 Good morning and welcome to the 13th meeting of the Covid-19 Recovery Committee in 2021. This morning we'll take evidence at the stage one of the coronavirus discretionary compensation for self-isolation Scotland bill. I'd like to welcome to the meeting Sandra McLeod, chief officer of Aberdeen City Health and Social Care Partnership, Michael Clancy, director of Law Reform, Law Society of Scotland, Mike Brewer, deputy chief executive of the Resolution Foundation, Susan McKellar, operations manager from Scottish Women's Convention. Thank you for giving us your time this morning. The session will be the first of the committee's evidence sessions on the bill. Before we hear from the deputy First Minister on 16 December, each member will have approximately 12 minutes to speak to the panel and ask their questions. We should be okay for time this morning, however I apologise in advance if time runs on too much. I may have to interrupt members or witnesses in the interests of brevity. I'll now turn to questions and if I may begin by asking the first question. If I could ask the panel in relation to the rationale for the bill and whether the bill as proposed is the most appropriate route for achieving its objectives, can I start with Sandra McLeod, please? Good morning. I feel that the bill in achieving its support for both people on low incomes to help them to remain in self-isolation is a positive move. In addition, I think that the impact from an NHS perspective in not returning to the previous date is also a positive move, given the impact that that would have. Sorry, I think that you just cut out there. Did you have anything else to add? No, okay. Thank you, Sandra. Can we move on to Michael Clancy? Good morning, everyone. Thank you very much indeed, convener. I am not going to comment on the appropriateness of the policy. I think that I can leave that to others to comment on, but what I can say about whether or not using the bill as the most appropriate measure will, of course, be alternatives. As the policy memorandum makes clear, those alternatives were considered to allow mandatory compensation provisions to resume when schedule 21 expires to issue regulations under sections 56 and 58 of the Public Health Scotland Act 2008. However, there were doubts about whether those regulations would be flexible enough or broad enough. Of course, it would also be possible for the Government to abuse powers under the coronavirus Scotland Act 2020, section 90, to extend the modification of the Public Health Scotland Act. However, that extension would only have been up to 25 September 2022 initially and would have been subject to six months extensions thereafter. I can see perfectly clearly why the Scottish Government alighted on the current solution, which is to produce the bill before the committee today. It seems to me—I hope that I am not talking out of churn—not having consulted any of my colleagues on that, but it seems to me that that is the most appropriate way to go. It is clearer. It allows the Government to achieve its policy objective. It also ensures that we get the opportunity to give evidence to the committee today. Mike Brewer, would you like to come in? Thank you, convener. The bill is an old one, is it not? It is basically there to stop the Scottish Government from paying out large amounts of money to everybody who has to self-isolate with an estimated cost of £300 million a year. However, it obviously focuses attention on the support that exists—it does exist—for those people who need to self-isolate through the self-isolation grant. Obviously, it is vital that that grant does continue while the coronavirus crisis continues and there is a pressing need for people to pay. We would support the bill that has been put before the committee, anything that will help families with low income, maintain some level of income that is coming in when they are having to self-isolate as of benefit. We would say that, obviously, with the uncertainty around coronavirus at the moment, with the new strains coming out, it is more important than ever that we keep that flexibility to be able to put that grant forward for those in the lowest income. Thank you, convener. Good morning to the panel. I have two different areas that I would like to ask about. The first question is to Michael Clancy. Good morning, Michael. It is just picking up a point that you make in your submission on behalf of the Law Society, which is a process point about the power for the Scottish Government to make regulations and the requirement that they should publish a statement of reasons along with that. You make the comment that you believe that it should be made clear that the statement of reasons should also explain why it is necessary to make the regulations urgently before they are approved by Parliament. Can you just expand on that? Please, Michael, and explain what the background to your thinking is on that particular point. Early. Let me just get the section in front of me. The powers for making regulations under section four of the bill include that if the Scottish ministers consider that regulations need to be made urgently, sections two and three of section four do not apply. The regulations that are then termed emergency regulations must be laid before the Scottish Parliament and cease to have effect at the expiry of 20 days, beginning with the date on which they are made. If emergency regulations are made, the Scottish ministers must at the same time lay before Parliament a statement of reasons for making the regulations. The point is that there is no definition of emergency. It is only if the Scottish ministers consider that the regulations need to be made urgently in section four and four, and why do the Scottish ministers think that the regulations need to be made urgently is the question that we are seeking the answer to here. That is why we suggested that the statement of reasons should also explain why the ministers require urgency in making the regulations before they were approved by Parliament. There could be many reasons for that. There could be a significant spike in coronavirus across the country. There could be some issues in relation to finance. There could be lost reasons. It is not really for me to speculate on what Scottish ministers' reasons may be in the future, but what we think is appropriate is that the Scottish ministers are transparent about the reasons for urgency. That is made clear to Parliament so that, in the contemplation of the regulations, after they have been made—remember, this is after they have been made—Parlament can then assess whether it was appropriate for Scottish ministers to take the route in section four and four. I hope that that answers your question. That is an issue that we can take up with the Scottish Government when we see them. I have a different issue that I would like to raise and maybe I can address this question to Susan McKellar, first of all, from the Scottish Women's Convention. I was concerned to read in your consultation response that, having consulted with women, none of them had been successful in accessing the self-isolation support grant or local self-isolation assistance service, despite all of them having to self-isolate. I do not know how many women you spoke to in this respect. It might be helpful if you could clarify that, but clearly that is a point of concern. The whole purpose of putting in place the grant scheme for self-isolation was to support those who are in that situation and need additional financial assistance. Can you give us a bit more background on that and explain why it is that people were not able to access the grants? Did they find it just too difficult to apply, or did they apply and where they turned down, or were there other reasons? We did a survey online, because we want to put a consultation in on the self-isolation grant. We put a survey out online and we did that through our network, so that reached over 4,000 women on our network. I think that there were more than 100 that I applied to the survey. We also went out to our networks and asked women who we knew had self-isolated if they had received the grant. Some of them did not even know what existed for them to be able to claim. Some of them said that they did not know how it would affect the current benefits that they were on. Some people were on universal credit and thought that, if they claimed for that grant, that would get taken off. In the future, there was not much information coming out from the advisers who were actually giving out the information. One lady had phoned to find out that she was entitled and asked if she was on benefits. She said no, but she was on a low-income bracket, but she never claimed benefits because she always worked. Because she did not claim the benefits, she said that she was not entitled when she probably would have been because she was on that—I do not even think that she was on the real minimum wage—but it was something that put her off from applying for it. We have instances like that. We also have instances where they thought that it would be too much hassle to go through that to try and get some money. By the time they got the money, they would be back at work anyway, so they did not bother. There was that kind of behind that as well. It depended on the health boards and stuff that we are putting out there. One woman said that she got an SMS text message saying to her that if she wanted to apply for the grant, she could do that by returning a message to the SMS. She did that and received nothing back seven weeks later. There are a lot of different things going on there that contribute to the fact that women are not able to access the funds. Some of them thought that they did not want to claim benefits because of the stigma and discrimination that is attached with claiming benefits. That was some of the findings that we found with the women that we spoke to. That is really helpful. Did you get any response from the women that you consulted with as to whether they thought that there was enough publicity around the scheme? Were they aware of it? How did they hear about it? What we heard from them was that there was not enough publicity about it. It should be in health centres and places where they were able to access during times. They should have been advised at the point of contact. It has been getting better, but near the beginning of the pandemic, when the grant was brought out, there was not much information coming out about it. Since furlough has been stopped, as you can see in your statistics, there has been more uptake in it because there has not been any other money coming behind that, so people are having to look for other things. That is when the uptake has started coming in, because furlough has stopped and people did not have anything else to help their income at that point when they were having to self-isolate. They said that, obviously, with the closures of libraries and things like that happening, it is making it more difficult for them to access, especially if you have technology poverty where you cannot get access online and your own home to get those things. It has to be more accessible for women in places that they are able to go during this period of time. They just felt that there was not enough support there to access those services as well and to talk them through it. I do not know if either Sandra McLeod or Mike Brewer want to add anything to that on this point. Sandra, you are nodding your head. Thank you. I think that there are some really valid points being made there, and I would just really like to share