Gweithio. Ysbryd, yma ymdau'r rhaglen o'r rhaglen yng ngyfyrdd ymlaen o'r Fyllgor 4 ym eich rhaglen o'r rhaglen i'r Fyllgor. Yn ystod y Prif Weiniddo, fe wynau'r rhaglen o'r rhaglen o'r rhaglen o'r Rhaglen. Mae'r gweithio ymdau'r rhaglen yn ni'n gwybodaeth. Dyma y gallwn y gwasanaethau yma, ac mae'r angen i ni'n gweithio'r rhaglen. We're at the start of the process of relaxing the restrictions that we've all been living with through these past few months, beginning with getting our children back to school. I want to talk to you today about how we are strengthening some of the essential measures which will help to keep us safe in the weeks and months ahead. We're investing in our successful contact tracing system and strengthening testing in workplaces, in hospitals and for everyone who has been in close contact with someone who has coronavirus. All of these measures will be vital to help control the spread of the virus as we begin to open up once again and to mix with more people. We know that whenever we come together there's always a risk that the virus will come too and we are now facing a very different situation to the one that we faced this time last year. The Kent variant is now the dominant form of the virus circulating in Wales. This variant is more infectious and faster moving than the form of virus we were used to dealing with. Our scientific experts have calculated that the Kent variant is up to 70% more infectious than other forms of the virus. This means we have to be careful about how we relax restrictions. It means that we can't rush this and we can't open everything at once. We also need to continue to take steps to protect ourselves even if we've been vaccinated. We will still need to have measures in place to quickly identify cases and to stop them spreading wherever they arise. Test trace protect is at the front line of our national efforts to detect and help control the spread of the virus. It has played a pivotal role in helping to protect everyone in Wales since its launch last June. We've carried out more than 2.8 million tests since the start of the pandemic, and there have been more than 205,000 confirmed cases of coronavirus. More than 167,000 people who tested positive have been contacted by a test trace protect service. Today I'm announcing an extra £60 million to extend our successful contact tracing system to the end of September. Contact tracing in Wales is a public service run by people who know their local area. We now have a team of 2,000 contact tracers and advisors working across Wales. Since June, they have reached 99.6% of people who have tested positive for coronavirus and were eligible for follow-up. They've also successfully reached 95% of their close contacts and advised them about self-isolating. The funding will also support the continued improvement of the contact tracing digital system. I want to turn now to testing. We're strengthening our testing regime to help identify more people who have coronavirus at an earlier stage, as well as those who don't have symptoms. We're expanding testing to include everyone identified as a close contact to someone who has tested positive for coronavirus. This will mean that when people are contacted by our TTP service, they'll be advised to self-isolate, but also to take a test as they start self-isolation and again on the day 8 of their isolation period. This will help us to identify more people with coronavirus and their close contacts who would otherwise be unknown to TTP, helping us yet again to break-change a transmission and to help stop the virus from spreading. But taking a test is not an alternative to self-isolating. If you have a negative test, this doesn't mean you can go back to work or school. If you've been identified as a close contact, it's really important that you do complete the 10 days of isolation and do the two tests. We're working with the police and our fire and rescue services in Wales to develop plans to regularly test the workforce to help find people who have coronavirus but do not have symptoms. Under Welsh Ambulance Service Trust, it's also carrying out regular testing of its workforce. Community testing to find more cases in people without symptoms is being rolled out in parts of Bridgend, Merthyr Tiddville and Rhondda Cynon Taf, and these are areas that have had a historically high rate of community transmission. I've also published a new framework for testing people who are admitted to hospital to prevent coronavirus. This will help to prevent the virus from getting into hospitals and causing potentially deadly outbreaks and making sure that people can be safely sent back to their home. It sets out plans to test people 72 hours before they're admitted for plan procedures, testing everyone who is admitted as an emergency and all those who are at higher risk, including dialysis and cancer patients. Before I take questions, I want to turn briefly to vaccination. Yesterday, we marked yet another significant milestone in our vaccination programme as we passed one million first doses delivered. This means, of course, that more than one million people in Wales have said yes to having their vaccine. It's an incredible achievement in just over three months and testament to all the hard work behind the scenes in making this programme a success. Our vaccination programme continues to go from strength to strength and I would encourage everyone to take up their appointment when it comes. I certainly look forward to having my vaccine in the coming days. Today, I can also confirm that all people experiencing homelessness will be included in Group 6. This includes people who are sleeping rough, people at emergency accommodation and people who are recently homeless but are now in supported accommodation. Many people in this group will be living with underlying health conditions which put them at risk of coronavirus harm. It's important that they are offered vaccination to protect them and the wider community. We'll be working closely with local authorities, the third sector and housing organisations to make sure we reach all of those who are eligible and we'll be taking the vaccine to people rather than expecting them to visit clinics for vaccination. Thank you. I will now take questions from jurists and, as usual, the answers will be broadcast on our social media channels. The first question today is from Sangita Lau from ITV Wales. Good morning. Well, good afternoon. Thank you, Health Minister. Could you outline what's been done to help hundreds of people who are left with debilitating problems, both mental and physical, in terms of funding and research to support those with long Covid? Long Covid is a catch-all term for those people who have recurrent symptoms or health care challenges from Covid and a range of people who have Covid-related harm that never get so significant they need to go to hospital. The challenge is it's different for different people. There isn't one single condition, one single set of treatment symptoms to deal with. That's part of the challenge. We're still learning about long Covid, about its ability to reoccur. Because it would affect different people differently, we need to have a treatment patho that we do have in Wales that looks at all those different professionals who need to be involved. In putting that together, we work with our allied health care professionals, our therapists, together with general practice, as well as doctors in secondary care too. That means we are looking at how we provide specialist help, and that specialist help will be available in different parts of the country, but organised around the person. We're not going down the route at this point of having a range of designated specialist clinics, but we're looking at how to learn from what other countries do as well as what we're doing ourselves, and Wales is taking part in a range of research collaborations across the UK to understand more about the condition, how we treat it, how we treat it successfully, as I say, for all the different variances that we know we're going to see in people. Is any of that research looking into the anecdotal reports of the impact the vaccine could be having to patients who are now living with long-covid? Well, we're looking at the impact of vaccination, and I'm sure we will also look in some of the research being done on the impact of people with long-covid, but there's a much wider bank of research being done about the impact of vaccination. The first point is about effectiveness and then transmission, and then if that does mean that people are more protected from long-covid, that would be a very good outcome too. So, we don't have an outcome yet from all of the research being done on long-covid or on vaccination, but if that does give us a better answer with better hope for the future to give people better care outcomes, then I would certainly welcome that as a good problem to have about how we roll out not just vaccination in all its forms, but how we successfully treat people to live their best lives, whether with long-covid or not. Thank you, and I've got Oyn Clarke from BBC Wales. Fynd ar gweinidog i eich edrych. Given, as you've mentioned, the big decisions due this week on easing restrictions, you, as health minister, no doubt will have seen the modelling, what struck you about that modelling? Given, as you mentioned, the improving public health situation right across Wales, what does that modelling tell you about the effects or merits of a stay local policy as opposed to allowing people to travel a little further afield? So, there's a couple of different things there. So, on the modelling evidence that we've got that we're going to publish, that does tell us that there are key factors about both