 1. Ruth Davidson The First Minister and all MSPs will have read further stories this week of women in Scotland dying from breast cancer unable to receive the drug Projeta, a life-extending drug available to patients elsewhere in the UK. There will be women this week and in the weeks to come who will hear the devastating news that they have HER2 positive secondary breast cancer. Because Projeta is a first-line treatment, it needs to get it quickly to benefit from that additional time to live. What would the First Minister advise them to do? First, there will not be a single family in Scotland that has not been touched in some way by cancer, including of course breast cancer. All of us know that being diagnosed with cancer is an incredibly difficult time for patients but for all of their families and friends. One of the things that is very important is that patients get speedy access to appropriate treatment and where that appropriate treatment is considered to be drugs, which includes drugs. However, as I have said many times in this Parliament, and I think that this is something that is appreciated by members across the chamber, the decisions around the approval of drugs in Scotland are not taken by ministers. They are rightly, in my view, taken independently of ministers in Parliament by the Scottish Medicines Consortium. Those decisions are based on clinical and cost effectiveness. On the Projeta drug that Ruth Davidson has highlighted today, national procurement officials and NHS national procurement officials are currently engaging with the pharmaceutical company that manufactures at Roche to explore how they can offer that drug at a fair and a transparent price. Those discussions are building on discussions that took place between the company and Scottish Government officials last week, I believe. My message to the company today would be to encourage them to resubmit Projeta to the SNC at a transparent price and allow the SNC to do its independent job. It will always be a source of concern where particular drugs that patients feel will be of benefit to them are not approved, even if that is just for a short period of time. Of course, there are some drugs that are approved in Scotland that will not be approved in other parts of the UK and vice versa. Those are always difficult issues, but perhaps because they are so difficult, it is important that we respect the independent processes in place. Ruth Davidson, for that answer. If women in Scotland lived just a few miles south of the border, they would not have to think about moving house or uprooting their family to have access to a medicine that keeps them alive. We know that a deal was done between the NHS in both England and Wales and with Projeta's manufacturer. The First Minister told us two weeks ago and has reminded us again just a moment ago that the drug company is in discussions with NHS Scotland. She also made the point that the Scottish Medicines Consortium makes decisions independently of government. Can she at least say today that if the same deal is offered to Scotland, as was offered and accepted to England and Wales, will it be accepted here? I would certainly hope that that is the case, but of course that is a decision for the Scottish Medicines Consortium. I do not have access to all the details of what the deal is. I do not know if that is the case with this particular drug, but often those deals are commercially confidential. That is an important issue. It is a very serious issue. I do think, though, that some of the way in which Ruth Davidson has characterised that is not entirely fair. For example, I could point to another drug for treatment of advanced breast cancer, which is available and approved in Scotland, but is not currently approved in England. There are other drugs that will fall into the same category. It is sometimes too easy to characterise those decisions in that way. Sometimes those situations arise precisely because we have our own processes in place. England goes through a different process through Nice. We have the Scottish Medicines Consortium, and I think that that is a process that is widely backed by people across this chamber. Those are difficult decisions, and it is right that we support the SMC to take those decisions. What Ruth Davidson is encouraging the company to do is make sure that the price that is being offered to NHS Scotland is as reasonable, fair and transparent as the price that is being offered elsewhere in the UK. I would certainly endorse that, and hopefully the discussions that are under way will lead to exactly that. I understand that the SMC makes the decisions independently of government, but I would also gently remind the chamber that the Government sets the framework under which those decisions are made. Because of a cancer drugs fund in England, Projeta has been available down south for more than four years, and it has had an effect. If we take an example, Bonnie Fox's son was just four months old when she was diagnosed with secondary breast cancer in 2015. Because she lives in London, she can receive Projeta and is still alive to see her son's third birthday. For years, women in Scotland have been missing out on this treatment. This drug has gone back and forth to the SMC for a decision three times since 2013. Can the First Minister honestly say that the system that her government has overseen for all those years has done its best by those women? If I was talking about another drug in England, I guess that the same argument could be made in reverse. Those are the outcomes of independent processes. It is not because there is a refusal to fund that is unreasonable, but it is about making sure that the company submits a fair price. If we do not insist on companies