In a retrospective study, referrals to a community old age psychiatry service were obtained for local practices a year before and a year subsequent to the introduction of prospective general practitioner (GP) fund-holding. Although overall patterns of referral were the same, there was a significant reduction in domiciliary consultations requested by fund-holding GPs which was not balanced by a rise in other referrals. The findings suggest a shortfall in the number of referrals to old age psychiatry services in the light of GP fund-holding, prompting speculation as to the fate of those who would otherwise have been referred.