Hospitals: Depending on the region, public funds are allocated by the LHU to public and accredited private hospitals (private hospitals must be accredited by the region in which they operate in order to contract with the SSN; public hospitals must also undergo the accreditation process). In 2010 there were approximately 200,000 hospital beds in public hospitals and 48,000 beds in private accredited hospitals. Public hospitals either are managed directly by the LHUs or operate as semi-independent public enterprises, similar to the traditional British trust hospitals. A diagnosis-related group–based prospective payment system operates across the country, although it is generally not applied to hospitals run directly by LHUs. There are considerable interregional variables in the prospective payment system, such as how the fees are set, which services are excluded, and what tools are employed to influence patterns of care. Regions even use different coding and classification systems. Moreover, in all regions, a portion of funding is administered outside the prospective payment system (e.g., funding of specific functions such as emergency departments and teaching programs). All regions have mechanisms for cutting tariffs once a spending threshold for the hospital sector is reached, to contain costs and offset incentives to increase admissions. Hospital-based physicians are salaried employees. Before 1999, all physicians could earn additional income by treating patients privately on an FFS basis, but since then public-hospital physicians have been prohibited from treating patients in private hospitals; all public physicians who see private patients in public hospitals must now pay a portion of their extra income to the hospital