▁patients ▁are ▁supposed ▁to ▁be ▁able ▁to ▁choose ▁the ▁clin ician ▁whom ▁they ▁want ▁to ▁provide ▁them ▁with ▁health care ▁and ▁that ▁money ▁to ▁pay ▁for ▁the ▁service ▁should ▁follow ▁their ▁choice . ▁ ▁Before ▁the ▁advent ▁of ▁the ▁internal ▁market , ▁in ▁principle , ▁a ▁GP ▁could ▁refer ▁a ▁patient ▁ ▁to ▁any ▁special ist ▁in ▁the ▁UK . ▁When ▁contract s ▁were ▁introduced ▁in ▁ 1 9 9 0 ▁these ▁were ▁called ▁ ▁extra cont ract ual ▁refer r als . ▁ ▁From ▁ 1 9 9 9 ▁the ▁concept ▁of ▁Out ▁of ▁Area ▁Tre at ments ▁was ▁developed . ▁These ▁refer r als ▁were ▁not ▁necessarily ▁related ▁to ▁choice ▁made ▁by ▁a ▁patient . ▁Special ised ▁treat ments ▁were ▁not , ▁and ▁are ▁not , ▁available ▁in ▁every ▁area . ▁ ▁The ▁reg ulations ▁provide ▁that ▁a ▁patient ▁can ▁choose ▁to ▁be ▁seen ▁by ▁any ▁N HS ▁trust , ▁public ▁body , ▁commercial ▁organisation ▁or ▁third ▁sector ▁body , ▁provided ▁it ▁holds ▁a ▁“ comm ission ing ▁contract ” ▁either ▁with ▁N HS ▁England ▁or ▁a ▁C lin ical ▁Commission ing ▁Group ▁when ▁they ▁are ▁referred ▁by ▁their ▁GP , ▁community ▁dent ist ▁or ▁opt omet rist ▁for ▁treatment ▁that ▁is ▁not ▁identified ▁as ▁being ▁immediately ▁required . ▁ ▁The ▁Government ’ s ▁mand ate ▁to ▁N HS ▁England ▁for ▁ 2 0 1 6 - 1 7 ▁issued ▁by ▁Jer emy ▁H unt ▁spec ifies ▁“ We ▁want ▁people ▁to ▁be ▁emp ower ed ▁to ▁shape ▁and ▁manage ▁their