some of the local practice that has been happening within Aberdeen just to pick that up. I think that the poverty agenda is quite significant around about health, so it is important that we ensure that people can access all of that. I think that from a local area that we did have, we have received around 3,234 applications for the grant and around a 53 per cent reward rate only. However, initially, there was quite restrictive on how things were going, but changes have definitely helped that move forward. There has also been things that have been created such as the dedicated web page and created an online application forum. Schemes promoted when staff are phoning people to say that they are going into isolation and also offering if there is a requirement for help to fill in the online application and someone will phone back, as well as our crisis support line for people who may also help the online challenges there. It is just to say that absolutely acknowledging what Susan is saying, but just to say that there is evidence and people are picking that up to really try to promote that as an opportunity for people to help on that poverty agenda. It was at Mr Brewer that said that this is an unusual bill and that we are saving money rather than spending it. Can anyone clarify if we had left or if we did leave the 2008 act in place, I know that the figure is £380 million or something would be the cost, but what would an individual be entitled to instead of £500? Mr Brewer, is that something that you are aware of? I think that the answer is that that is not known. In the paper that was put to, and in the estimates that were made by the Scottish Government or by the Scottish Pots or by Spice, sorry, I forgot on which one it was, it recognised that the cost, this eventually is £300 million, so it might be very high because it might be that the Government would oblige to compensate high earners for the full loss of their earnings. That is one reason why they thought that the cost of not passing the bill would be very high. If you have to fully compensate everybody, regardless of their earnings, fully for their earnings, then that is going to be a very large cost to the Scottish Government. Is that what happens if somebody gets Ebola or something like that? Is the 2008 act ever actually used? I do not know if any of the other witnesses can help me in that. It does not look like it. No, okay. I will ask the Government that one when we get there. As a comment, Sage had said that we need full pay and comprehensive support, but that would be very expensive. I know that we are not looking at the level here, but some of the responses that came in looked at the £500 level. Is the £500 appropriate? Has it been working? You are saying that a lot of people have not got it, but do you feel that £500 is appropriate, or should it be higher, or should it be organised in some different way? For us, the £500 is beneficial to anybody that is not getting any income. When we spoke to the women that we spoke to, quite a lot of them were on low minimum income wages. They were in jobs in the hospitality sector, and they were in jobs that were precarious—there were zero-hours contracts and things like that. For them, any money would have helped, but they did say that the ones that did not claim that the loss of money that they had was in real-time benefit. As in, there was more electricity costs, food costs and the fact that, even when they were trying to do their shopping, they were having to do that online. It was shops that delivered that were more expensive than shops that did not deliver, such as the supermarkets that Alde and Lidl do, but they are a lot cheaper than going to say, as the Morrison and Sainsbury's, but they are the only ones that can do the delivery. They did say that the costs that one woman went into her savings and used quite a lot of her savings during that period, because she did not want to claim that she did not think that she was entitled to claim those benefits. What we would say is that £500 would be a fair estimate, but it should go in line with real-life poverty as a major factor, so ensuring that that is meeting the real wage criteria might be more than £500. You would have to look at it on each aspect of what that person was earning and what technically they are missing out in including their electricity, their food and things like that. The figures are only one in eight. Workers are entitled to the payment anyway, and you have made the point that some people are not getting it. What about a single woman with children, a single mother who is a bit further up the scale, but just managing her mortgage, just managing food and electricity and all the rest of it? She is not going to get anything for self-isolating. Is there a problem there? Yes. We think that there is a problem there, because those are the people who can get tipped into that poverty bucket. Ten days is a long time, before that was 14 days, is a long time not to have any income. If you are not entitled to that grant, your employer might only pay you statutory sick pay, so you are losing a big chunk of your money and you probably do not have any savings there to dip into. It actually is putting you back and you are always trying then to get back on your feet to get to an even keel. With those costs going up as well, with regards to electricity, your fuel poverty is a major thing at the moment as well as food poverty and insecurity. More people are trying to access food banks than ever before, and most of them are working. They would be in that category. I think that it should be looked at on that basis, whether it is the real time, how much is this going to cost, and would that put that person under that real living wage? If it does, then they should be entitled to that grant. We saw figures that, when people are asked if they do self-isolate when they are meant to, 94 per cent say they do, but in practice, in reality, only 74 per cent are doing it. People's claims are somewhat out of line with what they are doing. What is your feeling about self-isolation? Is it actually working? Are people doing it? Our understanding is that it is one of the key contributors to help to break the chain of spread. From our understanding, it is something that is helpful. It is progressing, but there will always be people who choose not to follow the guidance and who choose not to. Susan rightly highlighted that the bill is trying to achieve anything that we can do to encourage people to help to support that and to help to support self-isolation as a positive step. Is there anything that we could be doing apart from paying the money? I am not sure. We are encouraging people to do that. We can give the acknowledgement that we have our contact tracers. Everyone is there. There is a high level of support that is given volunteer assistance—all that is in place—but sometimes it will come down to personal choice and whether people are willing to expose others to the risk. I was quite interested to hear what Aberdeen health and social care partnerships are doing in terms of promotion around this grant. It would be good if you could send some of that information to us. Is there a general issue—in any member of the panel, I think—that we need to do more? Government, firstly, in terms of seeing what it is doing and what is happening on the ground to promote the fact that people can get some kind of support if they are struggling? I think that we can always do more to support those kinds of grants and initiatives. The problem is that we are getting bombarded with so many different messages, and they are changing quite a lot. People are not sure what the current guidelines are and what processes they should go through. I think that when we are thinking of how we are promoting isolation and staying in, the adverts are great, but they do not say that you are entitled to it. There is not really anything on those TV adverts or anything like that to say that check this national phone number to check if you are eligible for our self-isolation grant. I think that more has to be done with regard to that. We have had over 700,000 people with Covid. I think that you have frozen there. Can we bring in Michael Clancy? Thank you, convener. There were two thoughts that crossed my mind in relation to the discussion, unless Sandra is back now in live motion. Maybe she wants to conclude her point. Sandra, would you like to come in? Sorry, she is not back yet. We cannot see her on our screens. Okay, very good. Okay, thank you. Two thoughts that crossed my mind. First, under section 56 of the Public Health et cetera Scotland act, there has to be a notification in writing that person is required to quarantine or self-isolate, as we call it. Therefore, it would possibly be that that notification in writing should be the place where information about the grant is made available directly to the individuals who are concerned and would be eligible to get a discretionary payment under the act. Therefore, that might be a way in which one could invite the Scottish Government to explore getting the information directly to those who might be eligible to claim the self-isolation grant. The second point is that, Mr Mason's point about 90 people saying that it will comply but only 70 per cent do. If there is a dispute that arises under section 56 of the Public Health act about persons entitlement, in other words, have they self-isolated or the amount of such compensation is the right amount, then there is a dispute mechanism in the act, which allows for an arbitration provision. If that does not result in an agreement, that would then go to the sheriff. Applying those sorts of solutions to questions about entitlement to the grant may take another leap of faith and might need some further tweaks to the legislation, but it gives us an idea of solutions to the issue of getting notification about the information, about the question of who is isolating and whether they are doing that and how one can resolve a dispute that might arise about entitlement to the grant, rather than compensation under the act in the round. I hope that that is helpful. Thank you, Mr Clancy. We have Susan McCulloch's back. She would like to come back in. Hi, sorry about that. I just lost my signal. What we are saying is that the more that could be done with regards to adverts and stuff, that to show people, especially ones on low income, that there is some support there would be helpful for them. There are instances of just listening there to make a list and with regards to the grant. I think that there has to be discreations in there. We had one woman who said that her contract for a new job was due to start the day after she was told to isolate, so she was not entitled to the grant or any statutory sick pay, so that left her in a prec areas position for 10 days. We have to look at those kinds of discreations amongst this bill. We have moved it forward with regards to the grant and some of the criteria that Sandra had said before. I think that we need to look at certain conditions. We need to look at it intersectionally to see what kind of things can happen and how we can make sure that as many people as possible can get that grant. I was trying to say that we have had over 730,000 people positive with Covid and only 43,000 of them. We are looking at that 6 per cent uptake. We know that poverty is a lot higher than that, so we know that people are not claiming, so we need to do more to make sure that they are aware that they are able to access that. What we would say is that people are not getting reasons why