submitting fair prices, there are fewer drugs that we are able to make available for patients. That is why those processes are so important. Ruth Davidson rightly says that it is the Government that sets the framework. That is why I am sure that she is aware of the significant reforms that have been introduced in recent years. For example, between 2011 and 2013, the combined SMC acceptance rate for orphan and cancer medicines was just 48 per cent. Because of the reforms that we have introduced between 2014 and 2016, SMC approval of ultra-orphan orphan and end-of-life medicines is now 75 per cent. Those reforms are leading to improvements, but that does not remove the need for very close consideration of individual applications. I want to see as many medicines and drugs are approved and available to patients as possible, but we would not be doing a service to patients if we did not have a robust independent process in place. It is right that we do so and all of us should support it. Of course, that responsibility is particularly important for the Scottish Government, which is why we have been having the discussions that I have spoken about and why we are encouraging the company to resubmit at that fair and transparent price that will allow it to be approved. Ruth Davidson In Scotland today, women with secondary breast cancer are faced with a choice. They can move home for a chance to live longer or they can stay put in the knowledge that that chance is denied them here. We urgently need a deal on progeta and we need to fix the system now. The health secretary promised a new system of negotiating on the cost of medicines in December 2016. At the time, Mary Allison, the Scottish director of breast cancer now said, we need to deliver those changes quickly and effectively. There is no time to lose. It is now May 2018, 17 months later. What is taking this Government so long to fix the system to help women to get access to medicines like progeta and can the First Minister give the exact date that her Government will put in place the new negotiating system that she promised so that we have greater access to treatments that let people live longer and better quality lives? The Montgomery review that was asked by this Government, by this health secretary to recommend reforms, there is an on-going process of implementing those reforms. It is partly because of the reforms that we have implemented that the figures that I read out earlier on have been achieved. There is further work being led by national services Scotland right now. It is important that we continue to reform a system as I am sure will be the case in other parts of the UK to make sure that it operates as well as it possibly can. However, this is the important point. No matter how good and efficient the system is, that does not remove the need for individual decisions to be taken on individual drugs. There is a process that is under way about progeta. I hope that process concludes positively as quickly as possible, but part of the responsibility there is for the drug company to come forward with a fair and transparent prize for the drug. I hope that one thing that we can agree on today is the encouragement to the drug company to do exactly that. I do not think that it is fair to, as I say, characterise it in the way that Ruth Davidson partly has today, because equally we could do that with other drugs in reverse. We have systems in place. Those are difficult decisions. I am sure that the health secretary will identify with what I am about to say. When I was health secretary, those were among the most difficult decisions that you ever confronted. The most important thing, as a health secretary—now as a First Minister—is to have confidence in the processes that we have in place. I have confidence in those processes. Of course, they are always open to improvement, but we must make sure that those processes are independent to get the right results and the fair results for all patients across the country. That is what we are determined to do. Question 2, Richard Leonard. Thank you, Deputy Presiding Officer. First Minister, how many families will be hit by the 57 per cent hike in childcare charges proposed by Glasgow City Council? Of course, the decisions that Glasgow City Council has taken and the decisions for Glasgow City Council are also involved, as I am sure that Richard Leonard will be aware of, extending beyond the national recommended provision, the number of free hours for families, as I understand it, earning less than £30,000. They have been working hard to accelerate the progress towards the doubling of free provision and doing that in a way that targets those at the bottom end of the income scale. Of course, we are committed nationally. In the last couple of weeks, we have agreed a deal with COSLA about the funding of our transformation of early years education and childcare. That is something that I hope that people across the chamber would welcome. Richard Leonard. The question that I asked was how many families in Glasgow will be affected by the SNP's decision to hike up childcare charges. The answer, according to a freedom of information disclosure, is 5,000. 5,000 families are already struggling with the cost of living. 