how effective the vaccine is in preventing mortality, in preventing serious harm, so those people would otherwise need to go to hospital, but also they're still developing evidence about transmission that we're not aware of. The modelling can't properly take account of the developing evidence about transmission. It gives us a range of scenarios to help us to plot the reduction in the amount of hospitalisation and the reduction in deaths depending on the effectiveness of the vaccine. In all of the scenarios, though, the key factor is in the response that we all have. In the choices that we make with the continuing restrictions we'll need to live with whilst each set of measures is released. It shows that actually the way we've got about things now with a very high level of people supporting the measures and living within the difficult restrictions and doing the right thing will have a much smoother path outwards with a much greater likelihood of not needing to pause and return back to other measures. If unfortunately we see people going beyond the path we're trying to chart out of lockdown and in particular if we see people mixing indoors then we expect that the virus will resurge and that will cause a real challenge and a potential halt to our path out of the lockdown that we're living with. So lots there about what the model evidence tells us is then the real world response to public that has got it to this point where more than half our local authorities in Wales have rates of less than 50 in 100,000 but of course that is taking place where there are lockdown rules in place that means that people can't mix more widely. It's about how sensibly we can all behave. I know there's lots of anticipation of what we might be able to do in the future but it really isn't born to stick with the process that we're going to be setting out and stay local is part of that. You recall previously in the spring we had a stay local period that was when we knew less about the virus but I think it was important in getting people ready for the potential for wider travel and people moving into different parts of Wales. We do know that if we're going to have an effective restart for parts of our tourism sector, the self-contained accommodation then that probably means that a stay local period probably doesn't mean that those businesses can open. So we are thinking about what stay local would mean. The First Minister will confirm that but again it's asking people to stick with it for a period of weeks and to be sensible about it, to recognise that if like me you're fortunate enough to live in Penarth then actually a few miles from Penarth you can do lots of things whereas if I lived in the middle of Powys or in the middle of Anglesey within a few miles I might not be able to do that. So we do recognise that if we go to stay local it will be slightly different depending on where you live and that I think is something that most of us in applying our common sense recognise so when a guidance around that would recognise that too. A few weeks of that and then we think we may be in a position to go beyond that but the First Minister will set out the confirmed thinking and choices of the government when he speaks to you on Friday. Thank you very much for that. Could I return to the issue of long Covid because as you will be aware the health committee has been receiving some powerful evidence today about the impact that has on people. Do you know of any projections about the burden long Covid will have on the NHS over the longer term and wouldn't boosting the support available be an investment to save in the longer term because many giving evidence do think that the current set up and you've explained it before is inadequate? Well part of the challenge is we don't know and we can't honestly say that we can give you a mathematical model or a prediction today that will say this is exactly the additional health care need will have from supporting people with long Covid and their care needs and that's part of the challenge why the research is so important it's why not getting stuck into a position where we say how we are approaching this issue today is right and will be the way we do this forever more because that cuts you off from learning and understanding as our knowledge base develops and I do understand there will be people who are frustrated who want different answers but actually that is part of the challenge with something that is still very, very new as a condition we still don't know quite how many people are affected the length of time they will be affected for the range of health and care needs that they will have and as I said earlier the variation in those health and care needs so the framework that we've developed is what we're doing now but will need to continue to learn and adapt that and I hope that will give confidence to people who I know are having very real health care challenges with long Covid in all its different forms that we haven't closed our ears or our minds to what is the best way to continue to support them now and in the future. Thank you all and I've now got Rebecca Miles from LBC. Thank you minister so as we've spoken a lot about in these briefings the topic of mental health and how people in Wales have been handling lockdown so just as health minister do you have any thoughts on Piers Morgan's reaction to the interview between the Duke and Duchess of Sussex of course denying or not believing Meghan Markle and do you think that was an overreaction? I thought Piers Morgan's comments about not believing what Meghan Markle had to say about her mental health was wholly unacceptable incredibly unkind and exactly where we should not be in public debate and discourse. We've won lots of ground by talking and being more open about mental health challenges not just in Wales but across the UK. The campaign the time to change Wales the time to talk about and get over some of the stigma I think the comments and the tone of them I think would have set a number of people back and that highly judgmental approach is really unhealthy and unhelpful and there are people who have had real challenges with their mental health for some people for the first time for others exacerbations and a reoccurrence of mental health challenges during lockdown and for him to deny without any knowledge or understanding really of what was happening in that family relationship and to say that he didn't believe her in particular about the suicidal thoughts he said he'd had. I thought that was damaging and unacceptable and he saw that mine and a range of other people caught him out too and actually please ITV reiterated that the campaign they've been running about getting ridden talking is something they are committed to. Obviously wish Piers Morgan well and the rest of his life wherever it takes and I hope that we can all learn something from this about how we behave and use the platforms of influence and power that we each have in our varying forms. Thank you minister just now on the alert level system so we published towards the end of last year of course then we knew about the Kent variant. We understand you've moved away from deciding if we can move down the levels based on coronavirus rates now without a dated road map and kind of any specific dates in when more parts of the country will be able to open up. How can people plan and know what to expect? Okay so when we published our coronavirus control plan with the figures and the headline indicators in numbers that we had we were always clear there'd need to be judgments made we'd need to take account of the scientific evidence and the public health advice that we get from the chief medical officers department and public health Wales on making decisions to both increase up the tears that we'd introduced but also to decrease as well. We didn't know the full impact of the Kent variant at the time that we introduced the plan we are much clearer now it's much much more infectious transmits much much quicker. Now that's a very different challenge to the one that we had in October November and the start of December. So the Kent variant being dominant is why we're much more cautious and that's the advice, the clear advice we're getting from our scientific advisors and the chief medical officer. The plan though and the tears that it sets out of different activities I think are a useful guide of how we're approaching our path out of lockdown and the easements we're considering it sets out the different risks for different activities and why we're considering some of those activities first. So I think it's a useful guide but you'll hear from the first minister tomorrow not just the choices we're making now but a signal I think for what we may be considering next. Now that's a deliberate choice not to have the much longer term roadmap that the UK government has set out but as you've heard from the deputy chief medical officer that does have several hostages to fortune a way we can't forecast with any degree of reasonable accuracy the position we'd be in in the middle of May or the end of June. But as I say you'll hear more from the first minister tomorrow. The next question is going to be from Adam Hale but the person on my screen it is Adam. That's okay I've got Rachel on my screen but it's going to be Adam Hale from Press Association next. I'm still here good afternoon Health Minister. Sorry I had a different face on my screen and I knew it definitely wasn't you. Will it be fair to say you've spoken about obviously the Kent variants and how that's affecting plans of opening up. Would it also be fair to say that you've perhaps been taken by surprise by the progress that's been made so transmission with the vaccination program which