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Yes—in whatever circumstance we look at, the Government accepts that argument. We have accepted it for many years and we have taken a number of steps to address it. Some of the available data and detail shows that the challenges that individuals face as a consequence of Covid will be made worse by other weaknesses in their health and fitness.

Mr Whittle makes a strong argument, which the Government accepts, for people to pursue a healthy living approach. Many of our public messages are supportive of such an approach: we encourage people to exercise, look after their health and take preventative action, so that they are in the strongest possible position to withstand the effects of conditions such as Covid or, for that matter, other challenging health conditions that people face in our society. The emphasis on preventative interventions is a core part of the Government’s health strategy and will remain so in the future.

The Cabinet will consider the steps that we will take on any future expansion of the vaccination certification scheme. That scheme works well. I fail to understand what the fuss is about. I think that it is a completely reasonable request for us to make. The arrangements are in place, and it functions well.

As I indicated in my response to oral questions in Parliament yesterday, in a system that involves more than 10 million individual vaccinations, there are bound to be teething issues on certain vaccination certificates. I have made it clear that ministers will help to resolve any issues. Indeed, I got an email last night from a gentleman who is not a constituent of mine who was looking for my help to solve a vaccination certification issue. That is under way. We will resolve such minor issues when they arise, but the vaccination certification scheme works perfectly well.

In our discussions on Tuesday, the Cabinet will consider any future expansion. We have put in place steps that enable negative lateral flow device tests to be an alternative to vaccination certification. That would remain an option for us to use in any future expansion and the Government will, of course, consider that.

Obviously, we will carefully monitor the impact of schools returning. That is central to the approach that the Government is taking, because we recognise that their return marks a gathering of individuals within our society at a fairly high level. As we know, the meeting of individuals from multiple households leads to the spread of the Covid virus.

We will monitor the situation closely. That is why we are taking a phased approach to the relaxation of restrictions. Although the current data is encouraging, the data could be influenced by the effect of schools returning, and we will now only just be beginning to see the effects of that in the numbers, to the extent that that will have an effect.

We do not have authorisation from the Joint Committee on Vaccination and Immunisation for the widespread vaccination of children who are in the five-to-12 age group. The JCVI has not made the case for that and, as the committee will know, we look to and implement the advice of the JCVI. The JCVI has indicated that it is appropriate to vaccinate some children in that group, particularly if the child might be clinically vulnerable or living in a household with individuals who are clinically vulnerable. We are taking steps to implement those recommendations, as has been confirmed in Parliament.

On the final part of your question, ventilation is ostensibly a local authority priority. We have been engaging with local authorities on ventilation over the past 20 months, and we have required them to enhance the monitoring of air quality in schools to ensure that we have a good understanding of where some of the ventilation requirements might need to be in place. On Tuesday, the First Minister announced further expansion of the funding available to local authorities to enhance ventilation schemes, should that be required. Local authorities have undertaken extensive audits of ventilation requirements on a classroom-by-classroom basis, and we expect them to act accordingly to address any ventilation weaknesses that emerge out of those surveys.

There is a huge amount of pressure on NHS boards around the country. It would be fair to say that all boards are under intense pressure. They are having to manage high demand for services as well as difficulties caused by staff absences that have been caused by omicron. Obviously, the changes to testing arrangements and isolation periods that the Government has implemented will be beginning to have a welcome effect by easing some of those staffing pressures.

We are confident about the sustainability of NHS services at the moment, but the position is constantly dynamic. Individual hospitals will come under greater pressure as a consequence of incidents that take place and the demand that presents itself. We are issuing and circulating advice across the national health service to encourage people to use the appropriate health services for the circumstances that they face.

At this stage, the national health service is coping in all parts of the country, but it is coping under enormous pressure, and the headroom that is available to cope with increased demand is very limited. For that reason, along with the Cabinet Secretary for Health and Social Care and the Cabinet Secretary for Social Justice, Housing and Local Government, I have been leading dialogue with local government about expanding the capacity of social care services around the country. Obviously, the more we have effective social care services in place in the community, the more we can support individuals to have their needs met at home and in all other care settings in order to avoid their presenting at NHS facilities. That is one of the crucial interventions that we are making to try to stem demand and pressure on the NHS.

I will draw in contributions from Professor Jason Leitch in relation to some of that material, but let me work my way through the points that Mr Fraser has raised.

On the reasons for individuals’ hospitalisation and whether people are in hospital because of Covid or with Covid, data has been developed by Public Health Scotland, which has worked with data sets from NHS Greater Glasgow and Clyde and NHS Grampian. Those are two significant boards—NHS Greater Glasgow and Clyde is the largest board in the country, and it covers a substantial share of the population. We have to get into proper perspective the scale of the population that is covered by the data that was the subject of release last week, if my recollection is correct. That data gives us a fairly substantial picture of the country. It demonstrates the pattern that about 60 per cent of people who are being admitted to hospital in connection with Covid are admitted because of it. That is relatively similar to the numbers in the studies that have been produced in other nations in the UK.

