NICE and the Franchising of the NHS

It was with great dismay that I read that NICE is to be divested of its power to act as regulator for drugs for the NHS. This is to be handed to GPs as part of the commissioning deal and will leave NICE as a pretty toothless organisation, ready to be thrown on the quango bonfire.

Those who read me regularly will know that I have a chequered attitude to NICE. On the one hand, I was furious about the blatantly political attempt to remove all dementia medicines from prescriptions. At the same time, I do recognise its value as a negotiator with pharmaceutical companies about the price of their drugs. Drugs in America can cost five or six times what they cost here, because there is not a national regulator between the companies and the patients. Removing this guard dog is going to make the price of drugs in Britain shoot up and place GPs in the invidious position where they might reject one drug, but the GP next to them might prescribe it.

But there is another element to this move. Some time ago I did an post on the European Cross Border Directive and the dangers inherent in this for the NHS. One of its proposals was for prescriptions written in one country to be recognised in another. I wondered aloud how this would work given that NICE did not permit the same drugs under prescription that other countries did. I think we have just been given our answer. The removal of a national regulator to be replaced with local ones, is turning the NHS into a group of health care organisations along the lines of the American HMO. Many GP practices are run by the likes of United Health and Atos; they also have their favourite drugs companies who pay them big bucks to promote their brands. This move is more dangerous than it looks.

Europe marches on. The franchising of the NHS marches on. The vultures are gathering..