The passage discusses the contractual flaws in the provider-purchaser system, particularly the ability to employ counselors within practices, which can lead to a lack of coordination, cooperation, and quality in service provision. It highlights the need for standardized training and quality controls for counselors to ensure effective primary care. The restructuring of psychiatric healthcare has moved from hospital-based to community-based services, integrating various professional disciplines into formal multidisciplinary teams. However, this transition requires a fair trial before market forces prove its effectiveness. The author argues that GPs should have contractual agreements with organizational models rather than functional arrangements, and that the NHS needs to become more network-like to foster cooperation and information exchange. Patient organizations should monitor the needs of patients and their carers, and the extension of choice for purchasers may reduce access to holistic care. The passage also includes responses to other articles, discussing the importance of cultural relativism in psychiatric diagnosis and treatment, the benefits of encouraging in-patients to access their records, and the challenges of cultural differences in mental health care.The passage discusses the contractual flaws in the provider-purchaser system, particularly the ability to employ counselors within practices, which can lead to a lack of coordination, cooperation, and quality in service provision. It highlights the need for standardized training and quality controls for counselors to ensure effective primary care. The restructuring of psychiatric healthcare has moved from hospital-based to community-based services, integrating various professional disciplines into formal multidisciplinary teams. However, this transition requires a fair trial before market forces prove its effectiveness. The author argues that GPs should have contractual agreements with organizational models rather than functional arrangements, and that the NHS needs to become more network-like to foster cooperation and information exchange. Patient organizations should monitor the needs of patients and their carers, and the extension of choice for purchasers may reduce access to holistic care. The passage also includes responses to other articles, discussing the importance of cultural relativism in psychiatric diagnosis and treatment, the benefits of encouraging in-patients to access their records, and the challenges of cultural differences in mental health care.