My hon. Friend is right about the advantages of primary care groups and trusts. From April, we shall devolve about £20 billion to those organisations, which is three times the amount devolved to front-line clinicians by the previous Government's fundholding plans. That will enable services to be developed more efficiently and effectively.

On the question of Gloucestershire, my hon. Friend will know that following last year's increase of 5.5 per cent. in the health authority allocation, this year's allocation has gone up by 6.31 per cent., which is a significant increase. However, it is for local people to determine the size and shape of primary care trusts, taking into account the views of all the people in the local health system. That means that the right balance must be struck locally between the need for an organisation that can stay in touch with the communities that it serves, and the need to keep management costs well under control to make sure that money is spent on patients, not bureaucracy.