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Editor's blog Wednesday 8 December 2010: NICE – real movement or rhetorical modulation?

Regular readers will recall that we have been watching developments regarding NICE fairly closely.

In particular, you may recall our pieces about:

The creation of a national cancer drugs fund to undermine NICE

Earl Howe declaring NICE “somewhat redundant”

Health Secretary Andrew Lansley confirming the intent to shift to value-based pricing, which doesn’t work

NICE CE Andrew Dillon’s email to colleagues revealing NICE themselves didn’t know anything about these proposed changes

Heath Minister Earl Howe’s difficulties in clarifying the future role of NICE

This report of various comments on NICE’s future by ABPI DG Richard Barker and  NICE CE Andrew Dillon at the Wellards annual conference

Word is now coming out of the Department of Health that a change of course is under way over the plans for NICE.

Health Secretary Andrew Lansley will make an announcement in the next few weeks.

U-turn or makeover?
Will the change be a genuine rowing-back from the plan to excise NICE’s explicit role in making rationing decisions for the NHS?

Or will it be about SoS Lansley saving political face, tweaking rhetoric and asking NICE to take the lead on non-binding value-based pricing ‘advice’?

Until the actual announcement is out, in black-and-white, we are not going to know. The former would be meaningful change; the latter would not.

Rationing is going to be a scaldingly hot potato over coming years, as Dr Clare Gerada of the RCGP explicitly acknowledges in her Guardian interview.

GPs are generally neither stupid nor financially illiterate. Any idea that GP commissioning consortia will want to take on this explicit rationing role, in the face of the pharma industry’s lobbying heft and patient power, is deep into biscuit contraceptive territory. It’s fucking crackers.

NICE is not perfect, but it is certainly not broke, and the Coalition’s plans to fix it have attracted very little support. The facts of economic life of NHS rationing have certainly not changed.

A change of mind on this would be a clear sign that SoS Lansley is waving, not drowning.