they are being rejected sometimes. It is just that your claim is unsuccessful. I think that we need to be more transparent about why those claims are being rejected and keeping information and data about that so that we can follow that to see if there are certain groups that are missing out on that and for what reasons. I thought that those points were really important in terms of looking at the wider spread. Can I just quickly come in and ask Michael just a quick question around the relevance of the 2008 act? There is consensus that it certainly would not be suitable in terms of the current Covid, but is the act itself too widely drawn? Do we need to actually visit the act at some point? I think that it is fair to say, Ms Rowley, that we have recommended that the whole vista of emergency legislation in relation to or different emergencies might need some revision because the options that would be at the hand of government prior to the pandemic would have been to deal with things under the Public Health Scotland Act or under the Civil Contingencies Act. We have not seen or heard of the Civil Contingencies Act since it was enacted and applied in relation to some agricultural emergencies in the early 2000s. There is a need to look at why we got into the position where in 2020 the Coronavirus Act of 2020, the UK act, had to be enacted at such speed with only four days parliamentary consideration in Westminster. Why was it necessary for the first Coronavirus Scotland Act to be taken under emergency procedure in the Scottish Parliament? We can understand why the second Coronavirus Act could be taken at a little bit more leisure, but nevertheless, fact that we had to make all this law indicates that our previous law for dealing with emergencies might not have been up to dealing with the problem and fit for purpose. Now, perhaps after the current emergency is fully over—I cannot begin to predict when that will be—we should all get our heads together and look closely at our emergency legislation and apply it, because clearly the Coronavirus legislation only applies to Coronavirus. If some other viral agent or some other form of emergency were to be visited upon us, what would we do then if we could not just apply that act to such a circumstance? We need to look at our law for emergencies and make sure that it is fit for purpose and flexible enough to meet every contingency. Thank you. Can I bring in Sandra McLeod? Hi, it is my response that has been covered by the two witnesses. Michael, I would like to come back to you quickly on the point that you were just talking about. The Civil Contingency Act was brought in during the Footh and Mouth outbreak in 2000. That was to stop people's access to the countryside, going on farms and so on. Is that a UK act? Does the Scottish Government have any access to that? Is it reserved, or can the Scottish Government use the Civil Contingency Act? Let me just call it up so that I can answer your question. It was enacted in 2004, and it covers all kinds of civil contingencies, not simply things like Footh and Mouth. It was not directed specifically at Footh and Mouth, but it was directed at all kinds of emergencies. The meaning of the emergency under the act is an event or situation that threatens serious damage to human welfare in a place in the United Kingdom, an event or situation that threatens damage to the environment of a place in the United Kingdom, or war or terrorism that threatens serious damage to the security of the United Kingdom. For the purposes of explaining that, it goes on to describe the loss of human life as being one of the causes or features of this disruption to services relating to health. It is another aspect that is clearly in this, and human illness or injury. One could argue that it could have applied to the coronavirus situation, but, in evidence to perhaps the Constitution Committee of the House of Lords or the Public Administration Committee in the House of Commons, Michael Gove explained that the act had really only been brought into effect in contemplation of something larger than a virus, but rather more focused on war or some other contingency. The coronavirus legislation is one thing that has been brought in specifically for the purposes of dealing with Covid-19. The Civil Contingencies Act is a much broader conspector, and it is more applicable to other forms of disruption to our national life. Is it amendable by the Scottish Parliament? It is a UK piece of legislation, so I think that the answer would have to be no. I have not checked schedule 5 to the Scotland Act, but I think that perhaps civil contingencies are a reserved matter. You have just raised something that I have not thought about at all. I have never even heard of the Civil Contingency Act. I assume that it was foot and mouth when you said it was early 2000s. However, if the Civil Contingency Act is there and what we currently have is the Coronavirus Act, going back to what you said that after this is all done and dusted, we need to look at some kind of public emergency act. Coronavirus has not just affected people's health. Should it have been looked at in a broader picture and used the Civil Contingency Act because it has affected business, it has affected freedoms, it has affected poverty, it has affected every aspect of society, so would it not have made more sense to use the Civil Contingency Act rather than a health act? It is possible to debate the merits of which piece of legislation you deploy for each and every kind of circumstance and challenge that the country faces. It is likely that somewhere the Civil Contingency Act legislation was looked at and discounted as giving the UK Government and the devolved Administrations adequate powers to deal with what was recognised as a global threat in very quick order. It was probably the right decision to go for a stand-alone piece of legislation that dealt with the coronavirus, which was comprehensive and dealt as much as possible with the types of problems that the Governments, because at that time there was the four nations action plan in place to cope with coronavirus. The four nations agreed on the coronavirus act as being the first part of the building block with the devolved Administrations in Scotland and Wales, taking on more in terms of legislation and subordinate legislation, growing exponentially across all the aspects of restrictions on movement and other things. It is fair to say that it was the right thing to do, and the Civil Contingency Act was probably thought about and discounted for the reason that it was not as broad-based and did not provide adequate powers to the Governments operating in and throughout the UK. I think that that is probably the reason why. I am being an absolute pedant here and I apologise. If we had gone down the Civil Contingency Act, would it not have been the same principle that those powers would have been devolved for the period of time to the devolved Administrations to allow them to use it? Well, the Civil Contingency Act, we are taking it off the topic of the day, but the Civil Contingency Act I think was created with a different perspective on the challenge that might be faced. Sure enough, parts of the act are usable in a way in which the act divides up the issues of urgency, consultation, enforcement, etc. The use of emergency powers is something that can be determined by a senior minister of the crown, but you would essentially be rewriting the Civil Contingency Act to take account of coronavirus, and you would end up with the coronavirus legislation if you were to try to modify the Civil Contingency Act to make it clear which authorities were being empowered to do what and what powers were being given. I think that it was probably the right decision to go with the specific coronavirus legislation and to deal with that in the way in which it has been dealt with, which was originally on a four nations legislation piece in the coronavirus act of 2020, and yet allowing the devolved Administrations, and particularly in Scotland, the Scottish Government and the Scottish Parliament to make law that was specific to Scotland, which dealt with amendments to Scottish law in the devolved sphere. We can cite examples of that in relation to movement in and around Scotland, movement out of Scotland, the questions about the way in which the courts operated, the questions about other things as well. I think that we would have ended up in the same place in one respect, but the right answer was chosen to enact legislation specific to the threat of coronavirus. Can I just ask Mr Felly, is this your next question in relation to the self-isolation bill? No, I'm going to ask Sandra. Sorry, not Sandra. Susan, you had 100 respondents to 4,000 people that you sent a questionnaire out to, and I'm absolutely not disputing the fact that we've got to get our message and everything better, but the fact that you only had 100 respondents, did you get the 100 respondents who didn't get it and 500 did? How would you know how many people aren't getting it? In Aberdeen, we've got 3,234 respondents and a 54 per cent's access rate, which isn't high enough. I absolutely accept that. Why was your respondent rate so low? I think that it was so low because everybody else has got everything else going on at the moment. It is a busy period, especially for women who have had the joys of having to homeskill, who have had to make sure that they were caring for other family members during this time, because they are always predominantly land-owned women. For the ones that responded to it, they were most upset about not getting the grant because of the situation that it put them in. I think that the reason that it was low was because other women were doing other things, and they weren't even aware that that was a grant to claim. We think that it was a low response because we sent it out there and we just took in what we can. We went out to networks and asked other women as well from different organisations what their information they were getting back. Although it was 100 women that responded to the survey, it is probable that because of everything else that has been going on, quite a lot are women members, like teachers, parents, older adults and some of them do not have the technology to be able to answer the surveys for us. That is a huge issue. Obviously, at the Scottish Women's Convention, we are trying everything that we can to reach as many women as possible. However, when some of the women in the islands and the highlands have not got broadband, we cannot get their views as readily as what we would be able to. We did not have the support at the time to be able to phone to get more respondents to give us that information. However, the ones that we did get were because they had a negative effect on that and wanted us to be aware so that we could pass that on to the Scottish Government and the health boards. They were from different health boards and different health boards had different outcomes. One of them was in Westin Bartonshire, another one in Glasgow, and they had totally different ways of which they were dealt with with their health boards. It just goes to show the parity as well with who is dealing with you, because Aberdeen signs as if they are getting it right. From what we hear, Glasgow is doing quite well as well, getting that message out there and informing people that there is a grant for them to be able to get. However, there are other health and social care partnerships that are not doing as well, but that might be to do with the way that the NHS is running in those areas if they