5,000 families are like the Spence family. Sarah Spence works for the NHS as an assistant practice manager in Anderson. It is a vital job, but she told me, I feel like I will be forced to give up work to look after my son, which is unfair, as I love my job in the NHS and I do not want to not work. Today, the childcare costs for her 18-month-old son, Ollie, are £420 a month. With those proposed increases, the family would have to find another £220 a month. First Minister, how many working-class families do you know with a spare £220 a month? First Minister. Many constituents in my constituency in Glasgow who benefit from the free childcare that Glasgow City Council makes available have made a number of changes to their provision, including increasing the numbers of hours that are provided free to families, as I understand it, earning under £30,000. Of course, the reason why we are working so hard and investing so considerably to increase the provision of childcare is to reduce the costs overall for families, not just families in Glasgow, but families across the country. The reforms that we are currently in the process of implementing with local authority colleagues will save families across the country thousands of pounds a year, as well as giving young people the best start in life. That, I think, is a direction of travel that all of us across the chamber should warmly welcome. Richard Leonard. First Minister, at your party's conference just last October in Glasgow, you said and I quote, "...some parents still face a struggle to find and fund the childcare they need to allow them to work." We are going to change that. So how does a 57 per cent hike in childcare charges change that struggle for working families for the better? It doesn't, does it? It changes it for the worse. First Minister, this won't allow people to work. It will slam the door on work for people. So will you listen to what 5,000 families across the city of Glasgow are telling you? Will you add your voice to their demand? First Minister, will you stick to your word? Will you stand up for these families? Will you stand up against these outrageous increases? First Minister. It's because I believe so strongly what I said in the speech that's just been quoted by Richard Leonard, that by the end of this Parliament, this Government, with our partners and local authorities, will be investing almost in total £1 billion doubling the amount of free childcare that is available to families across this country. Doing something that Labour never did in all the years that they were in power. We'll get on with the job of providing the money to local authorities to allow them to double their provision of free childcare, something that will be of benefit to children and to families the length and breadth of this country. Can I remind members that they should always speak through the chair? A constituency question, Liam Kerr. First Minister, on Tuesday this week, the press and journal reported that hoax calls to Aberdeen firefighters are a five-year high, which ties up vital resources and puts the lives of our brave firefighters and members of the public at risk. So what steps will the Government take to crack down on hoax 999 calls? Given that many of those calls are from those struggling with mental health difficulties, isn't this another case where local, joined-up approach from multiple services will succeed over top-down centralisation? My strong and unequivocal message to anybody making a hoax call to one of our emergency services is don't do it, because it ties up resources that those in need are depending on. In terms of the broader part of the question about mental health, I have a great deal of sympathy with that, which is why we are investing in mental health workers in non-health settings, particularly in criminal justice settings, which I think was something that I also announced recently in perhaps the same speech that Richard Leonard has just quoted. Those are important issues in terms of the provision of mental health support, but not everybody who will make a hoax call is in that position. All of us have a duty to remind people of how precious our emergency services are, how reliant all of us are at times on them and how all of us have a duty to treat them with utmost respect. Last Thursday, the First Minister will be aware that 25-year-old Shabazz alias Syrian refugee was stabbed six times in Edinburgh's now critically ill in the hospital. He had been at the time trying to protect his young female cousin when he was attacked at hospital in the city. Can I ask the First Minister what support the Scottish Government and its agencies are giving to local authorities and communities in Edinburgh and across Scotland in terms of protection and reassurance following what appears to be a clear, racially motivated criminal act? Well, thank you to Andy Wightman for raising this issue. I am, of course, aware of the case of Shabazz Ali, who was attacked and seriously hurt in the early hours of Thursday morning last week. Clearly, there is a criminal investigation under way into this incident, and as we are not aware of the full circumstances of the case as yet, we and I are obviously restricted in what we can say about the specific case. What I will say more generally is that Scotland must stand united at all times against all forms of racism and all types of hate crime. We want Scotland to be and to be seen to be a refuge from war and persecution, and any attack on any individual or group of people living in Scotland, regardless of who they are or where they come from, should be seen as an attack on all of us. The Scottish Government will do what we can with the local authority in Edinburgh and with other groups to provide as much reassurance and support as possible. I am aware that there is a fundraising campaign to raise funds for this particular individual, and I am sure that many people across the country will want to support that. Presiding Officer, police are battling a significant rise in the amount of crack cocaine flooding streets in my region and particularly in Fife. Offices have found that drugs have become much more available over the last six months, promoting a fear of an epidemic. The Scottish Government's drug