Chamber and committees

The Parliament’s Standing Orders are required, in accordance with the Scotland Act 1998, to set out that should provisions within a Bill require the Queen’s consent if the Bill were an Act of the United Kingdom Parliament, the Bill requires Crown consent. This means that since the establishment of Scottish Parliament in 1999 the interests that determine this matter in the UK Parliament affect the application of Crown consent in the Scottish Parliament. Guidance prepared by the Office of the Parliamentary Counsel for the United Kingdom Government – Queen's or Prince's Consent – explains details of these interests and is taken into account by the Scottish Government. This guidance is accessible here: https://www.gov.uk/government/publications/queens-or-princes-consent

The Scottish Parliament's guidance on Public Bills, available on its website, also outlines the interests that would determine the requirement for Crown Consent, notably at paragraphs 2.51-2.54: https://archive2021.parliament.scot/S5ChamberOffice/GuidanceonPublicBills_S5v2_FINAL.pdf

No guidance has been received from representatives of the Crown on the issue of Crown consent.

From 9 August, national guidance was updated to remove physical distancing requirements in most settings. This, however, did not extend to health and social care settings.

On 11 August, the Chief Nursing Officer Directorate (CNOD) commissioned NSS Antimicrobial Resistance and Healthcare Associated infections (ARHAI) and Public Health Scotland (PHS) to review current Infection Prevention and Control guidance as a matter of urgency, with a view to implementing a step by step reduction of physical distancing in non-clinical/para-clinical areas. ARHAI and PHS produced draft guidance which went out for consultation with key stakeholders including NHS Chief Executive Officers on 18 August with a closing date of 19 August.

ARHAI and PHS are currently drafting updated guidance which will issue to boards once this has been formalised.

Ensuring high quality palliative and end of life care for people towards the end of life is an important priority for the Scottish Government.

Since 2016, it has been the responsibility of Integration Authorities to commission and plan palliative and end of life care services and supports to meet the needs of their local population. The assessment of palliative and end of life care services is also their responsibility.

For this reason, the Scottish Government does not collect this data centrally.

However, Integration Authorities report on their progress using a range of indicators within their Annual Performance Reports, which provides some data on palliative and end of life care services. Information on the Core Suite of Integration Indicators can be found at https://publichealthscotland.scot/media/8411/2021-07-13-coresuiteindicators-background-and-glossary.pdf. It is, however, important to note that due to the pandemic, full data is not currently available for all indicators at present.

Public Health Scotland also publish official statistics on the percentage of time spent at home or in a community setting in the last six months of life. ( setting/percentage-of-end-of-life-spent-at-home-or-in-a-community-setting-financial-years-ending-31-march-2011-to-2020/"> Percentage of end of life spent at home or in a community setting - Financial years ending 31 March 2011 to 2020 - Percentage of end of life spent at home or in a community setting - Publications - Public Health Scotland ).

The Scottish Government is committed to ensuring there is resilience and capacity in the health and social care system to aid us in our mobilisation, support staff to recover from previous COVID-19 waves, and to manage the need to remain vigilant against any future wave.

The most recently published data indicates a total of 258,269 patients were seen at new outpatient appointments during the first quarter of 2021. This is down 20.4% from the same period in 2020, prior to implementation of social distancing restrictions. At 31 March 2021, 48.1% of those waiting for a new outpatient appointment had been waiting 12 weeks or FEWER. This IS down from 74.4% in the same period in 2020. At 31 March 2021,184,224 new outpatients had experienced ongoing waits greater than 12 weeks, up 177.8% from the same period in 2020 (66,325).

It is difficult to quantify the impact that the two-metre social distancing restrictions have had on capacity and throughput in outpatient settings, not least because of the differences in Wave one where elective services halted and Wave two where services began to remobilise. In addition to this there is considerable variance in the layout, structure and fabric of NHS facilities across Scotland.

Whilst the two metre distancing restrictions will have played a part in capacity and throughput, other factors will also have influenced them. These include bed closure, staff absences (including those who have been deployed elsewhere to assist with the pandemic or were shielding) and throughput lost to other IPC controls, which include removal of beds to reduce potential risk of COVID-19 transmission.

There has been a change in the way services have been delivered in outpatient settings, for example – staggered waiting times to avoid overcrowding within these areas/ reduce footfall, one-way access/egress and the use of Near Me where possible to avoid face to face consultations.

We are supportive of ensuring the organics sector, as part of the wider Scottish agriculture industry, contributes fully to our Ambition 2030 strategy to grow our food and drink industry.

We have committed to doubling the amount of land used for organic farming, doubling the amount of organic produce that comes from Scotland and are focussing on more organic produce being used in public sector food procurement. We are considering how best to build upon the Scottish Organic Action Plan and will be meeting with the Scottish Organic Stakeholder Group to hear their views.

The vaccination programme uptake in Scotland is highly successful overall with around 90% of the adult population (18+) having received their first dose - far beyond our planning assumption of 80% - and so far 73% have received their second dose.

To ensure good uptake amongst younger age groups the Scottish Government and NHS Scotland are undertaking a wide range of initiatives.

Drop in clinics are widely available for people who want a first vaccination or are 8 weeks or more from their second vaccination – regardless if they have an appointment in the system. Drop-in mobile centres are attending a range of sites such as football grounds, parks, workplaces and shopping centres.

