To ask the Secretary of State for Health what rules govern the purchase of health services from hospitals by primary care trusts with more than one hospital from which to commission services. (124108)

“The NHS in England: operating framework for 2007-08” signalled the introduction of a new national health service contract for primary care trusts to use when commissioning acute secondary care services covered by payment by results (PbR), from NHS trusts, NHS foundation trusts and independent sector providers. The NHS contract for acute hospital services covers agreements between primary care trusts (PCTs) and providers for the delivery of acute hospital-based care. The contract enables patients to choose where they are referred for elective care, and hospitals will be paid by PCT commissioners according to PbR rules for the work they do.

The rules and principles relating to the operation of the contract are set out in “Guidance on the NHS Contract for Acute Hospital Services for 2007-08”. A copy of this document is available in the Library. All acute NHS trust will adopt the new contract from April 2007. The contract will be applied to NHS foundation trusts either from April 2007 or subsequently, from the earliest point at which their pre-existing contracts become invalid.

The principles of patient choice apply equally to services provided by NHS foundation trusts which remain on the previous form of contract.

To ask the Secretary of State for Health pursuant to the answer of 2 March 2007, Official Report, column 1579W, on health services, if she will give a breakdown of her estimate that 90 per cent. of people's contacts with the health service take place outside hospitals. (127605)

A breakdown of the 90 per cent. of contacts with the health service that take place outside hospital has been estimated as follows: 26 per cent. with the family doctor service, 59 per cent. prescription items dispensed in the community and 5 per cent. other services, including district nurses and other community based staff.