strategy is clearly failing the residents of Fife. Can I ask the First Minister what future robust measures will be put in place to combat this issue as a matter of urgency? The First Minister will continue to support our police in the vital job that they do to get drugs off of our streets and our police work hard every single day of every week in doing exactly that. We are never and never will be complacent about the risk and the threat and the impact of drugs. However, in terms of the reference to the Scottish Government's drug strategy, I would disagree with that. Latest figures indeed indicate that the number of adults who reported drug use actually decreased from 7.6 per cent in 2008 to 9.6 per cent in 2014-15. The latest survey of drug-taking behaviour among young people shows that the majority of young people, 13 and 15-year-olds, have never used drugs. We have to be aware of that context while continuing to treat drug use as seriously as we do. Thank you, Deputy Presiding Officer. On this topic, what is the First Minister's reaction to news this week that, in Glasgow, cocaine can be delivered more quickly than pizza? The First Minister's reaction is that I am concerned about what has been reported in terms of cocaine use. That is something that should concern all of us. As I said in relation to the previous question, we are never and never will be complacent about that. However, we must put those issues in the context that I just did in terms of the declining use of drugs among the adult population. We are also giving additional resources to improve the provision and quality of services for people with substance misuse issues. While it is not exactly relevant to the cocaine issue that Adam Tomkins has raised, one of the things that we support—I know that Glasgow City Council supports it—and indeed this whole Parliament supported a couple of weeks ago is a safe consumption facility in Glasgow, because we need to look at different ways of dealing with the drug issue, and we are certainly open to doing exactly that. Does the First Minister share my concerns that the Tory-led Scottish Borders Council is reducing its share of funding for the bus service X101-102 with drawing its contribution of just over £135,000 to a measly £35,000, affecting many of my constituents in places such as Westlinton and Pericook? Does the First Minister agree with me that flies in the face of encouraging public transport and will she raise this with the Transport Minister? As I said earlier in response to another question and another issue, those are matters for the local council. However, I can well understand that the situation that Christine Grahame has outlined will be of concern to people in her constituency. I am sure that the Transport Minister would be happy to discuss it further with her, and I am sure that she will take him up on that opportunity. I want to ask the First Minister about Brexit. The Conservative foreign secretary says that his Prime Minister's plan is crazy. Labour members of Parliament are in open revolt. Two years on from the referendum, Brexit is a shambles and it is damaging the country. The First Minister's trusted former adviser, Noel Dolan, says that it is time for her to back her referendum on the Brexit deal. He is right, isn't he? I can just say that I am going to take the opportunity to tease Noel Dolan mercilessly, that, after so many years being my adviser, helping me with FMQs in opposition and in government, he managed to avoid being the story, and then, not long after his retirement, he manages to do the opposite. On the serious issue, I say this to Willie Rennie in all sincerity. It is not the SNP that is going to be a bloc if there is to be a second referendum on the EU issue. I think that if there is to be any prospect of that, it is not the SNP that he needs to convince. It is one of the main parties in Westminster that he will need to convince, and given that we cannot at the moment seem to even convince the Labour opposition at Westminster of the case for the single market, I am not sure that there is much grounds for optimism, but I would suggest that his target on this is the wrong one. It is quite an important point that, and I understand this, the motivation for people arguing for another EU referendum is that they hope that the result would be different from the one at the last time. That is not really relevant in Scotland, because, in the EU referendum, Scotland did vote to remain. The problem in Scotland is that our remain vote has been completely ignored. What guarantees can Willie Rennie give people in Scotland that, if that was the outcome again, our remain vote would not be ignored in exactly the same way all over again? Willie Rennie The problem for the First Minister is that time is running out. We could be leaving within months. She has told us before that she is sympathetic to this. She is sympathetic to a referendum on the Brexit deal, but if she is so sympathetic, why does she not just pick it up? No Dolan was not alone in speaking up for a Brexit deal referendum. Another former adviser, Kevin Pringle, agreed to two of the great thinkers in the SNP. First Minister, oh sorry, Mr Rennie, I thought you were finished. I am terribly sorry, carry on. And Keith Brown has a degree of sympathy for the idea as well. And Ian Blackford, he's open to looking at it as well. So with the backing of so many people in her party and the damage that Brexit is doing to the country, is the First Minister prepared finally to make a decision to put her government behind a public vote to back a vote on the Brexit deal? First Minister, I was enjoying that so much. Can I firstly thank Willie Rennie for his warm words of praise for so many of my SNP colleagues? Can I