Rational rationingBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7272.1356 (Published 25 November 2000) Cite this as: BMJ 2000;321:1356
- Neville W Goodman, consultant anaesthetist
Professor Sir Michael Rawlins is the chairman of the National Institute for Clinical Excellence (NICE), the organisation charged with determining best medical treatments. Medical evidence is often contradictory and value laden; many decisions about treatments will be difficult. Healthcare professions and the public alike want Sir Michael and his institute to be rational, logical, and impartial in their decisions. Confidence in NICE will be dented if it shows signs of bowing to vested interests, whether commercial or political, or of pursuing its own agenda, immune to logical argument. Unfortunately, NICE is hindered by its chairman's stubborn refusal to accept that one purpose of NICE is to ration health care. Although some commentators believe rationing is not necessary, rationing by one means or another occurs in all healthcare systems.
Confidence in NICE will be dented it if shows signs of bowing to vested interests
The chairman …
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