Thursday, June 24, 2010
When Nice turns nasty
We all know that the National Institute for Health and Clinical Excellence does a load of health economics work, calculating whether various drugs are cost-effective for the NHS. It's the centre of rows over drugs, often cancer drugs, which are denied to patients because they are too expensive for the benefit the drug provides.But what we sometimes forget is that Nice also does public health work, and just this week they have produced two reports endorsing a very New Labour, healthcare-authoritarian approach to two aspects of health. At the beginning of the week, they told us that it wasn't enough to educate people about transfats and nor enough to require that information about them be displayed on food packaging, both measures which are positive a pro-consumer health without interfering in choices. Now, they are calling for the government to ban them altogether (src).This morning, they have decided that it is not sufficient to warn pregnant women about the risks of smoking to their unborn children: midwives should be given smoking breath-test kits and instructed to test pregnant women to see if they are smoking (src). To their credit, the Royal College of Midwives has pointed out that Nice's proposals are a wasteful use of resources and that it is more productive to help pregnant women in a way which is not perceived to be judgmental or unsupportive.Previously, they have also proposed lowering the drink-drive limit and minimum pricing for alcohol, and the impression is given that we can expect Nice to step up its highly authoritarian campaign to tell the entire British public what they can and cannot do with their bodies.The public health section of Nice is clearly an unreconstructed part of the nanny state by which the previous Labour government attempted to control our choices. It also forms a part of the unpleasant spectacle of government lobbying government using taxpayers' money: an authoritarian government wants to pursue a certain, brave course of action but wants 'independent' cover, so a tame, publicly-funded quango magically produces a report advising ministers to do that which they wanted to do in the first place. The Coalition could save some money and make government more open, more transparent and more accountable by abolishing Nice's public health department.