obviously has us now further down the line in terms of fighting coronavirus but has left us in a position where easy restrictions hasn't kept pace with that progress. No I think that the challenge is that the position has changed and moved on so when we had the control plan we didn't have a vaccination program. We now have a vaccination program that's moving really quick and I hope people across Wales are really proud of what that vaccination program is doing and it's a good thing to be able to say Wales is leading the rest of the UK that's a positive. All parts of the UK are moving forward though. We're getting more evidence about the impact of vaccination on reducing the likely impact of hospitalisation and the number of people who are still losing their lives to Covid. There's developing evidence on transmission too. Now that gives us positives to add into the public health situation but the vaccination program itself isn't a guarantee there'll be no harm from coronavirus at all and you'll have heard not just my own chief medical officer but the chief medical officer for England too pointing out that it is possible we'll see a resurgence and that unlocking too quickly would be likely to lead to a more significant resurgence during the summer. Now that's really problematic for us. We may not lose as many lives as we would otherwise have done either in the spring or the significant loss of life through the second wave in the winter but lots of extra hospitalisations would be possible that would have a direct impact on the health service to other measures we need to take to ensure our health service isn't overwhelmed. So there is a picture we have to consider with a number of different moving pieces and it's also the case, the Kent variant, being a much more rapid variant in the way that it transmits and spreads. That's a fact we have to take account of too. So the deliberate step by step approach is the one that we're taking. It's the advice that SAGE have given to the UK government and all governments around the UK. It's the advice of our own scientific technical advisory group and of our chief medical officer. So when the First Minister stands here on Friday we have the considered views and choices of the government and ministers within the government about our choices but it will absolutely be based upon the scientific evidence and the public health advice about how we move out of lockdown as quickly as possible but as safely as possible and that will be a safely staged and phased approach. Do you think that enough consideration has been given to what some could see perhaps as moving the goalposts here and not opening up restrictions in line with the levels of transmission as per the original COVID level plan which of course could do harm to a lot of the confidence and public support that has been built up in the public during the pandemic? Well I think it's really important to be able to honestly say to people the picture has changed since we introduced the plan. The measures we had at the plan at that time if we still had that same variant of coronavirus as the variant we'd be dealing with then it was still a rapidly transmitting virus it's now much more rapid and so that means we need to take another step back to look at what that then means for the measures we take and how quickly we ease out of lockdown and that isn't just a view of ministers and the choices that I have to make with the First Minister and ministerial colleagues it's a very clear and direct advice of our scientific advisors here in Wales but at SAGE across the UK as well we've been advised on taking a phased approach we've got clear advice that taking a much more rapid approach would lead to a resurgence with real harm being caused now that does mean we're going to need to update our own coronavirus control plan we're going to need to update the figures in there to take account of the new reality of the Kent variant but I think most people understand that if that's the clear advice that we're getting then trying to ignore that and say we have to do what we said we do in November or December most people think that that as a choice would make no sense at all and I would not be prepared to gamble with public health with all of the harm that could be done and also the economic harm that would be done for trying to act in a way with figures that don't match the current reality the phases in the tiering what said out about the progress that we'd make I think that is all still very relevant but we will be updating the numbers in a position when we're able to do so so you won't have to wait very long for that or indeed for the choice of the First Minister speaking for the Welsh Government on Friday but the next stage is out of our Level 4 lockdown Thank you Adam I've now got Will Hayward from Wales Online Thank you Mark Drakeford has previously indicated that he will be considering the reopening of non-essential shops and retail in this lockdown review but he is also considering local travel restrictions can you just explain the thinking behind that why is reopening non-essential shops considered a higher priority unless of a public health risk than letting people go for a walk in a national park and in addition given that next week people will likely be able to go for a haircut before all the kids are back in school full time can you just explain how that is putting children first Okay so there are two quite different questions there so we're looking at how we safely ease out of lockdown as I said to Adam previously so we take account of the advice we get and then we have to make choices now within those choices the first priority of the Government remains getting our children and young people back to face to face learning as soon as possible so we do expect and the First Minister will confirm on Friday the next phase of that reopening of face to face learning the advice we had about reopening our schools for face to face learning was that there is a risk that it will increase transmission of the virus this isn't just about what happens within the school it's at least as much if not more so about the extra time that adults have if you're not at home caring for children and young people then actually you have more time to mix and see other people so there's a good reason why we've been advised by our own scientific experts our own public health advice and similar advice was given to the UK by Sage on a phased approach now that's what we're doing following that advice we are though in the very positive position that we have headroom enough to carry on with that phased approach and at the same time we can also make other easements that won't compromise our ability to reopen schools when we return from the Easter break and the choice is do we decide to do nothing and keep all other activity frozen and locked down despite the apparent room we have for manoeuvre and of course the rules we have in place are public health protection measures that's the basis of the significant restrictions we're living with and they have to be proportionate measures in place so we have to consider would it meet that legal test and there's just a broader point about public acceptability if we have that advice my chief medical officer and our scientific advisers would we really say that we'll stop people from doing that until not just schools have gone back on the 12th of April but we then need to wait an extra period of time to see the impact of those before other measures were taken that would also mean we'll we then have to have a much bigger unlocking of other activities after that time too so it would mean we'd have a much bigger bang approach to different easements at another point in the future so there's nothing cavalier about our approach to all following the science and the public health advice we have some room to do some extra things but they will be limited in what we're going to be able to do until we not just have our schools reopened but other forms of activity in the highest risk of course and you'll know this as well as all those people watching is extra indoor contact and I know that's really difficult I know some people want to be able to go and see friends, relatives, loved ones and just the social interaction with other people but that's the highest risk for us and our headline rates are decreasing because of the impact of lockdown and now also pretend the impact of vaccination so that I think should help to explain and underpin the approach we're taking and the scientific and public health evidence that we're still relying on as we make these choices to help keep well safe Thank you, I'm just a bit confused about the coronavirus control plan you said that when that was written you weren't aware of the new variant obviously when that was released we were in lockdown because the Welsh Government pointed out that because of the new variant that's why we were in lockdown but I'd like to ask you about plans in the USA to allow people who have all been vaccinated to mix together unrestricted have you considered such measures in Wales and can you explain your thoughts on them and how likely you are to follow a similar policy I'll happily deal with your confusion about the plan Will when we introduced the coronavirus control plan of course we didn't have the range of events we have now about the Kent variant and actually at that time we were aware of a new variant with some cases around Bridgend as a cluster more cases in North Wales we weren't completely sure about the spread of the Kent variant in the rest of the country what we were completely sure about was the increasing number of rates across the whole country we've learnt much more during the period of lockdown and the