are at capacity because of Covid and coronavirus. Quite a lot of the women who are part of the Scottish Women's Convention are aware of that. The NHS is to be protected, and some of them did not want to apply because they knew that it was going to take quite a little time away from other things for the NHS. That was another reason that was given to us, so that is just some of the background information on that. I will put up a reasonable brief, because a lot of the points that I want to cover have already been spoken about. The self-isolation grant is there to encourage people to self-isolate, and it is not put into a position where they have to make a decision whether to self-isolate or pay the bills. With that in mind, there are a couple of points that I was going to ask Susan McKellar. You talked earlier about the impact on those who are on zero hours contracts or part-time work, where their inability to work would perhaps be felt most keenly. Do they have an issue around having to prove loss of income in those particular circumstances, and does that then cause a difficulty in accessing the grant? At the end of the day, it is easy to access to the grant. You also mentioned those who perhaps are not within the criteria for the grant, but perhaps their income versus expenditure is a finely balanced—as many of us are—and their inability to work would seriously impact their ability to pay their bills, so is the scope of the grant wide enough as well? We do not think that it is, in relation to real-term what people are losing money-wise. In relation to women who were on zero-hour contracts, what they said was that it was because of that precarious work. Even if they were to isolate for the 10 days and they did not get that because they could not, they were not going to be affected by shifts going forward as well. Some of those employers are very unscrupulous and they do not use employment law the way they should. The workers are not protected. That was something that came up about unions because we spoke to women about being part of unions, especially with zero-hour contracts. It was about the fact that that cost money, even though it is quite low, and they do not want to rock the boat because that might stop them getting shifts in the future, which would have a serious impact. Some of the women who had been told to self-isolate would isolate, but they were getting pressure from employers to hurry up and get back to work because they were short staffed. They are getting that kind of impact as well, which then has that psychological impact on the person saying, I need to try and get back to work as soon as I can. You are not entitled to a grant. You are not getting that money. It puts that pressure on for you to break that isolation. We need to look at that as well. We need to look at the income with regard to the zero-hour contracts, because some weeks they could get 32 hours and other weeks they could get 8. We need to look at how overall their income generally runs like you would do. The Government do with regards to tax credits. You are paid for so much if that goes up, that reduces that idea. We need to look at that when we are looking at that grant. Especially for women who are on that red line. If being isolated is going to cause them to, in real terms, not achieve that living minimum income that they need, they should be entitled to get that grant. That should be something in there that they are able to claim for that and prove that that is the case. I have just a final quick question to Sandra McLeod about the impact on the health boards of the self-isolation bill. How is that impacting on your health board? Within the health board specifically with regard to the grants. I have checked that there was previously not a huge uptake for the 2008 act, as was said previously. The act and the grants are actually managed through the local authorities. People will be informed through contract tracing, so that is just something. When people are contacted to say that they have to require to isolate, the contact tracers will advise them and say, do you need assistance? Do you need to advise them of the grants? They will make them the link to the local authority. The impact on the health board at this stage would not be significant in a positive way. If it was not in place, the workload and the effect and the distraction to be able to claim and to process all of that payments would have had quite a significant effect on the health board. That is in a way being positive and has allowed us to really work with key partners across the system. It has allowed our local authority colleagues, our health board colleagues, and then linked into our third sector to really have that community and public community planning approach to that. I would say, just to summarise, that there is no minimal impact on the health board, which is how it was intended and which is a positive impact on the health board's being able to deliver their services. Does any other members have any more questions? I would like to thank the witnesses for their evidence and giving us their time this morning. If witnesses would like to raise any further evidence with the committee, they can do so in writing and the clerks will be happy to liaise with you about how to do this. Thank you very much. I briefly suspend the meeting to allow a change over of witnesses. Good morning. We shall now move to agenda item number two. The committee will take evidence from the Scottish Government on the latest ministerial statements on Covid-19 and subordinate legislation. I will start by saying a few words about the draft health protection coronavirus requirements Scotland amendment number four, regulations 2021. Last week, the minister of parliamentary business asked to speak to me about the changes to the Covid vaccination certification scheme outlined by the First Minister on 23 November. At this meeting, the minister explained that the Government is mindful of the concern expressed by this committee and the DPLR committee about the use of the made affirmative procedure. The Government has therefore suggested an approach whereby an expedited affirmative procedure might be used on this occasion and members will have seen from the correspondence from the minister of parliamentary business explaining the Government's position. On this occasion, I was minded to accept this suggestion. This means that the regulations were formally laid on Monday and were considered by the DPLR committee on Tuesday. Following its consideration of the regulations, the DPLR committee has written to this committee and members have a copy of that correspondence. Following our consideration of the regulations this morning, the regulations will be taken to the chamber at decision time later today. While I was minded to agree to the expedited timetable for scrutiny proposed by the Scottish Government on this occasion, this should not be viewed as setting a precedent for scrutiny going forward. That is something that we could keep under review. I would like to welcome to the meeting our witnesses from the Scottish Government, John Swinney, Deputy First Minister and Cabinet Secretary for Covid Recovery, Professor Jason Leitch, National Clinical Director and Elizabeth Sadler, Deputy Director of Covid Ready Society Scottish Government. Thank you for your attendance this morning. Deputy First Minister, would you like to make any remarks before we move on to questions? Thank you, convener. I am grateful to the committee for the opportunity to discuss a number of matters, including updates to Parliament this week and last week on Covid-19 and the instruments to which you have just referred. I set out with the First Minister on Tuesday while case numbers in Scotland have continued to fall, the emergence of the Omicron variant is deeply worrying and requires a proportionate and precautionary response. There are now confirmed cases of Omicron in Scotland and Public Health Scotland are working hard to identify any and all cases as quickly as possible. There are indications that Omicron may be more transmissible than the Delta variant, which is currently dominant in Scotland, although at present there is no evidence to indicate that the disease caused by Omicron is more severe than that caused by other variants. Our understanding of the new variant is developing and we will know more, especially regarding the protection offered by vaccines in the days and weeks ahead, thanks to the dedication of scientists across the world. Although I very much hope that our level of concern will reduce in coming weeks, our precautionary approach is the right one for now. As the First Minister set out on Tuesday, at this stage we are not introducing additional health protection measures beyond some necessary travel restrictions. Instead, we are asking everyone to renew their focus on following existing protections. We need people to wear face coverings where required, maintain good hygiene, work from home wherever possible, ventilate indoor spaces and test themselves regularly. Those protections are especially important as cold weather, and the possibility of festive gatherings mean that we may be spending more time inside with other people. This week, the JCVI updated its advice, which means that at least 1 million more people are now eligible for booster vaccines. That is good news, as we know that vaccines are effective and save lives. Indeed, according to a study published last week by the World Health Organization, there may be more than 27,000 people in Scotland who are alive today only because of the vaccines. With over 88 per cent of the adult population having had two doses of the vaccine and over 93 per cent one dose, Scottish ministers now consider it proportionate to amend the certification scheme to include negative test results. This change will make it possible for people who cannot be vaccinated or who are not yet fully protected and individuals who receive a vaccine not recognised by the MHRA to be able to attend venues covered by the scheme. The health protection coronavirus requirement Scotland amendment number four regulations 2021 make the necessary amendments to the Covid-19 certification scheme. With effect from 5 am on Monday 6 December, the scheme will allow people to show a record of a negative test for coronavirus, taken in the 24 hours previous to attending a venue, as an alternative to proof of vaccination. Certification continues to play a role in helping us to increase vaccine uptake to reduce the risk of transmission of coronavirus, to alleviate pressure on our health and care services and to allow higher risk settings to continue to operate as an alternative to more restrictive measures such as capacity limits, early closing times or closure. I am very happy to answer questions from the committee. First Minister, the reason for us agreeing to the expedited timetail for the Scottish Government's view that the regulations are required to come into force on 6 December for the record, could you please explain why the Scottish Government considers it the sixth of December and not another date is when those regulations should come into force? Essentially, convener, we want to ensure that the regulations are in place to facilitate an increased level of protection and assurance in the run-up to the festive period. Obviously, from 6 December onwards, people will be engaged in the activities that are habitually associated with Christmas, with retail and hospitality opportunities. Therefore, putting in place the regulations at a moment where we are preparing for such events is