Young people within the eligible Joint Committee on Vaccination and Immunisation (JCVI) age cohorts will still also receive a scheduled invitation which they may attend if the time and date suits. A dedicated self-registration portal allows SMS notification to take account of the greater turnover of registered addresses amongst young people.

We continue to engage with young people in a variety of ways, including through social media outlets, to make sure they have access to the correct information on vaccines. To this end the Scottish Government has developed a comprehensive set of public information campaigns across TV, radio, print and online to disseminate quality information on vaccines and positive encouragement to take up vaccination invitations.

We are presently strengthening communications targeting the 18-29 age group, such as the Roll Up Your Sleeves campaign, to ensure we vaccinate as many people in this cohort as possible.

All NHS Boards have dedicated inclusion plans within the vaccination programme, outlining how they will actively offer vaccination to people who may face barriers in taking up the vaccine. Some examples of outreach include offering vaccinations in places of worship, in other community settings, providing concessionary bus travel to appointments and working with community leaders to promote uptake.

We are continuing to discuss a range of measures with universities and colleges to help ensure students get vaccinated as soon as possible before arriving on campus. We remain in regular dialogue with Universities Scotland and Colleges Scotland and have agreed with Health Boards and Higher and Further Education Institutions to appoint Single Points of Contacts in universities and colleges. Additionally, we are engaging with the Health Boards to support vaccine delivery for both international and home based students where there is local need, including the possibility of on-campus pop-up clinics.

Since May 2021 we have a system in place through NHS Inform to provide people with a record of their vaccination status if they need this for international travel. Scottish residents who want to demonstrate their vaccination status can request a certificate through NHS Inform before they travel. This can take up to 14 days, but current turnaround is typically 2-3 days.

It remains the case that if people are returning from an amber list country and are not fully vaccinated in accordance with the exemption, they must self-isolate for 10 days at their accommodation in Scotland and must book a day 2 and day 8 testing package , prior to departure. Details of this can be found at the link below.

It also remains the case that if people they are returning from a red list country they should follow the managed isolation guidance as set out on:

Coronavirus (COVID-19): international travel and managed isolation (quarantine) - gov.scot (www.gov.scot) .

People need to be aware that countries may move between the red, amber or green list country at short notice. They are advised that they should not assume that a country on the green, amber or red list now will remain on the same list over the weeks and months ahead.

This government has seen a 54.2% increase in the consultant radiologist workforce (from 223.5 WTE in September 2006 to 344.6 WTE in March 2021). While information on numbers of radiologists according to specialist cancer fields is not centrally held, the numbers of Clinical Radiology Consultants currently employed in each NHS Board, including Doctors in Training, are as set out in the following table:

NHSScotland Clinical Radiology Consultants, staff in post by NHS Board in Whole Time Equivalent (WTE) including Doctors in Training.

Green recovery must form a central part of Scotland's emergence from the COVID-19 pandemic. In relation to air quality, the key challenges will be to understand how the air pollution reductions seen during lockdown periods can be maintained long-term and sustainably, and how these changes can benefit the long-term health of the population

On 15 July 2021 the Scottish Government published its new air quality strategy 'Cleaner Air for Scotland 2 - Towards a Better Place for Everyone' (CAFS 2). CAFS 2 sets out a series of actions to deliver further air pollution reductions over the next five years. These actions include work being progressed across Government which will benefit air quality, such as continuing to take forward introduction of Low Emission Zones in Scotland's four largest cities, a £500 million funding commitment to active travel over the next five years, a reduction in motor vehicle kilometres by 20% by 2030 and the ban on the sale of new diesel and petrol cars and vans, also by 2030.

We are also taking forward proposals to control the sale of the most polluting domestic fuels, produce a code of good agricultural practice for improving air quality in Scotland and develop a public engagement strategy on air quality. At the same time we will ensure that CAFS 2 integrates fully with other Government plans and strategies that have implications for air quality, such as the Climate Change Plan update, the National Transport Strategy 2 and National Planning Framework 4.

The Scottish Government recognises how important healthy meals are for boosting children’s energy, concentration and behaviour which, in turn, leads to improvements in academic attainment.

All children in primaries 1 to 3 have benefitted from access to free school lunches since January 2015, and from this month all children in funded early learning and childcare are receiving a free meal in every session. Ministers are now committed to going further by expanding free school meals to all pupils in primary and special schools during the course of this parliamentary session, as well as introducing free year-round breakfast and lunch provision to support children outside of the school term. We are also committed to piloting approaches to universal meal provision in secondary schools.

To start delivering on this commitment, we have provided local authorities with funding of £49.75 million to enable them to provide support to families who are eligible for free school meals during the school summer holidays, and to expand the provision of free school lunches during school term-time to all children in primaries 4 and 5, throughout the course of this school year. Further expansion of universal free school lunches will be delivered for children in primaries 6 and 7 by August 2022.

In addition to the free meal commitments, the Scottish Milk and Healthy Snack Scheme launched on 1 August 2021 replacing the existing UK Nursery Milk Scheme in Scotland. All pre-schoolers who spend two hours or more a day in eligible childcare settings registered with the scheme will be entitled to a serving of fresh milk. Unlike the UK scheme, a piece of fruit or portion of vegetables will also be offered and children who cannot drink cow’s milk for medical, ethical or religious reasons will be offered a specified non-dairy alternative.

This is a major programme of change during this Parliament that will deliver benefits for hundreds of thousands of children.