Kent variant has become the dominant strain and as I said in my script our scientific advisory is up to 70% more transmissible than the previous versions of the virus now that isn't knowledge that we had when we introduced the control plan that's why we're looking to revise the figures in the plan but we still need to exercise judgement and take account of the advice that we're getting from our scientific advisors and the chief medical officer so we'll be open about that and as you know we don't just publish on a regular basis the advice my technical advisory group but every time we go through the 21 day review we publish the chief medical officer a summary of his advice as well so the public can see the advice he's giving and how that then relates to the choices that we're making but I think revising the plan to go back to the figures will be helpful again but the phasing through I still think is highly relevant for all of us when it comes to USA of course the choices are there for US administrations both the White House and at state level we have a different system here we're of course interested in how other people around the world are experiencing and moving on the difficult balance between saving lives and livelihoods when you'll see the model evidence so I'm keen that we do get to publish and you can review it'll show that actually even with a single dose of the vaccine there's still risks for people once people have had two doses of the vaccine there are still some challenges for us about those other people and we don't expect to get the whole adult population who've had their first dose until the end of July so we still need to balance those risks so I don't think we're going to be saying to people you can throw all the restrictions to one side once you've had your vaccination I think that sort of cavalier approach could reintroduce lots of harm very quickly so exactly the sort of challenge that Chris Whitty has been highlighting in his evidence yesterday but also our own advice here from the Chief Medical Officer too but I do think as you see more and more evidence published to help inform public debate and opinion I think that'll reiterate the approach we're taking here in Wales and I am absolutely certain we're doing the right thing here in Wales for Wales and that's exactly what I'm here to do thank you Will I've now got Rachel Nurse from the National Good afternoon Health Minister the test and trace system in England has been criticised for costing £37 billion and having little effect how much did the Wales test and trace system cost and what difference has it made well I think we're due to spend about £45 million within this year the additional investment that I've announced today is to make sure it can carry on going into the next financial year as well because we're still going to need our contact tracing service here in Wales to help keep us safe and I think you can see the impact of it earlier the over 167,000 people have been successfully contacted by our service the fact that over 99% of our positive cases initial cases have been contacted 95% of their close contacts last week 88% of those contacts were contacted within 24 hours of us having their details so it's a highly effective service and it's one that I'm proud to say is a public service that is more efficient in our counterparts in England in terms of reaching people more efficient in terms of the speed but also more efficient in terms of the value for money as well so it's the area where we regularly beat ourselves up in Wales and say things must be better somewhere else and aren't they always better in England this is a clear example where we should be proud that our public sector approach the NHS and local government together is delivering a better service it will be even more important as we start to open up more areas of activity that's why we say to people please if you've got the symptoms get a test isolate and please follow the advice of your local contact tracers thank you First Minister what benchmarks are you measuring health minister what benchmarks are you measuring that effectiveness by because it clearly wasn't effective enough to prevent the spread of the virus because we're in lockdown now and also the lockdown in autumn well this is part of the challenge isn't it the contact tracing service is there as part of the sweety measures that we have to keep Wales safe but it's not a fail safe and it doesn't mean that an effective contact tracing service means that people can go and mix freely and ignore the rules and restrictions we have this is the balance in what we have to do from a government point of view to help keep people safe the guidance and advice we give people but the choices we all make in our day to day lives as well and the virus doesn't really care about the effectiveness of the contact tracing service the fast spreading virus wants to carry on reproducing and moving and moving on now that we know leads to significant harm so a really effective contact tracing service one that we have here in Wales and I'm very proud of is part of how we keep Wales safe but the biggest part of how we keep Wales safe for the choices that we make and actually that's the reason why we're seeing the headline case rate 4 in the way it is the choices we're all making about not just following the rules about doing the right thing and as we ease out it'll be the choices we make that'll be the most important factor in how successfully we stay out and how successfully we're able to open up other areas of activity in the future too I remain very very great to people across Wales for their support for the approach we've taken here in Wales thank you Rachel I've now got Steve Bagnell from The Daily Post thank you Health Minister with restrictions possibly easing in the coming weeks could you give your perspective on the higher rates being seen in north west Wales compared to the rest of Wales at the moment and the recent outbreak at Osbuti Gwyneth could this influence whether areas like this are put into different restrictions here as Wales moves out of the current lockdown or will all of Wales move out the same across the country well the figures are slightly higher in north Wales but if you look at the figures for the hold of north Wales they're still reducing compared to a week ago think about where we were a few weeks ago we still had some very high rates within north Wales there a significant move on from there so the pace is slightly different in different parts of the country but actually we're in a much better position and that again as I said in answer to Rachel is about the hard work that people have done the way people have supported those measures we do think that the outbreak within Osbuti Gwyneth has an impact on what's then happening within the community with the two are linked and it's because they start when there's a relatively high amount of community transmission the transmission rates of positivity rates in north Wales are slightly higher than the rest of the country so it does show that whilst we can plot our way out with some easements we all still need to be careful and take care in what we're doing and in doing the right things on good hand hygiene on keeping our distance in particular avoiding indoor contact with people and that means that we're more likely to maintain the progress at this point we don't think that we're going to move different parts of Wales at different speeds but it is an option and we'll have to look at the evidence and the advice we get at different points in time but I wouldn't anticipate that north Wales will be held into lockdown for longer than the rest of the country and that certainly isn't the approach that I expect the First Minister to confirm on Friday Thank you You've touched on this with concerns of a third coronavirus wave as restrictions are lifted will the Welsh Government approach any third wave differently with a vaccine programme being rolled out or will it broadly be the same with restrictions applied as needed and possibly further lockdowns? If we were to have a further wave we would have to look at the evidence at the time now this may well be a challenge for a different government and a different health minister that's a choice people will get to make in the coming weeks but the evidence that ministers will get will have to set out as it does for us our understanding of what is happening in terms of people's behaviour our understanding of how the virus is being spread our understanding of if there's any change in the virus that is material consideration and then how we can then act on how the virus is being spread to try to interrupt transmission the biggest part is still about the choices we all make but if we did need to take other measures to keep the public safe then this government would certainly be prepared to do that as we have done at various stages over the last year but our objective is to try to come out of this lockdown in a phased way that puts a real premium on the lives that we can save but also having a sustained reopening of more economic activity and wider activity too so that's why we've got the regular reviews we have it's why we've placed at store on the scientific and public health evidence and advice that we get but in the future we'll always have to deal with the evidence and the challenge of what we see in front of us and our ability to intervene and interrupt that to save lives and livelihoods Thank you Steve I've now got Rob Taylor from rexham.com Good afternoon we've asked this recently but you've mentioned that everything can't reopen at once there is a ramp up of preparation work from a range of local businesses who are expecting to reopen fully on Monday Are you