To ask the Secretary of State for Health what arrangements he proposes to make to permit general practitioners whose practices are too small to qualify for budget holding to obtain treatment for their patients outside their own districts; and if he will make a statement.

All GPs will continue to be able to refer patients in line with their clinical judgment. Contracts for health services will provide a more effective way of giving practical effect to GPs' referral decisions.

My hon. Friend's reply should show GPs that the rules are flexible enough to enable them to refer patients outside their districts for treatment at other hospitals, even though their practices may be too small for budgeting. How do this year's referral figures compare with last year's, now that there are new rules?

The key point is that for the first time district health authorities have been working closely with general practitioners about where they want to refer patients. That means that it is possible to build on improvements in service, take quality into account and negotiate more effective targets for the future. Contracts have been placed to cover 95 to 99 per cent. of GPs' likely referral needs.