Mr. Bernard Gloster:

The 4% was a measure of what we did with third-party insourcing over 27 months versus what we did in our ordinary day job. That is where the 4% came from. The response to the 4% is in the initiatives the Minister has outlined, such as the outpatient toolkit, the deployment of the POCC contract to outpatient clinic at weekends and a central referral mechanism, reducing 2:1 ratios. There is a whole series of things that come together. I am absolutely confident that there is no reason the health service cannot meet that 4% challenge, even if marginally we have to use a bit of outsourcing to help that for a short time. Outsourcing is much more appropriate to use. I have given the Minister the assurance. We will never be able to advance the initiatives if we keep using third-party insourcing for that 4%. We have to break the chain at some point.