remind him that all those great thinkers, and I agree with them that they are all great thinkers, all support Scottish independence? I am so honoured to be with Willie Rennie on that issue as well. I will concentrate on Willie Rennie for the moment. I would say this in all seriousness to Willie Rennie. The SNP is not a bloc to this, but equally the SNP is not capable of bringing about a second referendum on the EU position. Willie Rennie would be better spending his time trying to persuade Labour of that, as hopefully together we can all spend our time trying to persuade Labour of the case for the single market and the customs union. So I agree with Willie Rennie and his characterisation of Brexit is a complete and utter shambles, and I hope that common sense breaks out in a number of ways. But I think that Willie Rennie would be better to spend his time trying to persuade those who could make a bigger difference here, and I will leave the great thinkers of my party to persuade him and a whole host of other things as well. Further supplementary, Maurice Corry. Thank you, Deputy Presiding Officer. 100 years ago this year, the people of Islay witnessed the tragedies of the sinking of HMS Otranto and SS Tuscania off the coast of Islay, resulting in a huge loss of American servicemen enroute to support the Allied Forces effort in Europe in World War 1. Will the First Minister join me in thanking the people of Islay and the World War 1 Commemoration Committee of Islay and for the very moving service of commemoration at the War Memorial in Portellon and other commemorative events on Friday last week held in the presence of a mad of her Royal Highness, the Princess Royal and Admiral Timothy Lawrence and senior representatives in the UK Government, the Scottish Government and senior diplomats in the United States of America, France and Germany? First Minister. Yes, I will. I was very sorry personally not to be able to be in Islay on Friday of last week due to the funeral of a personal friend in Glasgow that I had to attend, but it was a tremendous ceremony and the commemorations and I would take the opportunity to thank the World War 1 Commemoration Committee not just for their work around the Islay commemoration but all of the work that they have been doing to commemorate the battles and key events of World War 1, but it was an opportunity, I think, to pay tribute to the spirit and generosity of the people of Islay and, of course, the American servicemen that benefited from that generosity, so I would thoroughly endorse all of the comments that have just been made. Further supplementary, Anna Sarwar. I listened carefully to the exchanges between the First Minister and Ruth Davidson around the breast cancer drug projeta. As we know in the Montgomery review of the SMC, one of the recommendations that we won on those benches was for an interim accepted period. That was to allow for life-prolonging medicines to be made available while the SMC and the medicines company negotiated a price. Why has that not been implemented? Surely that is the answer to give those life-prolonging drugs to those breast cancer patients. Drugs can already be made available on an exceptional basis through individual patient treatment processes and that is an important part of the process that we have in place. As I have already said, we are introducing, on an on-going basis, the recommendations of the Montgomery review. Some of them require very careful consideration and I hope that Anna Sarwar and others would accept the need for that. We will continue to take forward those reforms to ensure that patients do get the fair access to drugs and medicines that all of us want to see. Further supplementary, Alex Cole-Hamilton. On Tuesday, a young doctor in my constituency contacted me to say that 10 days ago, after a gruelling recruitment process, she had been awarded a place that would see her become a consultant in her desired field of medicine. On Friday, a week after making plans with her partner to move house, she received the devastating news that, due to an administrative error, all offers were being withdrawn. All told, that has affected over 100 doctors in Scotland, some of whom had bought houses and resigned positions on the strength of those offers. Does the First Minister support calls for an inquiry into this matter and will her Government consider offering some form of compensation to those doctors in Scotland who are financially disadvantaged by that mistake? First, as Alex Cole-Hamilton will no doubt be aware, this is a UK-wide issue that has arisen in this affecting doctors, not just in Scotland but in other parts of the UK. Of course, we are paying very close attention to that and will consider the particular points that Alex Cole-Hamilton has made. If the doctor in his constituency wishes to, I am sure that the health secretary would be happy to correspond with Alex Cole-Hamilton directly in order to see what advice and help can be offered. I will ask the health secretary to correspond more generally with Alex Cole-Hamilton about the action that the Scottish Government will be looking to take to make sure that the situation is rectified and secondly that it cannot happen again in future. First Minister, this morning, BT announced that it will cut thousands of jobs in back office and middle management, while creating additional jobs to support network deployment and customer service. Can she advise the chamber what the implications of the decision are for Scotland? I am aware of the announcement that BT made this morning. As of yet, we have had no indication from BT on exactly how that will affect its Scottish operations. We will be seeking further information from BT over the next couple of days. We will, in