The position is not too dissimilar to the position with earlier strains of the virus. If my recollection is correct, the data in the previous exercise that was published by Public Health Scotland showed that 68 per cent of people in the previous survey that was undertaken had been admitted to hospital because of Covid.

In the context of the volume of data that we publish on these questions, the data that has been published on that issue gives us a pretty good understanding of the balance and breakdown of that information, and Public Health Scotland will be working on further iterations of that data in due course.

The second point relates to vaccinated and unvaccinated individuals in hospital. From the latest data that I have seen, the analysis has shown that the unvaccinated hospitalisation rate was 59 out of 100,000, while the boosted hospitalisation rate was 15 out of 100,000. That means that the unvaccinated are four times more likely to be hospitalised than people who have had their booster or third dose.

I hope that that data helps, but I will draw in input from Professor Leitch, who will provide further detail on that.

In the over-70s group, 95 per cent have had boosters—

I will look at those figures specifically, but we must have the context that there is a very high level of vaccination among the over-70s. We take a range of steps, such as the prioritisation of care homes for the delivery of the vaccination programme. At the outset, there was a bit of criticism of the Scottish Government that we were not moving as fast as England, but we were doing the painstaking work of making sure that people in our care homes were well vaccinated, and that level has been very high.

Equally, we have to ensure that people who are housebound are vaccinated. I have dealt with a number of cases in my constituency where vaccinations of people who are housebound were undertaken more slowly than people would have liked, but my recent case load indicates that that position is substantially enhanced. I agree with Mr Rowley on the importance of vaccination, but we have to keep a sense of perspective, because we have very high levels of vaccination in those age groups.

Does Niamh O’Connor or Professor Leitch want to add anything to what I have said?

It is a very careful judgment that has to be made, and Mr Mason puts a fair and challenging point to me. The situation that we must consider involves a balance of considerations around a number of factors, such as the prevalence of the virus, the presence of hospital cases, the pressures on intensive care and a variety of other social and economic indicators, not least the wider wellbeing of the population, the ability to sustain restrictions and the impact that those might have on the mental and economic wellbeing of individuals.

There is a careful balance to be struck, and I hope that Mr Mason accepts from the explanation that the First Minister gave on Tuesday and that I have given today that, while we are hopeful, the Government continues to take a cautious course in the relaxation of restrictions.

We are taking a phased approach. In the course of the week, I have dealt with a range of broadcast media and handled criticism that the Government did not go further in the relaxation of measures than we did on Tuesday. A number of sectors have strongly expressed those criticisms. In essence, Mr Mason puts to me the counterpoint and asks why we are going as fast as we are going. It is a not unreasonable point.

We judge that enabling some of the larger events—such as those in outdoor football stadiums, where vaccination certification and lateral flow device testing are required among at least 50 per cent of the crowd—to take their course is a reasonable first step in the relaxation of restrictions while we consider whether, with the benefit of another week of data, we can see a wider improvement in the situation that allows us to relax measures further. I acknowledge that it is a careful balance, and it is one with which the Government wrestles with a great deal of consideration.

Again, it is the balance question. In a moment, I will invite Professor Leitch to give some detail on the clinical justification for the change, because we need to hear that. Ministers have heard it and come to conclusions about it.

There is an important perspective that has to be borne in mind. It goes back to many of the questions that we have wrestled with as ministers and shared with the committee on a number of occasions about the four harms framework. Multiple harms are created as a consequence of Covid. Loss of economic wellbeing is one of them. Loss of social interaction is another. Ministers have to be conscious of those factors when we take decisions on matters such as self-isolation.

We have been criticised for taking too long to relax the self-isolation rules, but we took an appropriate amount of time to make the judgments within the context of the arrangements for, and the policy approach that we have taken to, managing the pandemic. That will be an important point in relation to the judgments that we will have to apply in the future.

I invite Professor Leitch to add some remarks on the clinical explanation for the relaxation of the self-isolation requirements.

We are tackling the issue. We have the capacity available in cities to enable people to be vaccinated. We have headline messaging and marketing, which is encouraging people to undertake the vaccination. Very focused communication has also been issued to individuals who have not had a booster vaccination; we have been communicating with them directly to encourage them to do so.

Given the point that I just made that there may well be time gaps between the moments at which people have been vaccinated, the capacity will be maintained to ensure that opportunities for vaccination are available for individuals. I assure Mr Rowley that the Government intends to maintain the messaging and the communications and approaches to individuals, and that we will maintain capacity to ensure that we can deliver the vaccination programme.