comfortable that all sectors are aware of what the review will entail and that they've been signalled to appropriately and there won't be a situation on Monday that businesses will be ready and expecting to open but calm? Well I think I'd say two things the first is that we have had regular conversations with sector-wide bodies to talk about what might be possible to talk about the time that they would need to get ready to reopen as well because for some sectors it's longer than others and we've also tried to be as open as we can do about that unless it comes to my second point and that is that in that openness we can't give absolute cast iron guarantees because if in the figures that we see today or tomorrow we see a spike in different areas and different activity that may cause us to reconsider and think about what we're doing Now I think the first one is going to be able to give more certainty tomorrow because actually the public health position is improving week on week over the whole of the country but if in three or four weeks time we were seeing a different position we may need to reconsider some of the advanced signals that we hope to be able to give about the next phase coming out of lockdown so yes I think we do have regular engagement with those different sectors that we're looking to be able to reopen and to reopen safely but it's also the case that you can't say that we'll never have to retreat or to put the brakes on but really as I said repeated is about the choices we're all making to want to recover more freedom but to keep it and not to have to go backwards Thank you and the North Wales Health Board has welcomed a significant increase in the AstraZeneca vaccine this week but has also warned that expecting less of both vaccines next week is this yo-yo supply what's to be expected I suppose and can you give an overview of the expected supply in the coming few weeks and lots of words such as increase, decrease are being used can you give context to what that means well we think that we will have a significant increase in the figures not to the ones published today that show a further increase in the day before we think that will carry on through the next week we will then see a step backwards in the supply that we have of AstraZeneca for a period of time we'll then see a much more steady state that's our expectation of vaccine supply and I've had conversations with AstraZeneca and Pfizer but also a regular conversation with the UK government vaccines minister and the challenge will be making sure that we can deliver when we have the supply and I think we will be able to do that you'll see that in the figures this week and then managing public expectations about when the supply becomes slightly less but actually even in the last few weeks when we had a reduced supply we've still been seeing thousands and thousands of people every day first and a second dose so even in the reduced areas of supply if you think back to where we were in January we're regularly doing on a daily basis more than we were doing in a week at the start of the vaccination program and that does show how our suppliers have scaled up their activity to deliver more of that and what's really important is our vaccine teams are then going out to successfully deliver that into people's arms they're doing it really quickly and that's the way that I know from the patient feedback I've seen it's something that people are really impressed with both the process but also the level of care and interaction they're having with those staff at that time so I can't give you exact figures on where we are we're publishing information every week as you know on vaccine supply and we'll continue to do that to be as open as we possibly can be and finally Andrew Nuttall from the leader we've said for Wales like there is in England we've got sort of a rough idea up until the Easter period but then again the public are not aware of any future plans whereas England are going a little bit further into the summer and I believe Scotland are also around the end of April having some sort of rough guidelines of what people can expect are there any future indications of what can be happening in Wales after the Easter break or will people just simply have to wait and see for further updates on their lives and potentially this is the sum of the manner I mentioned and the information that we already have publicly available well we've been really clear that the long term plan that England have set out into the middle of the summer is something that requires a level of forecasting that we don't think is sensible or reliable there's an awful lot of hostages to fortune within that and I just don't think that is a sensible approach it's a choice that the UK are entitled to take for England but we have decided to give more certainty in the way we're phasing out of lockdown and I think that's really important because I think offering people false hope will actually destroy trust in what the government is saying much better to have a more focused approach to phasing out in the way that we have been advised to do so that does mean though that you won't have to wait very long though Andrew because the first minister will be here on Friday in the next phase and hopefully giving some further signals as well about the next stages that we're considering so we're doing that in a way that will give people some distance into the future but not the months and months of forecasting that I've referred to previously as a level of astrology that I don't think is a very helpful way to chart our way through this unfinished public health crisis Thank you and care home visits are part of the review on Friday what you've mentioned in this conference a number of times and the approach will have to be taken because of this new variant the Kent variant being more dominant than any approach needed to be taken has this sort of factored into your decisions is there any sort of indication you can give to sort of loved ones and care home staff of what they can expect on this Yes we're considering the improving overall position but how we have a range of measures to keep both visitors, staff and residents in care homes as safe as possible there is no zero risk activity but we're doing a range of things we've already invested for example in visitor pods to allow more visiting space for people to attend we've already indicated there'll be lateral flow device tests available for people to take as well it's an extra measure to take out potentially positive people who don't have symptoms to avoid the potential harm as well and also we've got regular testing on that basis for our staff in those environments as well so I'm hopeful we'll be able to move forward with a different approach to visiting that will allow more people to see their loved ones and that'll be all confirmed on Friday as well and I hope people see that there's not just good news in what it represents but also taking that consistent approach of a phased approach that puts a real premium on public health and safety and I think that's the approach that most we want to see continuing here in Wales but good news I hope for us all on Friday when the first minute will confirm and the next steps forward as we look to ease our way out of lockdown Many thanks Andrew and everyone who stayed with us for the end of today's event


The next item of business is a statement by Humza Yousaf on protecting those most at risk Covid-19 vaccination programme winter 2022. The cabinet secretary will take questions at the end of his statement and so there should be no interventions or interruptions. Thank you, Presiding Officer. I welcome this opportunity to provide an update to the chamber on the winter vaccination programme for 2022. Vaccinations for the most vulnerable this winter started on Monday, so this week marks another key milestone in our continued effort to protect against Covid-19 and provide resilience for the NHS this winter. As a nation, we have faced enormous challenges since the start of the pandemic, the challenges that stretch beyond the initial and serious health impacts of the virus. However, I think that it is important to recognise just how far we have also come. For many of us, though I absolutely accept not all of us, life feels like it has largely returned to normal. We have lifted all legal restrictions and protective measures. That is only possible because of the game-changing Covid-19 vaccination and high levels of uptake amongst the Scottish public who have come forward to receive it and the army of vaccinators up and down this country, to which I think that we are all eternally grateful to. More than 12 million Covid-19 vaccine doses have now been administered in Scotland. In fact, we have among the highest rates of Covid-19 vaccination uptake of first, second and third doses anywhere in the UK. At one point during our last winter vaccination programme, we had one of the fastest vaccination roll-outs in the entire world, a fantastic achievement in protecting the most vulnerable in our society against serious illness and death. The European Centre for Disease Prevention and Control estimates that Scotland's vaccination programme has averted around 28,000 deaths amongst those aged 68 and over. We have an estimated total reduction of 86 per cent in fatalities due to the vaccine, the highest percentage in Europe after Iceland. Every single one of those saved lives is someone's family member—it is someone's friend. It cannot be stated enough that our health service and everyone involved in the vaccination programme are owed by all of us a huge debt of gratitude. This autumn and winter, we will build on the success of previous programmes, including the spring-summer programme, which has just drawn to a close. Like previous rounds of the vaccination, Scotland's spring booster programme enjoyed tremendous uptake. As of 5 September, 70 per cent of those with suppressed immune systems, 86 per cent of the elderly in care homes and 92 per cent of those aged 75 have received that spring booster dose. That represents 87 per cent of all those who are eligible for a fourth dose, which has exceeded our expectations and planning assumptions.  