an appropriate way, share that with members who have an interest in it. Obviously, this will be a concerning time for the company's employees, who may be affected by the decision. Scottish Government officials have already contacted BT Scotland to offer guidance and to see whether we can provide any assistance. However, as we have further information, we will share that with Parliament. Can I ask the First Minister if she will provide an update on progress towards tackling excessive parcel delivery surcharges affecting many parts of Scotland? I recognise the long-standing concerns about parcel deliveries to rural areas and very much appreciate the work undertaken by Richard Lochhead and organisations like Citizens Advice and Highland Council. The Government has worked with them and others on the issue, including the development of a statement of principles for fair delivery charges, which was subsequently adopted by the UK Government. The Business Minister will host a meeting on 27 June, with parcel delivery companies, retailers, consumer groups and others, to discuss what further action we can take. I will give an assurance to Richard Lochhead that we will continue to do everything that we can. However, I remind the chamber that the regulation of prices for parcel deliveries is reserved to Westminster and that it is time that the UK Government also took serious action to address the issue. Richard Lochhead Can I thank the First Minister for her answer and also the news about the ministerial meeting that is going to take place? Can I tell her that I continue to be inundated with cases on justifiable excessive parcel delivery surcharges imposed in homes, businesses and mury and throughout Scotland, by some companies, when others deliver free or for a modest charge? That is also not just a rural issue that main major online retailer Wayfair, for instance, imposed surcharges for some items on Falkirk, Greenock, Dundee, Paisley and other places, but offer free delivery to places such as Penzance in the south of England. It is welcome that online platforms such as eBay and Amazon have met and recognised their problem and want to help to sort it out. It is also important that the advertising standards authority is now dealing with companies that promise free delivery to mainland UK but then exclude parts of mainland Scotland. If the First Minister is aware that many retailers continue to apply an additional charge after transactions as well, which is absolutely illegal, and other companies refuse to deliver to the first Scotland— Richard Lochhead Hurry up, Mr Lochhead. Given that the case for regulation that the First Minister mentions is getting stronger and stronger, will she personally intervene and take that up with the UK Government so that we can scrap that £30 million, £6 million surcharge in Scotland? First Minister, can I thank Richard Lochhead? He has done absolutely sterling work on this issue. Both raised the awareness of it at government level but also contributed to some of the actions that we are now seeing being taken to address. It is an issue that mainly affects rural issues, but we have just had a timely reminder from Richard Lochhead that it is not only rural issues in Scotland that are affected by unfair and excessive delivery charges. It is something that has got to end, and we are determined in the Scottish Government that we will play our part in ensuring that that happens. I will give Richard Lochhead the assurance that we will take it up again with the UK Government, because meaningful change will only happen if the Government that holds the main levers and responsibilities here takes a far more active role. We have made many representations in the past, and we will continue to do so. The UK Government should be insisting that all consumers, wherever they are based, whether in rural communities or major cities, receive fair, transparent and timely delivery of their parcels. I think that people everywhere in Scotland have a right to expect that. It is supplementary. Jenny Marra. Legal parcels are being delivered by companies to households all over Scotland containing illegal drugs, including street valium selling at £20 a tablet. What powers does the First Minister have at her disposal to stop legal delivery of illegal substances? That is an important issue. Obviously, the member is raising the issue of illegal substances. We often have issues of delivery of other goods that can be damaging or used in a damaging way. I will ensure that a letter goes to the member setting out exactly what powers the Scottish Government has and where we may again have to look to the UK Government to take action. For example, I know that there is currently consideration of legislation to deal with the issue of knives, and that includes parcel deliveries as well. If it is acceptable to the member, I will make sure that that information is provided to her so that we can make sure that we are doing everything that we can to address what I recognise as a serious issue. To ask the First Minister what action the Scottish Government will take to reduce the number of cancelled NHS operations. The First Minister We continue to support health boards to keep all cancellations to a minimum through better scheduling and planning of elective care. In 2017-18, on average, 830 operations were carried out each day, and that compares with around 22 cancelled for capacity or non-clinical reasons. NHS Scotland staff numbers under this Government are at a record high, and we have also committed to an additional 2,600 nursing in midwifery training places and additional medical training places over this Parliament as well. Rachael Hamilton I thank the First Minister for that answer, but this year, NHS