the pragmatic approach that the Government wants to take to maximise protection and to maximise the involvement of members of public in the assurance that we are trying to create. In light of the new variant and also trying to suppress transmission, I have a comment and a question from members of the public. One of the comments is that I work as a symptomatic Covid-19 tester. My colleagues and I find it shocking that people who come for testing will arrive with families and friends in tow. Sometimes we get full carloads, usually no one is wearing masks and it is obvious that they have been to a drive-in fast food outlet before attending for their test. We have been told that they are now had their test and they are taking their family out for lunch to cheer them up. This brings me to a question from Geraldine from South Ayrshire. What is being done to ensure people who self-isolate while symptomatic or waiting for test results as a message does not appear to be getting through? I think that the importance of the, there are a number of points in the question and the scenario that you put to me convener, a key response is the necessity of ensuring that the baseline measures are habitually followed by everybody in all circumstances, whether one is going for a PCR test or not. There are baseline measures that are important that should be applied, so ensuring that people are wearing face coverings in the appropriate settings to make sure that people are following the basic hand hygiene measures, they are all absolutely critical at all times. The Government, as members will be familiar with, is habitually in our public messaging in Parliament but also in our wider public messaging through television advertising etc are reinforcing those messages. The second point that I would say is that when individuals are coming for PCR tests, the highest and greatest degree of care has got to be taken. The individuals who are coming for PCR testing, in the scenario that you put to me, if a whole car load of people from the same family are being tested, then it is understandable that everybody is in the car. I would encourage people only who need to go for PCR testing and to observe all the hygiene measures that are appropriate in those circumstances. The final point is that when it comes to observing the self-isolation requirements, the guidance could not be clearer or the requirements could not be clearer. For example, if an individual has symptoms or has caused to secure a PCR test, or if they have undertaken a lateral flow test and have tested positive, that should instantaneously bring about a change in behaviour because that person is potentially infectious. Therefore, every bit of care has to be taken in relation to the movements of that individual and the observation of the restrictions that are appropriate to make sure that they are minimising the risk of transmission. I can assure the individuals who have contact to the committee that those messages are uppermost in the communications of the Government. Thank you very much. It is really important that we reiterate the importance of the guidance and following it. I move on to Murdo Fraser. Thank you, convener. Good morning, cabinet secretary and other witnesses. We were discussing the Omicron variant and the impact that we have. I think that it is now generally understood that the best way to try and address this is to accelerate the booster programme. We heard yesterday about a number of incidents of individuals who turned up at vaccination centres expecting to be given the booster and were then turned away because it had been less than 24 weeks since their second jab, which clearly was not in line with the new Scottish Government guidance. Has that issue now been resolved? Yes, the issue has been resolved. I regret very much that some individuals had the experience that they had yesterday, because the guidance changed and that should have been applied in all vaccination centres and scenarios. In the light of what emerged in what I am advised was a limited number of cases yesterday, we have reiterated the guidance to all health boards to ensure that all vaccination centres are operating to that new updated guidance, which of course only emerged at the start of this week. However, I regret the fact that some individuals were inconvenienced in the way that they were. Obviously, the fact that people are so willing to come forward for the booster jags at such an early stage after the change of guidance is an indication of the public attitude to participate in the programme, which is welcome, which makes it doubly disappointing that people were inconvenienced in the way that they were. Okay, thank you. That is very helpful. You have just referenced the fact that there will be substantially increased demand now for boosters. I think that the public will expect this. They will be seeing the news headlines around the Omicron variant and will be concerned about that. Therefore, there will be a lot of extra demand. Is this capacity in place, therefore, to respond to that demand and what steps are being taken to increase that capacity, particularly over the coming weeks? In terms of the capacity of vaccines, yes, the capacity is there. There is no issue with that. Obviously, we have to go through the process of vaccination in an orderly fashion to make sure that it can be done efficiently. We have already expanded significantly the availability of vaccines as part of the programme. Obviously, the change in JCVI guidance on Monday increases the number of people who are then eligible for a booster vaccination at this particular moment. If my memory says we are right, I think that an additional 1.3 million individuals immediately become eligible. Colleagues will understand that we cannot vaccinate 1.3 million people in one day, so we have to increase capacity to move through that as efficiently as we possibly can. That work is under way to ensure that we are satisfying that understandable demand that there will be in the community. I am confident that we will be in a position to administer all of—Prior to the JCVI guidance, we were confident that all eligible individuals would be able to secure their booster vaccination before the turn of the year. We are confident that, with the new JCVI guidance in place, we will be able to reach that point by the end of January. Obviously, there will be a period of time when people will have to wait some weeks to secure their booster jag, but they will certainly be getting it earlier than would have been the case in any other circumstances if, for example, they had to wait 24 weeks after the second vaccination that they received. That is very helpful. Can I ask about the connection between the booster jab and the flu jab? Many people, including over 50s—which you and I, the cabinet secretary, will fall into that category—have been invited for boosters to get the flu jab at the same time, but in some cases that means that they will not be getting an appointment until January. Is that a risk? The peak flu danger season, presumably, is early January, so the fact that we might not be getting a flu jab until January, is that not creating additional risk for people? I will bring in Professor Leitch on some of those questions because we get into the assessment of clinical risk. If I perhaps explain the thinking behind the programme, essentially we took a decision this year to vaccinate more people than ever before for flu along—and whilst we had a commitment to administer the booster jags for a range of population groups. Our judgment was that the most effective and efficient way of doing that was to, as far as possible, combine the flu and Covid booster vaccination programmes to ensure that we were using resources wisely. We were calling people in when they could get two doses together. I had my flu and booster jag on Sunday in a very efficient programme in Blygauwri town hall. The programme is designed to try to make as much progress as possible. Obviously, there will be some individuals who are getting a flu jag probably slightly later in the year than they would have got it on a stand-alone programme arrangement. Professor Leitch can set out the clinical issues around that, but what we are trying to do is to maximise the protection that is available to individuals and the protection that is available within society in as efficient a programme as we possibly can do. Although I accept that, for some individuals, they may get a flu vaccination slightly later than they would ordinarily have received it. The DfFM is right. A couple of things about flu. There isn't any just now, so no panic. Nobody needs to worry yet about catching flu. There are single-figure numbers across the whole country. I don't anticipate that will last. The flu season is later than we think it is in our heads. Most people think that flu comes with the winter. It does, but it takes a bit of time. The real flu season for hospitals is into the new year. It is into January, February, March and April, so it is not usually November and December. There are exceptions in the year, but this year is not. It may be that we are going to get away with fewer numbers than we usually get, and that would be fantastic, because the hospitals could really live without more respiratory disease, frankly. We will need to make a judgment about when we start to call people for flu because the Covid appointments have now shifted. People who were expecting to get Covid and flu in January, that probably stays, but if they are getting Covid in March, I would expect you to go for your flu vaccine before then. Each board will make a judgment now that we have changed the Joint Committee's advice. We have changed the operational plans. Part of those operational plans are the flu vaccinations, so we will now shift some of them forward and backward. It may be that we can do more joint than we thought, because we were going to bring people in. That will all get sorted out at a board level and people will be told. If people are confused or worried about it, they can talk to their own GP. They might well not vaccinate them, but they can at least reassure them about where they are in that process and the risk that they are facing. Can I pick up? The First Minister said that the capacity is there. There are no issues with that. I noticed a tweet there just as you came in for something. Cercode, who says, turned away from my Covid booster in Cercode this morning, seems the message still hasn't filtered down. It wouldn't have been a big deal, but the place was deserted. It is this question about the mismatch between what the Government is saying in this place and what is happening out there. Tuesday night, I went along to the drop-in centre at Dunfemin. It was open from 5 to 8. I had queued for about 40 minutes. I got to the front door of the vaccine centre at about 25 past, at which point the staff announced that there were an R50 still waiting inside and that they were going to have to stop. Although I was lucky that I got in, there were about 40 turned away, that doesn't suggest the capacity is there. More importantly, once in, the staff told me that one had to put up quite a bit of abuse because of the massive long queues. The staff were brilliant. Clearly, they had never lifted their heads for the whole evening. What they were saying is that it is fine for politicians to stand up in Edinburgh and tell people to go and get their boosters. However, if we haven't got the staff in place, we are not prepared for it. There is a clear mismatch and a struggle. Where are we at? Obviously, there are