Chamber and committees

Thankfully, it was unsuccessful.

Yes. There is a natural sequence to these things. We have to do the part of the process that involves setting out the approach to complaint handling, and that then has to inform, to whatever extent is judged appropriate, the revisions to the ministerial code.

We hope to be in a position to complete any issues in relation to the ministerial code within three months of the formalisation of the policy. I hope to formalise it by the end of February, subject to the various views that we want to listen to, and then take the three months to resolve any issues with the ministerial code.

We have within our staff members a broad range of such characteristics. I might invite Lesley Fraser to say more about this, as it falls within civil service territory, but it is an active recruitment—or, I should say, personnel—priority for the Scottish Government to make our employment as diverse as we can. We have a number of networks in the organisation with which we regularly discuss staff matters; those discussions are conducted through civil service channels, and a huge amount of energy is taken up with ensuring that that dialogue is appropriate.

Ian Mitchell might want to comment on that point but, in the investigation process, we neither prescribe nor prohibit that. That it is the best way to say it. We will give the issue further consideration and, perhaps, discuss with individuals who have had experience of such processes to gauge their reaction.

In a moment, I will ask Professor Leitch to deal with the question of epidemic and endemic, because judgment with a clear scientific basis has to be applied to that, and it is appropriate that he provides the committee with that advice.

On the second question, there is one point of detail in Mr Fraser’s analysis on which I part company with him. From my recollection, I do not think that the projection or suggestion was made that omicron would lead to a significantly greater number of deaths. The fear of omicron was that a huge volume of cases would give rise to a large volume of hospitalisation, which would place a burden on the national health service. In the emerging evidence from South Africa, it appeared that omicron, although generally a milder version than delta, would still give rise to a sizable number of cases in the population that would result in hospitalisation.

I would contend that the combination of the measures that the Government put in place, the response of members of the public and the change in behaviours that took place in the run-up to Christmas enabled us to flatten the omicron curve. The number of cases was of a magnitude that would have led to much more acute measures being taken with previous variants; it was much higher than the number that resulted in the lockdown of 4 January 2021, for example. In the position that materialised, the combination of the vaccination strategy, the measures and restrictions that were put in place by the Government and the change in public behaviour and participation enabled us to flatten the worst effects.

However—we must be really careful about this point—we still have huge demands on the NHS as a consequence of omicron. We have more than 1,500 patients in hospital with Covid just now. That is a very high number, which is putting acute pressure on the national health service.

On Mr Fairlie’s first question, the Scottish Government’s position on the wearing of face coverings—whether in crowded public places, on public transport or in schools—has not changed in the light of yesterday’s announcements by the Prime Minister. There is absolutely no change in the Scottish Government’s position, of which Parliament was advised on Tuesday. If there was to be any change in that position, Parliament would be advised. As things stand just now, the Scottish Government is crystal clear that the requirement to wear face coverings in public spaces, on public transport and in secondary schools remains absolute.

I am struck by yesterday’s comments by the chair of the British Medical Association council, Dr Chaand Nagpaul, who said:

“It is vital that the Government”—

the UK Government—

“acts according to the data and takes a measured approach. Removing effective infection control measures like mask wearing on public transport and indoor crowded spaces will inevitably increase transmission and place the public at greater risk, especially for those who are vulnerable.”

Those are very significant words of warning, which are taken seriously by the Scottish Government.

I invite Professor Leitch to address Mr Fairlie’s second question, which was about clinical advice.

There should not be an issue there. Individuals who are required to self-isolate, which is the case if someone tests positive with a lateral flow device test, should be eligible for a self-isolation support grant. If there is an issue with that, I will look into it carefully with local authorities to ensure that people who require such support are able to obtain it, given the requirement for them to self-isolate due to the arrangements that we now have in place.

I contend that the relevant data is clearly available because Mr Whittle has just recounted it to me. The collection of such data enables us to see comparative levels of referrals for individual cancer treatments and a variety of other treatments, the number of cases that have been handled and the period and time at which they have materialised.

A sustained effort has been put in to maintain cancer services throughout the challenges of the pandemic. When other services were paused, cancer services were maintained. However, I have to acknowledge that individuals will have been more reluctant to come forward for wider health treatment during the pandemic, and the evidence and data reinforce that point. It is important to reiterate the necessity for individuals to come forward for treatment of this type. When people have concerns about their health, the national health service is open and available to deliver treatment to them. It is important that, at all stages, individuals hear the message that the health service does all that it can to deliver.

Obviously, the capacity of the health service to deliver in that respect depends on the degree to which we can suppress the effects of Covid on it. The omicron wave has essentially reinvigorated the number of patients who are in hospital with Covid. If we look back to just before omicron, we were down to about 900 patients being in hospital with Covid—I think that the number was actually lower than that—but we now have in excess of 1,500. Suppressing Covid enables the health service to devote more resources to addressing the type of condition that Mr Whittle fairly puts to me as being important to members of the public.

Essentially, that is reconciled through the four harms framework that I discussed in my answers to John Mason. I will remind the committee of the details of that. The Government has assessed the relationship between health harm directly from Covid, non-Covid health harm and economic and social harms. Although Mr Whittle is correct to say that some people who have lost their lives to Covid will have had other conditions, other people have lost their lives directly because of Covid.

The Government has been trying to enable people to experience as much of normal life as we can hope for while we wrestle with a global pandemic. That has a bearing on the extent and nature of the health treatments that are available and that can be delivered.

All the preventative health interventions that the Government supports—such as the smoking cessation programme that Mr Whittle mentioned—need to be part and parcel of what we put forward to members of the public as vital elements of the health protection that individuals ought to pursue in order to lead a healthy life. That should be sustained during Covid, and any treatment as a consequence of that needs to be sustained in that context as well.

Although it is important that we focus on additional health harms that are different from those that are caused by Covid, the hard reality is that it is inevitable that the capacity of the national health service to address those issues will be greatly enhanced if we ensure that there is less impact on the health service as a consequence of Covid.