Advancing our continued offer of vaccines and boosters will ensure as much protection as possible to those who are most at risk. Today, we are publishing the deployment plan for the winter 2022 vaccination programme, which sets out the detail of how we will administer vaccines to those who are in most need here in Scotland. This year's deployment plan still has at its heart the aim of tackling Covid-19. It recognises that there are other challenges that put pressure on the NHS and endanger the health of some of our most vulnerable members of society. A key risk as we move into the winter is seasonal flu. As Cabinet Secretary for Health and Social Care, I am acutely aware of the pressures that the flu and Covid combined can weigh on both the NHS and people's personal health, too. That is why I am pleased that we will offer, wherever possible, both the Covid-19 and flu vaccine in the same appointment to those who are eligible. As part of our approach to tackling winter pressures head-on, we are aiming to vaccinate as many people against flu and Covid as possible by the beginning of December, while ensuring that we have the necessary capacity in the system to achieve that. I am also aware of the strain that the NHS is under. In order to achieve the pace that we need, we may need to accept that there may well be some overlaps of cohorts receiving their vaccines and there may well be some small and, I hope, limited geographical variation, as we do not want to hold any one area back, particularly later on in the programme. That will not be unique to Scotland, I suspect, but against this challenging backdrop the goal remains to vaccinate those most vulnerable as soon as possible. As ever, our decisions on who to vaccinate and when are guided by the clinical expertise of those in the joint committee of vaccinations and immunisation. In line with the committee's recommendations this winter, a Covid-19 booster will be offered to residents and staff in care homes for older adults, frontline health and social care workers, all adults aged 50 and over, those aged 5 to 49 who are at clinical risk groups, including those who are pregnant, those aged 5 to 49 who are household contacts of people with immunosuppression and carers aged 16 to 49. Everyone eligible for a Covid-19 vaccination will also be invited for a flu vaccine and can safely receive both vaccines at the same appointment. That is why this winter, as I have already mentioned, we will aim to administer the Covid-19 flu vaccine at the same time as possible. That will save time and will avoid the need for repeat journeys to vaccination centres and, hopefully, will protect as many people as possible against the serious health risks that are posed by Covid-19 and seasonal flu. The final point is particularly important, as we know this year that seasonal flu arrived much earlier than expected in the southern hemisphere. In addition to those eligible for a Covid-19 winter vaccination, the deployment plan sets out a range of other groups who will be offered the flu vaccine, prioritising those who are most at risk. That has been our approach from day 1, in accordance with the advice from JCVI. The winter vaccination programme started Monday with care home residents. Many care home staff are being offered their vaccine at the same time, or, alternatively, they can book their appointment through the online portal, along with health and social care workers, which has been open since 22 August. Alongside care home residents and staff, health and social care workers and individuals who are housebound are being vaccinated from Monday 2, ensuring that we protect, as I say, the most vulnerable first. We have already scheduled more than 800,000 winter vaccination appointments for those aged 65 and over, with hundreds of thousands more being scheduled in the course of this week, so I urge all those who are eligible to please wait until you have been contacted. Anyone who has any doubt at all about whether they will receive an appointment should visit the NHS Inform website for more information. Given that the immunity that is conferred by vaccination can wane over time, it is important that we maximise protection for the most vulnerable ahead of winter, when the threat from Covid-19 and flu is likely to be at its greatest. By prioritising those who are most at risk, we can also limit strain on our NHS, as it recovers from the worst effects of the pandemic. On 15 August and 3 September, the MHRA granted regular say approval to two updated by-valent vaccines, so-called because of their dual aspect, which targets both the original strain of Covid and the Omicron variant 2. By-valent vaccines have been deployed as part of our winter vaccination programme from the start of this week. The vaccine news will depend on clinical eligibility, but also crucially on vaccine availability. However, I want to reassure the public that both the existing and the new by-valent vaccine provide excellent protection from severe illness and hospitalisation, and I would urge all those who are eligible to take up the offer of the vaccination whenever they are called forward. The vaccination programme is a vital step in our plans to address as many of the winter pressures as possible, but we are also well aware of the bigger picture. We cannot fail to acknowledge the cost of living crisis and all that entails the potential that we know for industrial action. Of course, we will work hard to ensure that that does not happen. Inevitable bad winter weather, all of those issues, plus more, may make it difficult to travel to large-scale vaccination centres than previously. Of course, the fact that restrictions have been lifted—legal restrictions—certainly means that those large-scale venues are quite understandable and quite rightly going back to their original purpose. For this reason, for those reasons, we are instead offering smaller local clinics to facilitate access to those who need it most, with more than 440 clinics available across Scotland during the programme as of 6 September. We are also taking steps to ensure that people who may experience barriers or feel less confident are able to come forward for vaccination. Although we have a general level of assurance in vaccine supply and delivery, that may of course be impacted by extreme adverse weather or disruption to transport routes, and we will do all that we can to overcome those challenges. This year's winter vaccination programme will, without any doubt, confront serious challenges. Our NHS is still in the midst of a period of recovery and sustained and significant challenge as we work towards ambitious targets and bring it down the backlog left by the Covid-19 pandemic. Nevertheless, I am very confident that the programme will be delivered in line with current JCVI planning, with the most vulnerable being vaccinated by the beginning of December, and will, like previous rounds of vaccination, achieve a high rate of uptake. If I may, I would like to say to this Parliament and the public again that these vaccines provide excellent protection from severe illness, which could otherwise strike at the very worst time of the year. I strongly encourage everybody who is eligible to take up the offer of the vaccination. I look forward to providing a further update to Parliament, detailing our progression through the programme in the coming months. The cabinet secretary will now take questions on the issues raised in his statement. I intend to allow around 20 minutes for questions, after which we will move on to the next item of business. I will be grateful if Members who wish to ask a question were to press their request-to-speak buttons now. I call Sandesh Gilhani. I welcome the roll-out of the winter flu and Covid vaccination programme. This is the first bivalent vaccine targeting both the Omicron and the original strain of Covid-19. As seen throughout the pandemic, working together as the United Kingdom, we are able to swiftly get jabs into arms. An early procurement of this bivalent vaccine is only possible because of the broad shoulders of our United Kingdom. As a GP, I urge everyone who is eligible to please get vaccinated as it will save your life. Cabinet Secretary, with the best well in the world, some people will not receive the letter through error, and some eligible people, for example uncaid parers, might also not be lettered through not being known about. How does somebody who feels they are eligible but do not receive a letter, book and appointment? I thank Dr Gilhani for his comments and reiterate them around if you are eligible, please do come forward. I can also say that there are good four nations working. I have to say that although, obviously, I have not had the opportunity to meet the new health secretary, but I am certain that that will continue with her new position. Those who are eligible will be contacted sometimes differently depending on the local structure. For example, the way of contacting those who are household contacts of those with immunosuppression might be different in Orkney than those who are in Glasgow. If you have any doubt whatsoever about your eligibility, we can direct people towards NHS Inform. If they are digitally excluded or unsure, they can also call the vaccination