a phenomenal number of operational issues about the running of a programme of this magnitude. We have to bear in mind the numbers. We have now passed 10 million vaccinations that have been undertaken. It is a colossal undertaking that has been achieved as part of the programme. I pay tribute to the staff who are delivering the vaccinations, but also to those who are organising the programmes, because it is not a simple logistical exercise. There are a number of points in Mr Rowley's question to me that I think need to address. The first one is in relation to the tweet that Mr Rowley has just raised with me. We have reiterated the guidance to health boards. It is important that that guidance is applied in all scenarios and circumstances on the ground. I will take away the fact that there has been an example raised with me where that message has clearly not reached all of the distribution points for the vaccination programme. Obviously, we have had a change of circumstances of the advice, which is relatively new, so it takes time for those messages to get across, but I will make sure that that is taken up. The second point is in relation to the capacity questions. When I answered Murdo Fraser, I said that there was certainly capacity in terms of the availability of vaccines, so there is no adequate provision of vaccines. The question will be about the best means of administering that programme at a local level. Of course, there is a whole range of different options about how we might go about doing that. There are probably, I suppose, three main options. There is drop-in, there is self-selection of appointment by the online portal, and there is setting of appointments by letter by health boards. Obviously, if we set letters and with each option there are upsides and downsides, setting letters out gives an order and an organisation to the programme. The downside is that it takes time to get all that infrastructure put in place to administer and distribute the letters, and also there is quite a reasonable level of do not attend on the appointments that get put out. We have opted for the portal option in some circumstances. The portal option gives the choice to people to select their appointment. I was able to choose Bloor-Gowrie Town Hall on Sunday morning, suitably down the ground, and I got my vaccination. For some people, digital access is a challenge. For other people, they may find that there are no appointments to suit their choices. Drop-in, as Mr Rowley has recounted, can be quite challenging if too many people decide to drop-in at the one time. Mr Rowley cited the Cercodi vaccination centre this morning, where the member of the public who has tweeted said that it was quiet. The one that Mr Rowley went in Tuesday night in Dunferman was very busy. The smoothing of demand is quite difficult in a drop-in-only system. What we have tried to opt for is a means of balancing out the best of those if we could possibly can do. When I went on Sunday morning for my vaccination, there was a couple behind me who were dropping candidates. They were not put into a different queue or anything. They were right in the queue behind me, and they got taken just right after me. We are trying to work through every possible practical permutation to maximise the amount of access that we can have in place. Obviously, if there are 1.3 million people who are now eligible for a vaccine and they all decide to turn up for a drop-in vaccination service today, there will not be adequate places to enable all 1.3 million to be vaccinated. We are trying to balance that programme over the country with a number of different mechanisms to enable us to maximise participation in the vaccination programme. There is a lot that we do not know about the latest variant, but what we seem to know is that the evidence coming out of South Africa is in terms of how quickly it spreads. It is a massive worry to all sign this. The evidence seems to be there that this thing can spread much more than the delta variant, which in itself at the time was bad. Given the fact that people are queuing up for boosters and being turned away because the capacity does not exist, do you not think that the Government needs to look health board by health board and look at what is in place and what needs to be put in place? The health secretary the other day was basically on the radio telling people that there was not enough staff and there would not be enough staff because you cannot bring staff to all other parts of the NHS, but what needs to be done? What other professions could be brought in and trained quickly to be able to support? What we need is a mass vaccination surely to happen as quickly as possible, and that is only based on the evidence that we have seen today. We do have a mass vaccination programme. We have a mass capacity under way. We are vaccinating. We are distributing about in excess of 60,000 vaccinations on a daily basis in Scotland today. We are the most vaccinated part of the United Kingdom with the highest levels on all first, second and third and booster vaccinations. We have a very comprehensive mass vaccination programme. The Government is looking health board by health board. Health boards have submitted their plans to government about how they can intensify the vaccination programme, and that dialogue continues between the Government and health boards to maximise that capacity. This is a programme that has got to take place in a whole variety of different geographies around the country in different scenarios. I assure Mr Rowley that we are trying to maximise the capacity of the vaccination programme, but Mr Rowley also has to accept from me that there is a challenge. Just in the two pieces of evidence and information that Mr Rowley has given the committee, he highlighted the challenge. You have got the Cercodi vaccination centre today, this morning, I presume before 11 o'clock in the morning, quite quiet, and you have got the confirmed vaccination centre at 5 o'clock at night, 5 to 8 at night, very busy. In a sense, that illustrates the challenge of operating a programme, which is that we are providing capacity where in Cercodi this morning drop-in appointments could be fulfilled because it was quiet, but in confirmed on Tuesday night it becomes even more problematic. I assure Mr Rowley that every step has been taken to maximise. Professor Leitch has been involved in work to expand the pool of individuals coming forward to deliver the vaccines. I will ask him to say a little bit about that in a moment. However, the number of people who are coming forward from within the health service to administer the vaccination programme, the more we draw in people from other disciplines, the more we will have to address the issue of what other services the national health service can deliver. If we draw in other healthcare staff who are delivering elective activity to deliver the vaccination programme, then we will obviously reduce the capacity for the elective work of the national health service. I know how much that matters to members of the public and to members of Parliament, that we try to do as much elective work as we can, but perhaps Jason Leitch can give some more detail. You have covered it really well. It is a real balance, Mr Rowley. We are, for context, vaccinating faster than we have ever vaccinated in history. We are vaccinating the fastest any country in the world is vaccinating across the whole of the UK, apart maybe last week from the Republic of Ireland. We have put out recruitment calls from every board for anybody who can come and help us from medical students through to optometrists and dentists. I did a private visit to Greater Glasgow and Clyde's HR department earlier this week, which is in the old York Hill hospital, just to thank them and meet them. They have been overwhelmed by a new set of recruitment individuals who have come forward from the most recent advert. It takes a little bit of time to get those people on board, depending on their history and whether they have done vaccination before or whether they are a clinician or a student. That is going very well, and they will put those people into the shifts as quickly as we possibly can. Glasgow, for instance, has vaccination centres throughout the city and the broader health board going every day. Drop-in clinics are awkward for us, for the very reason that you have just described. We would rather logistically have people appointed and then we know that they are going to come and there is an order with which we can do it. Then we can plan the next what is effectively two months to vaccinate those one to two million individuals with the Covid booster. The only other thing that I would say—and it is Mr Fraser and you—is that you are both right that vaccination is, in Mr Fraser's words, the best way to fight Omicron. It is not the only way to fight Omicron. It is really important that we do not just think about that. I know that that is not what you are suggesting, but we should not just think about vaccination. Of course we need to do it and we need the tens of thousands of people who are doing it today in vaccination centres, both staff and citizens. We also need to think about how we protect the population and ourselves from Omicron in other ways, as well as just vaccination. I am going to talk about vaccine uptake and where there is a bit of hesitancy. It is from questions that we are getting from the public to the committee. It is vaccine in women's reproductive health and breastfeeding. A number of people have been in touch regarding women's health and the vaccine and some are asking if fertility has impacted. I know that we have covered this before, but if we are getting the questions then clearly the message still has not got out to some individuals. Some are asking if fertility has impacted in any way of having the vaccine. Others have asked if breastfeeding women will be eligible for the booster vaccine and if the health and social care partnerships midwives have appropriate information and training on eligibility for the vaccine. Payments have highlighted inconsistency and knowledge and understanding across HSBCs in Scotland in relation to breastfeeding and vaccine eligibility. I am going to add one more for yourself, Jason. If you do not mind, I have a constituent who is very concerned about getting the vaccine because she is on cancer drugs. Will he answer that in the round? I think it would be best if Professor Leitch responded to that. Let me be as blunt as you would expect. There is no contraindication to the vaccine if you are pregnant or breastfeeding at all. There is no biologically plausible mechanism for the vaccine to cause you any more challenge than if you weren't pregnant or not breastfeeding. Is that blunt enough for him? If you do not believe me, you can head to the Royal College of Obstetrics and Gynaecology, the Royal College of Pediatrics and any trusted source of clinical information, including our own NHS inform. Young Scott has some really good information for our young people to help them to make those choices. The other thing is that it is really important that we do not suggest that vaccination is always an easy choice for people. The vaccination centres do not force you to be vaccinated. In fact, one of the reasons to go to a vaccination centre might be to have that conversation. You can leave unvaccinated—nobody is going to force you to be vaccinated—and the best people to have that conversation with you may well be the senior clinicians who are in that vaccination centre in Cercodi or Dunferman or wherever. They are