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DH is absolutlely right. In my opinion, to put weight behind achieving parity for MH service users in this area of choice is sorely needed. Too often the consequence for patients is poor access. Perhaps the most important area of all would be around crisis community services, where patients, supported if necessary by carers and others, could nominate to receive these services from a provider with a properly functioning service in place and excellent track-record. Don't get bogged down over PBR over this, either provide a good service or live with the admistrative consequences of a bill from the patients provider of choice.