helpline for confirmation about whether they are eligible or not and how they will be invited. I also say to Dr Gilhani, who is very aware of that, that this is our second winter vaccination programme. That, for many people, might be their fifth dose of the vaccine. I suspect that people now are in the rhythm of knowing whether they are eligible or not. Some might not be, and therefore, if there is any doubt, you have any doubt whatsoever, do not hesitate to call the vaccination helpline for further information. Presiding Officer, let me in advance thank those who will be involved in running the winter vaccination programme. We are very grateful for all of their efforts, but we know that the Covid vaccine lessens the impact of Covid, but we also know that it does not stop people from getting Covid in the first place. That remains a significant concern for those who have underlying health conditions who were originally on the shielding list and told to stay at home. Not all of them are eligible for antiviral medication, and we have yet to see the use of prophyllactics to prevent those who are most at risk from getting Covid in the first place. Can the cabinet secretary tell us when he will extend eligibility for antivirals to all those who are on the shielding list and when will access to prophyllactics be given so that we can protect the very vulnerable from getting Covid in the first place? First of all, I forgot to say in my response to Dr Gilhani that I am writing out or should have landed in most MSPs inbox an update on the winter vaccination programme. That will include details of who is eligible and is much of a leadership role. I have my role as cabinet secretary for health and social care. I hope that all MSPs will cascade that information locally. If they hear of any individuals who have any doubt about whether they are eligible or they think that they are eligible but are not getting any further information, they are more than happy for them to contact me, too. I recognise what she said. I recognise that there are people out there who may not be suitable for whatever clinical reason to get a vaccine, although the vaccine does remain, of course, the best protection against the serious effects of Covid. There will be some people who may not be able to exhibit immune response due to whatever clinical condition they have. On widening the access to antivirals, that is a clinical discussion that is very much taking place. I have been contacted by the likes of, for example, Parkinson's UK, who I know are very keen for their members—those that they represent with Parkinson's—to be eligible for certain antivirals. I understand that one of the clinical trials under way is now in discussions with those with Parkinson's to gather that clinical data. That on-going evolution of the antivirals and the eligibility is a process that is on-going. Jackie Baillie will be aware, but I am happy to give her more detail in writing, that there is a particular prophylaxis, which is of interest to many people. It has got a conditional regulatory, a conditional marketing authorisation, but that authorisation was given before the prophylaxis, before Evershild was tested against Omicron. Therefore, there is insufficient data to give us any credible evidence that Evershild is effective against the Omicron variant. I understand that the UK Department of Health and Social Care has offered to explore the possibility of a clinical trial for Evershild. I am very supportive of that and will make it very clear when I meet the UK Health Secretary, the Secretary of State for Health, that I would be expecting that Scottish patients would also take part in those clinical trials. Emma Harper will be followed by Tess White. As a nurse, I, too, would like to encourage all those who are eligible to take up their vaccine offer. Many of those who are eligible for vaccines will face accessibility requirements, particularly those who are housebound. Accessibility should never be an obstacle for people who receive in healthcare. With that in mind, what arrangements have been considered in the roll-out of the next round of vaccinations, especially for those with accessibility needs? This is an issue that has been well rehearsed in previous iterations of the vaccination programme, but it is absolutely right that Emma Harper raises it. There may be people who are now housebound and who are not housebound in previous iterations of the programme, and I want to give an absolute assurance that they have not just been thought of in this programme but given real priority when it comes to the vaccination programme. Housebound patients will be offered both flu and Covid vaccinations within their homes at the same appointment where appropriate. Those who are eligible will be contacted by their local board. People who are housebound have not been contacted much like anybody else who feels that they should be eligible, as Dr Gohanne asked me, but have not been contacted. They should call the national helpline and the number for that is 0800 030 8013. Cabinet Secretary, the deployment plan highlights that many health boards are using the Scottish Ambulance Service to reach deprived or rural communities. We know that the Scottish Ambulance Service is already under pressure. How will that be adequately resourced to ensure that those communities are not overlooked? Cabinet Secretary? Can I contribute to the work that the Scottish Ambulance Service has done? I think that many members here have visited their mobile units up and down the country. Some of those mobile units—Teswight is right—have been in a remote rural area. Some of them have actually been in urban areas as well, but they have been a great asset to us in this vaccination programme. The planning for the winter vaccination programme has been done very much in that hand-in-glove with the Scottish Ambulance Service. I would say to Teswight that in remote rural parts and island communities in Scotland, there is still largely a reliance on those local, hyper-local vaccination centres. I think that I said in my statement that there are around about 440 vaccination centres. That will hopefully give some level of confidence to Teswight that remote rural and island coverage is very good indeed in terms of the vaccination centres, let alone the additional complementary assistance that the Scottish Ambulance Service can provide through their mobile units. Fiona Hyslop, to be followed by Paul O'Kane. The cabinet secretary may be aware that West Lline has a bigger population than the city of Dundee, and that my constituency of Llanlithgow is the most constituent in Scotland with a significantly disproportionate number of over 50s residing in it. The Pyramids facility in Bathgate provided the space for the very welcome over a third of a million Covid vaccinations, unlike other mass vaccination centres that are now understandably closed. What assurances can the cabinet secretary give me that staffing levels and venues, if they are to be based in GP surgeries, in my constituency and across the country, will have the capacity and support that the cabinet secretary needs to ensure demands from the large number of people who will be eligible to have their winter Covid booster will be met? I agree with everything that Fiona Hyslop has just said, and for various different reasons, those large mass vaccination centres are no longer available to us. They are being used for their original purposes. Some may have closed down, but there are still large centres in some parts of the country. However, I am very assured by the plans that I have seen by local health boards up and down the country, by using those local sites that are high in volume to hopefully provide that reach right across the country. In terms of staffing, if Fiona Hyslop is absolutely right, the very constrained timetable that JCVI is asking us to work under means that we are going to have to hit a run rate. Every single week, there is near the record run rate that we hit last year. Last year, we had that kind of boosted by the Bells campaign, if members remember correctly. That is on top of the usual winter pressures that we may well face. Therefore, if there is another wave of Covid, for example, that will undoubtedly have an impact on staffing. Those things are being monitored, contingency plans are absolutely being put in place, but it is fair to say that this is a really ambitious programme. The impact on staffing and the pressures on staffing are significant, but we all know the importance of the vaccination programme. That is why I am so grateful for every single member of that vaccination programme that is helping us with this winter programme. Paul O'Kane, to be followed by Gillian Martin. I note what the cabinet secretary has said in terms of vaccination services being as local as possible, but we know that rhetoric does not always match reality. There have been numerous examples of NHS Highland patients being made to make 100-mile round trips, and there have been numerous examples of people with respiratory illness being instructed to travel to Glasgow. It is also critical in terms of delivery to recognise that the RCN is balloting for strike action, with more than 90 per cent of nurses having rejected the Scottish Government's pay offer. What specific actions are being undertaken to ensure that vaccination centres will be as close to people as possible, and what action, further action, is the Scottish Government taking to resolve the pay dispute and ensure that nurses are paid a fair wage, including those who provide vital vaccination roles? I am satisfied that the number of venues that we have is sufficient for the ambitions of the winter vaccination programme. If, for example, there