well-equipped. If the individual that you first meet is not able to answer your more technical question—for cancer drugs, for example—we have escalation processes in place in the centre and on phones to even more senior immunologists and virologists and others, we will be able to get all the information you would require. There are tiny numbers of people who we would have to reappoint in a specialist centre and think about that, but that would be very small numbers. Your patient with cancer medication, it depends entirely on what it is. If it is long-term, probably no risk, but the best answer for them is to talk to their care team that is looking after them and they will be able to point them in the right direction. It is vanishingly rare for you not to be able to be vaccinated. Even during cancer care, it is vanishingly rare, but there are some, so we should just check with their care team if it is safe for them to be vaccinated. As I said, I know that we have been over this before, but it is worth re-emphasising. We are seeing a number of pregnant women across the UK fall ill with Covid and proportionately more than we would expect if it were random. We are seeing pregnant women both in the UK and around the world falling ill with Covid because they are choosing not to be vaccinated, and that is a much, much bigger danger than the vaccine. Good morning, Deputy First Minister, Professor Leitch. This morning, when we were speaking to some of our experts, I was suggesting that the emergence of Omicron was expected and the mutations of a virus were expected. The question that I was going to go down was how are we going to manage this process going forward, because it will be a continual process. The response that we got was that Omicron matches the worst-case scenario modelling that they had done, which is really what I did not want to hear, to be quite honest. I know that it can change the way in which I was going to ask the question, but with that in mind, the scientific and medical communities are obviously examining currently the impact on transmission, severity of condition and vaccination effectiveness. How are you considering measures that need to be taken while we are waiting for that? Given, as one of my colleagues said, the likelihood is that there is increased transmission rates, with the potential stress on the NHS that we heard at South Africa, have gone from a few hundred cases a day to over 8,000 within two weeks. It will be a little bit of time until we find out exactly the impact. Where are we with that thought process? Those, frankly, are the fundamental dilemmas that we wrestle with all the time. It is why, in my opening remarks, I used the words that we were taking a proportionate and precautionary approach to handling the situation. There is modelling that is undertaken on a regular basis of the likely course of the pandemic. It looks at a variety of variables. If we go back a few weeks, it was looking at the potential impact of COP. It looks at the impact of winter. It looks at all sorts of scenarios. It gives essentially a central, a better and a worse scenario, based on prevalence and circulation of the virus. Obviously, we hope for better. We prepare for central, and we hope that we do not reach worse. Obviously, different sets of actions are required if we are facing the better or the worse scenario rather than the central. That is why I use the word proportionate in our judgment, but the precautionary one is important as well. At this stage, if we look at the pandemic today in Scotland, case numbers are high but fairly flat. They are comparatively speaking. The last seven days are slightly down on the previous seven days in numbers of cases. The level of hospitalisation of Covid patients today is slightly lower than it was. It is still over 700, so if we did not have those 700 people in hospital with Covid, we could be doing other treatments for those 700 patients. There is a very careful judgment to be made about what are the proportionate steps to be taken. If Omicron turns out to be more transmissible than Delta, what that will say to us is that there will be more cases if the level of serious illness is no different to Delta than we will be hospitalising a relatively small proportion of percentage of the cases, but that would be a larger number of people if the number of cases are higher. That is when even more pressure comes on the national health service and when services become under pressure. Although the level of seriousness of illness may not change, but the volume changes significantly, that is when we have to take more dramatic action. Today, I do not have a justification for doing that because I can look at the scenario about Omicron, but I cannot put out the compelling evidence base that says that we need to do the following more severe measures because that evidence base does not yet exist, but it may well exist. That is what the Government keeps under review on a constant basis. Your expert is correct. Down a microscope, that looks terrible. It has some of the mutations that we already know are linked to vaccine escape. It has some of the mutations that we know are linked to increased transmission, and it has some new ones, so we do not know what they do in rough terms. What we do not know is how it performs in the real world. We do not know if virologists can talk about the fitness of the virus to summarise what it can do. We do not know in the long term if it is fitter than Delta. If it is fitter than Delta, we can only slow it, we cannot stop it. It will overtake Delta for the world, and Delta has become the dominant virus around the world. We have to do two things, and I think that we have done them. We have to stop it coming. When it is here, we have to manage it like we used to manage the original virus, if you remember, by trying to put a ring of steel around those cases. You remember first outbreaks in Cuperangus, in Gretna, and so trying to really focus on those individual outbreaks. We are really dealing with two simultaneous pandemics just now. The health protection teams are dealing with Delta in the way that this committee fully understands, with restrictions, with testing and with vaccination. At the same time, we are dealing with a new pandemic of Omicron in a much more targeted way where we are going, we are doing enhanced contact tracing, we are doing enhanced PCR testing to try and control it. Now, if Omicron is better than Delta, we can only slow it down. We cannot stop it. We cannot hope that Delta stays and Omicron goes away. That will only happen if it is not as fit as Delta, and we need to know three things. We need to know transmissibility, severity of disease and vaccine escape. We can tell some of that down the microscope, but most of it we need re-world data. If you have 10,000 Delta cases, 3% of them go to hospital, 1% of them die roughly. What are those numbers for Omicron? Is it 3% and 1% or is it 4% and 2%? That is a massive difference, but we just cannot tell. In South Africa, the early signs are bad, so it took Delta 100 days in South Africa to be the dominant variant. It has taken Omicron 20. That would suggest increased transmissibility. Now, we do not know they are much less vaccinated than us. They are a different, younger demographic than us, so you cannot make exact extrapolations to your context or the Japanese context or the Californian context. We need more time. Probably the sentence that I say most often to the Deputy First Minister on a daily basis is, I need more time. Sometimes we do not have time. You have to make decisions in a proactive way before you get all that data. I think that that last point, if I could just follow that up, convener. I think that that, in a sense, is the completion of the argument about proportionality, that at some point we have to make a call, which we think, on the basis of the best clinical assessment that we can have around these three factors of vaccine escape, transmissibility, serious illness, that this is now the moment to act. I accept that there might not be all of the demonstrable evidence to support such a conclusion or the conclusive certainty, but the Government has been making judgments of that type since March 2020. That is really helpful. It leads me on to the point that I do raise reasonably regularly. It is around the idea that this committee is going to look at an investigation into the excess deaths that we currently have in Scotland, which is sitting about 12 per cent above average, not all Covid-related. I suppose that, with the emergence of the moment, this is even more acute, how we make these decisions, in that there is a mortality associated with other conditions that are non-COVID-related. At some point, we are going to have a look at it. I am sure that the medical profession is looking at it much more deeply than we are. I am really looking ahead. How do we get to a point where the balance allows the conditions that have a mortality associated with them? How do we see a route to get back to that sort of normality? I think that this is a significant question and a legitimate question into the bargain. In my answers to Mr Rowley, I was making the point—completely legitimate questions from Mr Rowley about expanding the scale of the vaccination programme. One of the options could well be to say it right. Let's turn the dial down on elective work and let's put more resources into the vaccination programme. If we do that without wishing to personalise this, I shall use those distinguished members of Parliament to illustrate my point. Mr Rowley might be more happy, but Mr Whittle will not, because his primary concern is about the treatment of non-COVID conditions that are perhaps leading to early mortality, because health services are not able to undertake all that we would ordinarily hope for them to be able to undertake. That is why we have to invest in all the precautionary measures that we possibly can do to avoid the circulation of the vaccine. We are not powerless about the circulation of Omicron. We are not powerless in any shape or form, because people can come forward for their vaccinations, which of course they are doing, and they are doing in substantive numbers. People can observe the baseline measures on an absolutely routine rudimentary basis to try to put up those barriers to the circulation of the virus. There are all sorts of steps that we can take to our contact tracers who are doing—it is absolutely incredible to watch what they are doing around these early cases on Omicron—just quite jaw-dropping the degree of intensity of looking for where people have been, who they have been close to, what is happening around it, to try to, as much as possible, interrupt the circulation of the virus. There are a whole variety of devices that we have to do, because the more we do that, the more we can address—or have as much activity to try to address the core point that Mr Whittle puts to be. On the point of the six months coming down to three months, I suppose that I kind of thought, well, I'm getting my booster vaccine in six months, so I'm quite safe for six months and I got it on Friday, but now it's three months. Partly that sends out the message that you're at risk after three months. Is the vaccine protection waning quicker than we thought? Are we going to have to get a vaccine every three months? I think that there's a—I'm going to bring in Professor Leitch, because we're the clinical nature of some of these points, but I think that it would be fair to say that there's obviously going to be vaccine waning. So part of what we have seen