Painkillers

NICE costs £60 million a year. More money and more candour is needed!

By: The Leader @theleaderspeaks
Published: Friday, August 22, 2014 - 12:13 GMT Jump to Comments

The tabloids portray NICE as the angel of death, a skeletal hand withholding resources when it is literally a matter of life and death- but we need NICE to save the NHS!

In thirteen short years NICE has changed its name three times and its corporate structure twice. Many of us missed some or all of these changes, because throughout the entire process NICE has remained NICE.

NICE was set up as the National Institute for Clinical Excellence in 1999 and moved in with the Health Development Agency in 2005, becoming the National Institute for Health and Clinical Excellence. The Health and Social Care Act 2012 added “social care” to NICE’s remit and NICE was reborn as the National Institute for Health and Care Excellence. Then on 1 April 2013 NICE changed from being a special health authority to a non-departmental public body (NDPB).

NICE claims to be “independent”. The 2013/14 NICE Annual Report borrows an opening line from earlier NICE annual reports. “NICE was set up in 1999,” they say, “as an independent organisation to reduce variation in the availability and quality of NHS treatments and care.” A few lines further on, “as an NDPB, we are accountable to our sponsor department, the Department of Health, but operationally we are independent of government.”

It is difficult to stop the Cynicism Turbo Drive (CTD) kicking in at this point. In what meaningful way is NICE “non departmental” and in what way is NICE independent of government if NICE is accountable to the “Department” of Health and the DoH is an executive arm of the government. In what way is today’s NICE anything to do with the old, original, NICE? This sort of mealy mouthed double-speak, developed by squirming politicians suffering a tongue lashing by Paxman or Humphries, does nothing except encourage cynicism.

Over the past few years the “independent,” “non-departmental” NICE has delivered a steady stream of bad news regarding which health services the public purse will pay for. This stream seems set to become a raging torrent in the future. NICE looks awfully like a buffer (designed, refined, polished and perfected over 13 years) between the politicians and their departmental civil servants on the one hand, and the ever more demanding public on the other. NICE looks like a scapegoat paid to take the blame for all the bad news the politicians do not want to be associated with.

The tabloids would have us believe that NICE is the angel of death, whose skeletal hand withholds resources when it is literally a matter of life and death. But a strong argument can be made that we need NICE to save the NHS. Many would argue that unless we can modify our expectations of just what “national healthcare paid for out of taxes” can deliver, and unless we can acknowledge and accept that “cost to treat” is the legitimate and final arbiter of what we get then the NHS, as we understand it today, looks like an endangered species. NICE seems like the only structure with a hope of managing that adjustment to our expectation.

Can NICE really sustain its claim to be an independent purveyor of “advice” and “guidance”? We don’t think so. NICE is an executive arm of government and no amount of truth management can disguise that. It’s time to admit the truth and start valuing NICE for what it is doing and can do in the future.

At the moment NICE costs about £60 million a year and is controlling it’s costs even though it is doing more and more work by not filling posts that become vacant. “More for less” is possible of course but “more for nothing” is not. NICE is going to cost us more and we need to be clear about what it delivers in order to feel good about spending the money we need to spend to feel good.

                                                                                 -o0o-


Joe Tibbetts, publisher of The Independent Daily, and Ben Gowland, CEO of the Nene CCG in the English east midlands, will be recording a series of weekly podcasts, RealityBites, examining UK healthcare and the Health Service. The RealityBites Podcast will be published each week on Monday morning and will be accessible and downloadable from the front page of the Information Daily. The first podcast will be published on Monday 25th August.

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