is a need for more vaccination centres, I would expect local health boards to adjust their programme accordingly. He mentioned Highland alone. Highland has 121 vaccination centres, so I hope that that gives some level of assurance to Paul O'Kane about their coverage. In terms of the second part of his question, we are in regular dialogue with the trade unions. I want to see a fair settlement. I understand why they are asking the RCN's example for an above-inflation increase, but, of course, as John Swinney has said in the last couple of days and spoken to the chamber, our public finances are constrained. Nonetheless, while I am disappointed that 5 per cent has been rejected, I completely respect the mandate that trade unions have been given. Therefore, we are getting back around the table with them to get to, hopefully, a fair deal for our NHS staff up and down this country. Julie Martin, to be followed by Alex Cole-Hamilton. In the refugees in the past few years, most recently, those fleeing from the war in Ukraine, what steps are going to be taken to ensure that all refugees who may not be registered with the GP can be made aware of the vaccine programme and access appointments? That is a really important point raised by Julie Martin. That has been part of our winter planning for this particular vaccination programme. Materials have been translated into Ukrainian into Russian. Of course, we know where those Ukrainian refugees are, and, therefore, there is a targeted effort to ensure that the material gets to them directly. They do not have to be registered to a GP to get the vaccination. We will continue with those efforts. We are also talking to a number of community and third-sector organisations to assist us with that communication. There is good working going on. I have said to those health board areas that are hosting Ukrainian refugees, which is a significant proportion of our local authorities. I want us to work with our health boards to be as proactive in this endeavour as we possibly can be. Alex Cole-Hamilton, to be followed by John Mason. Vaccine hesitancy will be as big an issue in this roll-out as it has been in previous roll-outs, particularly given that people believe that we are now living around Covid as just a way of life. What additional messages can the Government give to those people who are sceptical about the efficacy of vaccines and how important it is to take up the new booster jab? Cole-Hamilton is absolutely right. It has been one of the concerns that I have had that, as Covid is perhaps not as prominent on the agenda as it perhaps was in previous iterations of the programme, I do not want there to be any complacency setting in the indications thus far from the portal that has been opened for health and social care workers and from the work that has been done in care homes. It does not suggest that the uptake has been affected, but it will not be complacent about that. We all have responsibility, primarily myself, of course, in the role that I occupy, but we all have responsibility to continue to communicate the benefits of the vaccine. I urge everybody to do that. I certainly will do that in my position. It is not just about vaccine hesitancy. We know that there are certain groups within the population where the uptake has been lower. That is where we are going back to Tess White's point. That is where our mobile units can be really effective if they are outside particular community facilities. We know that they have been deployed previously in the goodwara, mosques and areas of high deprivation, and they have been a fantastic resource in that sense. If I can give Alex Cole-Hamilton absolute reassurance that nobody in the Government is being complacent, I urge everybody here to communicate the benefits of taking up the vaccine. Thank you very much. We were told previously at the Covid Committee that worldwide some 20 million lives have been saved by the vaccines, and yet there is a lot of misinformation and disinformation on social media. Can the cabinet secretary confirm that 20 million is roughly the figure of lives that have been saved, and can he reassure those who are made nervous by social media? Yes, he is referring to a study by Imperial College London. He is right that the number of lives saved is just below 20 million—19.8 million. We know, of course, as I referenced in my comments, that Scotland and Scotland alone, 28,000 lives, have been saved by the vaccine. There is a lot of disinformation, and we are doing our best to counter that disinformation by promoting the benefits of the vaccine on social media platforms that can reach a far wider audience than a watching our proceedings here in the chamber. We will continue with that effort to counter disinformation, and, as I said to Alex Cole-Hamilton, I think that we all have a responsibility in that. I welcome the update from the cabinet secretary. We are in a cost-of-living crisis, and I am sure that the cabinet secretary would not want anyone to not be able to make their appointment due to not being able to afford to get there. Has the Scottish Government had any conversations with health boards about what support may be offered in those circumstances? We have told health boards—they have been very willing to do that—that we have to factor the cost-of-living crisis into our planning. The cost-of-living crisis is a public health crisis. We know that. Therefore, that planning is well under way. If people do not feel that they can leave their house because they cannot afford to do so, they should, of course, contact the national vaccination helpline. They can contact the local health board, and my absolute expectation would be—I will further reiterate this to our health board colleagues—that we would do everything in our power to get to those people or, indeed, to those people to us at no cost to themselves if, of course, the cost of travelling to a vaccination centre is indeed prohibitive. Thank you, cabinet secretary. Centralised vaccination centres simply do not work in rural areas. One has found an vulnerable elderly couple in Straths Bay have been given their appointments on two different days in two different locations, with one being asked to make an eight-hour round trip of 70 miles to Inverness. That does not fit in with your statement to provide more local centres. I favour GPs in rural areas rolling out vaccines as they did earlier in the pandemic. If GPs are willing to do that, are you willing to support them? In short, yes. I would say to Mr Mountain that, if he wants to furnish me with those specific details, I am happy to follow that up with the appropriate health boards. I gave the details of the local arrangements and how many local centres there are. If there has been an issue with scheduling, that is, of course, regrettable. My colleague Fergus Ewing and I had a meeting with local GPs. If local GPs, for example, in North Highland, are keen to be a part of that vaccine programme and if they are needed, there should be no restriction on behalf of Government. For example, we know that GPs have been used—in fact, they visited a GP in the island of Bute in Rothsy, where they were administering vaccinations. There is not a legal restriction in that sense, if GPs are willing to do so. We know that it is not part of the contract, but if they are willing to do so. On his specific point around his constituents, I am happy to delve further if he is able to provide the details. Clearly, we want vaccination centres to be as accessible as possible. To minimise, again, as far as possible, lengthy travel to get vaccination, especially for people who are reliant on public transport. Will the cabinet secretary advise if the number of venues for vaccination will be kept under review? It absolutely will be kept under review, and I would expect if there is a need to adjust, then health boards would adjust accordingly. They will absolutely do that. I have seen that happening in previous iterations of the vaccination effort. I will make the point that I made to Gillian Mackay. If anybody is concerned about the cost of travel or their ability to travel and arranging transport to and from vaccination appointments for, for example, mobility issues or indeed other issues, there is support available from each board. You can go to the NHS and form website for the details of that. You can also call your local health board a vaccination helpline or indeed the national helpline, who can direct you to the right place as well, because we want nobody, we want no barriers to anybody coming forward for the vaccination. Again, I would urge anybody who is eligible to please come forward to protect yourself, but also to protect others and, of course, to protect our NHS too. That concludes the ministerial statement. The next item of business is consideration of two parliamentary bureau motions. I ask George Adam, on behalf of the parliamentary bureau, to move motions 5, 9, 1, 0 on committee membership and 5, 9, 1, 6 on committee substitute. The questions on those motions will be put at decision time and there is one question to be put as a result of today's business. I propose to ask a single question on two parliamentary bureau motions. Does any member object? The question therefore is that motions 5, 9, 1, 0 on committee membership and 5, 9, 1, 6 on committee substitute be agreed. Are we all agreed? Thank you. The motions are therefore agreed. That concludes decision time. Before I close this meeting, I do appreciate that members are deeply concerned about the health of Her Majesty and I would advise members that Parliament will ensure that members are informed of any news that we may have to share with you about business over the coming days. I close this meeting.