in the course of the last few weeks was an increase in cases in the older age groups. If we go back over the last two months, we saw an increase in the number of cases in the older age groups, and then when the booster vaccination programme started kicking in in those older age groups, that came down more aggressively than in other age groups. Professor Leitch can tell me if I've got this wrong, but I would deduce from that that vaccine waning was taking place, but the booster arrested that and gave more protection. Let's do it after two months. I think that there will be clinical points that will come out to—because there may not be a justification for so-doing, because there may be sufficient vaccine protection for a sufficiently long period of time. It may be that six months—this is a new disease, so clinicians and scientists are trying to work their way through what's the best answer. Their judgment has been six months. It may be—that's been revised by JCVI to three months. I take four from six to three. It is, but it's also a recognition of the necessity of taking—I go back to my two key words, proportionate and precautionary. In the light of Omicron, the precautionary stance of moving to an earlier time for the booster jag strikes me as being a rational consideration for the JCVI to arrive at. A few things. I'll try and be quick. Remember that the JCVI advice is not before three months. It's not at three months. It's not before three months. Before, it was not before six months. So they know you can't do everybody on the Tuesday night they release their news release. They're smart. So they know we're needing a bit of running time to get to everybody. So mine's on the 17th of December. That will be 26 weeks. I could have brought that forward. I'm going to go on the 17th of December. I'm not 10 days. I figure it's not going to make that much difference. I may live to regret that, but that's my present position. I'm going to try a metaphor. Immunity is not like an on-off light switch. It's like a dimmer light switch. I can't tell what your dimmer's doing and you can't tell what mine's doing. All I can tell at a population level, if you look at number of infections, number of hospitalisations, number across the whole world, and the vaccine you've used and how well it went and which age you did, the boffins can then say, oh, Scotland's dimmer has reduced. So we need to turn it back up again. And the way to turn it back up again is to boost oldest, youngest, all the way down. Now, they've got to take into account that we had a large gap between one and two. Israel didn't. They waned first. So it looks as though it wanes. Now, what will happen next is we'll watch the dimmer again. I would be very surprised, and the immunologists tell me this, that it will dim less than next time because your body remembers. So each time you get one, it stays higher for longer because immunity is complicated. It's not just antibodies. There's also cells remembering things. So it may well be that the next booster might be a little bit further out. And the next one again might be a little bit further out. Or you might say, we'll only do the elderly next time because young people, their imprint has stayed on for longer. But that's all quite difficult because you've got to take serial blood tests from people to check they've got immunity and then you've got to watch the whole population to see how the dimmer is working. And if you need to turn that dimmer back up again, you vaccinate from the top to the bottom. Have you been sent to vaccines to maybe give longer protection? We absolutely could because principally around new variants. So if the variants again are not like a binary light switch, so Omicron will not escape the vaccine completely. But it may be, I'm completely guessing, might be 60 per cent protection rather than 95 per cent protection. In which case you'd probably for next year want to adjust the vaccine. And the companies can do that, they say within 100 days and then they can produce it. And we'd have it within probably six months start to finish, approximately. So you're back into making the, so not only are you turning the dimmer up, you're making it more efficient. You can turn it up faster because you've got it against the one you wanted. Okay, thanks. Metaphor, I think I overstretched it. No, I get the point. That's helpful. It's not black and white, it's pretty clear. On the question of the certificates, vaccine certificates, I think on Monday, if I'm right, a negative test is going to be allowed and possibly some other variations. Will that appear on the app or the certificate? The lateral flutus will not appear on the app, no. The lateral flutus won't. And what about the booster? Because I've got a constituent in touch saying that when he goes to Germany they want to see a recent jag. Yeah, the app is being revised to include the booster jags. And we expect that to be completed on the update available in early December. There is a critical date of the 15th of December, when I think a number of European countries will make it mandatory for booster jags to be evidenced on Covid vaccine certificates. And the update will be in place by then. The app will be updated for international travel and boosters from the 9th of December. It will take longer for the app to be updated to include boosters for domestic certification. The current domestic certification scheme defines fully vaccinated as having had two vaccines and doesn't at the moment include the requirement for a booster. If I may, my final question would be what about children aged 5 to 11? Are we thinking of vaccinating them? We are waiting advice on that point from the GCVI and that is an issue that has been explored by the GCVI. We will obviously look carefully to the recommendations that come from the GCVI in that respect. That concludes our consideration of this agenda item, and I'd like to thank the Deputy First Minister and his officials for their evidence today. I now move on to the third agenda item, which is consideration of the motion on the expedited draft affirmative instrument considered during the previous agenda item. Members will note that SSI 2021 oblique 425 was laid on 19 November, and we had intended to take the motion on that instrument at that meeting. The Delegated Powers and Law Reform Committee has decided to consider this instrument at its meeting next week, so we will defer consideration of that motion. Deputy First Minister, would you like to make any further remarks on the draft affirmative instrument on the vaccination certification scheme before we take the motion? No, convener. I'm satisfied with what I said. I'd like to invite the Deputy First Minister to move motion S6M-02332. Can I have any comments from members? I hope to make this point in the earlier session, but time ran away with us. It's really just to draw to the Deputy First Minister's attention the comments that have been raised with us by the DPLR committee, who looked at the instrument on Tuesday. The instrument before us allows the use of a negative lateral flow test as an alternative to a vaccine certification for entry to certain premises. I think that that's a welcome step. It's something that's been welcomed by the business community and brings Scotland into line with, I think, most of not all other European countries who operate a vaccine passport scheme. The issue that the DPLR committee raised was the fact that this change effectively relies on individuals' honesty, because it is relatively easy for people if they wanted to present a false negative test. They raised the issue as to whether or not that was something that would come into the Government's consideration and whether there was any thought about making the system more rigorous, for example with the introduction of sanctions for people who presented a false negative test. I don't know whether the Deputy First Minister can respond to that, or if he has any thoughts on behalf of the Government on that point. I think that members of Parliament have wrestled with this question for some considerable time. Indeed, Mr Fraser is correct that a number of members of Parliament, including myself, have pressed the Government to take this step for some time. Of course, the Government has indicated that we want the scheme to be in place that would primarily assist in the boosting of vaccine take-up, which is why we resisted this particular move to begin with, because it didn't suit the purpose of our scheme. We did it at the same time indicate that the risk that Mr Fraser put to me was a risk. Just for the completeness of the argument, I put that on the record. There is a risk here, but I can't deny it. I hope that members of the public are part of the culture that we as a society have to take forward if we are serious as a society about trying to resist the spread of the virus, that we test ourselves and follow what either the one or the two red lines say to us when the test is completed. I would encourage members of the public to take this process deadly seriously. I know that many members of the public are doing so. The demand for lateral flow tests is very high, thankfully. If people go back to the questions that you put to me, you can hear at the very beginning about how seriously people are taking the testing approach. The testing approach is really important as a tool in stopping the circulation of the virus. For somebody to be reporting a test that is inaccurate, I don't think that I can—if Mr Fairlie forgives me, I'm not sure it's for me to decide what is fraudulent and what is not fraudulent, but it is not the right thing to do and therefore undermines the purpose of the scheme and the taking of the test. I would encourage members of the public A to test and B to report the findings accurately. Very briefly, because I do have to be in chamber, but I'm making this point and I'm using the word fraudulent, because if you are 18, 19, 20, Christmas is coming up and you are going out with your mates, you don't feel bad, but that test comes up as a positive. You might just chance your luck because you feel okay. I have a genuine concern—that was always my concern—about going down this road. I accept those points and that's why I make the plea for people to be—I don't think it's just 18 or 19-year-olds. It's everybody. I am personally undertaking lateral flow tests much more frequently than I was doing twice a week. I'm now doing them much more frequently because of the degree of interaction that I have in the course of my work. I have no social life, but I do have a lot of interaction in my work. That's not a pandemic. That's not a pandemic. That's nothing new, but it's because of the degree of interaction that I now have as a course of my responsibilities. I'm just conscious of time. I'm being members happy for me to put the question to the motion. The question is that motion S6M-02332 to be agreed. Do members agree? The motion is agreed to. The committee will publish a report to the Parliament setting out our decision on the statutory instruments considered at the meeting later today. That concludes our consideration of this agenda item and our time with the Deputy First Minister. I'd like to thank the Deputy First Minister and his supporting officials for their attendance this morning. Thank you. The committee's next meeting will be on 9 December when we will be taking evidence from stakeholders on the vaccination programme. That concludes the public part of our meeting this morning. I suspend the meeting to allow witnesses to leave and for the meeting to move into private.