borders has consistently had the highest or second highest rate of cancelled operations due to capacity or non-clinical reasons. After one of my constituents had her operation cancelled, the Cabinet Secretary for Health and Sport wrote to me calling it, quote, highly regrettable and totally unacceptable, but her operation was cancelled again. The Cabinet Secretary for Health and Sport wrote again and again, saying that it was unacceptable. When will the First Minister realise that we need action and simply repeat bland statements of regret and saying that it shouldn't happen just isn't good enough? First Minister I would never diminish the importance of any patient who has their operation cancelled for a non-clinical reason, but it is also important, as I did in my original answer, to point out the fact that that will be a very small percentage of the total number of operations that take place each and every day in our health service. We are working with health boards and will continue to do that to reduce the number of cancellations and to reduce weights. The Scottish Access Collaborative, for example, the development of the modern outpatient service, are all initiatives that are about improving the position, and we will continue to work on them. Particularly in March of this year, we saw an increase in cancelled operations, particularly down to the very adverse weather that we had faced in many health boards. More than half of all cancellations for non-clinical reasons were down to the weather, but we will continue to remain focused on ensuring that the number of operations that are cancelled for reasons that are not clinical are kept at an absolute minimum. First Minister, for what impact the EDF energy announcement on the acquisition of the Nearshaugai project will have on renewables jobs and the supply chain in Scotland? We welcome the purchase of the NNG project by EDF energy renewables. In August 2017, just to give some context of this, the Fraser of Allander Institute estimated that this project would contribute 0.6 per cent of GDP, which is about £827 million to the Scottish economy over its lifetime. It also predicted that the project would create thousands of jobs during the construction phase and over 230 operations and maintenance jobs for the 25-year lifetime of the wind farm. As I mentioned in the chamber last week, I met with the chief executive officers of EDF energy and EDF renewables last Thursday afternoon. They committed to meet with the energy minister as soon as possible to discuss their plans for the project. I raised with them then, and this further meeting will provide a further opportunity to seek assurances on how the Scottish supply chain will benefit from the acquisition. I share the First Minister's welcome for the project and look forward to hearing more from the energy minister in due course. Does the First Minister agree that support for training will be vital if workers such as those in BiFab are to take full advantage of such opportunities going forward? If so, what training support will her Government's agencies provide so as to ensure a future for the arts in methyl and Stornoway, as well as for the arts in Burnt Island? Yes, I believe that training is very important in the future of the industry. Our agencies, Skills Development Scotland and Scottish Enterprise already focus very much on that. Indeed, one of the particular things that we focused on during the oil and gas downturn was a training initiative that I think that Lewis MacDonald welcomed at the time that helped people working in that sector to retrain for other sectors, including renewable energy. Lewis MacDonald mentions BiFab. That is one of the contracts that, although there are no guarantees, gives grounds for optimism for the future of a company like BiFab. As the chamber knows, we are very focused on ensuring that we do everything that we can to support BiFab. When the acquisition by DF Barnes was announced, it was made very clear that it was not a magic solution and that hard times still lay ahead, that the yard has to win contracts. However, that acquisition means that BiFab did not close, and what we now need to do is support it to win contracts from projects like that to ensure that it has the bright future that all of us want to see. In July 2016, Brian Wilson, the former Labour energy minister, told the BBC that offshore wind in Scotland is pretty much dead. Does the First Minister share my view that Brian Wilson has been proved wrong again? Will she join me in calling for everyone who wants to see the creation of valuable jobs in Scotland in Scottish engineering and to fight climate change to get behind the development of all the offshore wind farms in the Forth and Tay, given the enormous potential that they have in both regards? I agree very strongly with that. We have seen massive reductions in the cost of offshore wind in recent times, and there is huge potential for Scotland in that area. The Forth and Tay projects have a combined economic value in excess of £6 billion, which in turn presents some real opportunities for the Scottish supply chain. Although the placing of contracts is always a commercial decision for developers, collectively our aim is to secure as much work as possible for Scotland. To help to achieve that, we will combine our efforts and those of our enterprise and skills agencies in making sure that we are doing exactly that. Offshore wind undoubtedly is a massive opportunity for Scotland, and I think that many of those who have predicted otherwise have indeed been proved very wrong. That concludes First Minister's question time, and we will move on to members' business. May I ask those who are leaving the chamber to do so quickly and quietly, please?