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Regarding anon 1:44pm you need to remember that the tariff is based on the average cost of the NHS Acute Hospital. So whilst private sector and others take some of the simpler casemix leaving the acute hosptials with the richer casemix it is this richer casemix cost that informs the tariff. This is why we have the patient/procedure selection flexibility so that those getting paid tariff (which is for a richer than average casemix) but not doing the full range of casemix actually get paid less than tariff.