One of the emerging big issues here is not just the price, but the incidious removal of our clinical autonomy. We need to think very carefully about giving them enough information about how we treat patients with specific conditions as they may well intend to nail us down on cost per condition and treatment. ie they will only pay for previously agreed treatments in the same way that the dentists have to get pre authorisation for any procedure. We all know that every patient is different and requires subtle, and even not so subtle changes to a treatment plan depending on a very wide variety of variables.my feeling is that people who do tender, at whatever price, are digging themselves a hole that they will find very difficult to climb out of. It is all about control.