In a country where the state controls healthcare to such an extent, the National Institute for Health and Clinical Excellence (NICE) really has to exist in some form. Death panels or not, without serious reforms it is necessary that someone somewhere decides which medicines can be afforded and which can’t. However, NICE does more than this, it also makes recommendations on “how to improve people’s health and prevent illness and disease”. Much the pity.
In the space of a week they have made two headline-grabbing recommendations. First was their suggestions that:
- manufacturers should stop using trans-fats
- a maximum intake should be set set for salt of 6g per day for adults by 2015 and 3g daily by 2025
- hidden saturated fat substantially reduced
- efforts be made to make unhealthy food more expensive than healthy food
- restrictions should be enforced on unhealthy food television advertisements until after 9pm
- planning restrictions should be imposed to time-limit fast-food outlets
- unhealthy food should have traffic light labelling
To top that, yesterday they suggested that all pregnant women should have their breath measured for carbon monoxide levels when booking to see a midwife. The Department of Health is keen on the idea, stating: "We welcome the publication of these new guidelines. Smoking in pregnancy is a major public health concern posing risks to both mother and baby. We want the NHS to use this guidance to develop the best possible services for pregnant women."
It is no surprise that liberty is not a factor in the proposals of a Quango, but even they have to draw a line somewhere. Clearly on this occasion they have gone too far and should have been shot down. There are clear arguments to be made on unintended consequences – whether increased food prices for the poorest or vulnerable smoking mothers avoiding health professionals for fear of condemnation – but ultimately the argument of ‘enough is enough’ needs to win through.
Utility and efficiency are not the only measures of effective policy. Like all Quangos and regulators, their remit needs to be cut down to what is purely necessary in areas that the state is near monopolistic provider and removed entirely from nannying us.