Dear Sir Michael,
Thank you for taking the time to reply to the debate in this list. I
can certainly appreciate the reasons why NICE has felt unable to make
all its data public.
What bothers me about these NICE recommendations is that instead of
telling us whether beta-interferon works or not, NICE is in fact making
a judgement whether the health service can afford a treatment which does
appear to work to some degree. NICE has therefore taken on the role of
rationer and in my view risks losing its credibility as impartial
assessors of clinical excellence.
The hostile reaction from public and profession are very understandable
as neither has had the opportunity to participate in an open debate on
just what the NHS should provide.
Some hostility is no doubt also born out of the disappointment we feel
that a body which we welcomed in the expectation that it would report on
the best evidence-based treatment has now been subverted to make
rationing decisions under the guise of "clinical excellence".
Do you therefore accept that NICE has become a National Institute of
Clinical Affordability rather than Excellence?
Paul Flynn.
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