friday, so, understandably, we will take some time to consider our response. I do not think that there is much in this review for Scotland, to be perfectly honest, although we are very happy to discuss and consider what benefits there might be. What there is is an attempted power grab, taking decisions around priorities away from Scottish ministers, with a suggestion of funding improvements on one route being dangled in front of us. So if UK ministers really want to be helpful, why don't they just deliver the funding needed for infrastructure investment in line with the established budgetary mechanisms for Scotland so that this democratically elected Parliament can determine our own spending priorities in line with the devolution settlement? Well, it's perfectly obvious from that answer that the First Minister hasn't read a word of the review because it does nothing that she's suggesting that it does. I was pleased to hear from the Transport Minister earlier who, unlike the First Minister, is prepared to have talks with the UK Government on the funding for the A75. That would be a good thing. Actually, a theme throughout the review, if the First Minister bothers to read it, is that both Governments should work together. On that note, it says that both the UK and Scottish Governments previously agreed to develop options to support a rail journey time between Scotland and London of three hours. They were both working on it, but we know that transport Scotland officials were told to stop working on that. They were ordered to stop. Will the First Minister now allow them to restart that vital piece of work? That letter allegation there is just not the case, so I'm not going to engage further in that. I too heard the Transport Minister and agree entirely. I said in my original answer that, of course, we will discuss with the UK Government how we get benefit from the connectivity review. Let's not forget that it's not that long ago that we've been told that this connectivity review was going to deliver a bridge from Scotland to Northern Ireland. That was the big headline-grabbing commitment that seems to have just gone by the wayside. On, for example, the A75, there's no specific commitment to funding in that, so yes, we will discuss that. However, a really important thing that we have to determine here is that those so-called promises actually are delivered in practice. What we often find is either that the promises don't materialise to go on another issue. Earlier this weekend it was put to, I think, the Deputy First Minister in the chamber. The Prime Minister tweeted that the UK Government was ready to help the Scottish Government in our response to the storm damage yesterday. The Treasury confirmed to us that that didn't actually involve any financial support. We often have to scratch below the surface. The other thing that we need to check is that it is additional funding that what they are giving us with one hand is not being taken away from us with the other hand, because that very often turns out to be the case. So yes, we will discuss those things and hopefully we can come to a position where there is mutual benefit to be had there. I don't think that it should be a controversial principle in Scotland to say why don't we just do these things in line with the devolution settlement, in line with the established funding mechanisms, rather than a UK Government for political reasons trying to go over the head of the democratically elected Scottish Parliament. Our return to supplementaries, and I call Siobhan Brown. A new report from the ONS has shown that the Scottish economy has suffered a 6% hit as a result of Brexit, while Northern Ireland has prospered in the EU single market. Does the First Minister agree that this report lays bare that Scotland is paying an outrageous price for being ignored by the Tory UK Government as they imposed Brexit against our will, and that Westminster control is anything but a disaster for Scotland? Yes, I do agree. I'm not sure whether the Tories, while Siobhan Brown was asking that really important question, were laughing or groaning in despair, but they were certainly making lots of noise because they don't like the reality of this being pointed out to them. Brexit has been a democratic insult and offence to Scotland because it has been imposed upon us against our will, but what we are now finding out, including in the study that Siobhan Brown has cited in the chamber today, is that the economic impact of Brexit in Scotland is severe and is likely to become more severe. Actually, we are one of the worst hit parts of the UK. Conversely, Northern Ireland, which is managing to stay within the European single market, is not suffering that damage. That tells us that having these things done to us is not just undemocratic, it does us real damage, which is why the sooner we get all powers into the hands of this Parliament through independence, the better, so that no longer do we have to put up with things like Brexit. Evidence given by bereaved parents to the Scottish hospital's public inquiry is now to be kept secret after legal applications by the Scottish Government and Greater Glasgow and Clyde health board. This is a hugely concerning development and risks undermining the confidence of the public inquiry. The First Minister has already said that she will not tolerate cover-ups or secrecy from health boards. In this case, her own officials have acted to ensure that this evidence is heard in secret. Beyond the public inquiry, what steps will be taken now for the allegations made by parents, bereaved parents, to be fully investigated by Police Scotland? Miles Briggs is just wrong in his characterisation of this, and I would suggest that anybody who wants to understand the reality here should go and read the judgment, the decision of Lord Brody in this case. The family here have given their full evidence to the inquiry, so that information is all available to the inquiry. Of course, it is entirely for the police and the Crown Office to determine what information they need to access in line with any criminal investigation. The decision here, as is made clear in the published legal note from Lord Brody, was all about making sure that there was fairness towards all those with an interest in this inquiry and that individuals who had no opportunity to challenge allegations were not put in the position of having those allegations publicly made. Interestingly, the family's own council conceded that the applications were well merited and did not oppose those applications. Of course, Lord Brody can decide at any point to overturn that decision or reconsider it. That is entirely a matter for the judge. However, the reasons for the restriction order are fully set out in his published legal note, and I think that anybody who reads it will see quite clearly the reasons for them. Ross Greer Thank you, Presiding Officer. I have been contacted by constituents employed at City of Glasgow College who are concerned by college management proposals to cut facility time for their union representatives by more than a third. That is despite a significant increase in the demand for the support provided by staff unions due to the pandemic. I believe that the further education minister wrote to college management about this issue a number of weeks ago, but they are still refusing to engage seriously with staff unions to discuss their proposal. Can I therefore ask the First Minister if she agrees that it is essential that staff union representatives are given the time that they need to provide adequate support for their members? First Minister Yes, I do. Absolutely. With apologies, I do not know all of the detail in relation to the City of Glasgow College, although if the Further Education Minister has written clearly that is something that he has already had an involvement in. The management of colleges is for them. They are the employers of staff, but let me say unequivocally, as I have said many times before, facility time for trade union officials is an important part of ensuring that trade unions can do their job of representing and standing up for their members. It is really important for any employer, and it is a responsibility of the Scottish Government as an employer to take seriously ourselves to make sure that the facility time is there for union officials to do their job. I would very much hope that the college will meet trade unions and that that can be resolved satisfactorily. That concludes First Minister's questions. I heard from the First Minister earlier that the vaccinations and people will not be turned away, but I have been contacted just now to be told that in sterling, patients indeed are being turned away. Will the First Minister please get a grip on the situation? Mr Gilhane, that is not a point of order. Your comment is on the record.