NICE rules – literally…

Baroness Young, chair of the newly-formed Care Quality Commission, has revealed that guidance from NICE would become legally enforceable from 2009/10, with doctors to face tough annual checks on their compliance, and failure to comply will be punishable by suspension, fine or prosecution – even the closure of the practice if they dare to put the patient first.

Baroness Young told the recent NICE annual conference in Manchester that policing clinical guidance was set to be a key part of the CQC’s work, and admitted the commission had been handed ‘draconian’ powers by ministers.

Er, how is that a good thing? And when did “guidelines” attain the status of law? It’s appropriate, though – Draco, a sixth-century BC Athenian legislator, was in favour of savage penalties for the poor, while handing out slapped wrists to the wealthy, a policy clearly embraced by this government in its current proposals for the treatment of the chronically sick and disabled, and single parents. James Purnell, Work and Pensions secretary has clearly embraced the beliefs of Draco wholeheartedly.

‘We want to raise the profile and highlight the importance of NICE guidance and build this into the new registration scheme,’ said the out-of-touch-with-reality old bat, adding, ‘I have an image of a patient sat in front of their GP or consultant with a card with the NICE guidance so they can interrogate their healthcare provider.’

What an amazingly stupid idea. In my experience most patients have little or no understanding of the requirements of their particular illness, and would take up a ludicrous amount of GP’s time with these idiotic checklists. On the other hand, I’ve made it my business to know as much as possible about my conditions – I know what the optimum maintenance treatment is, and what I need to treat exacerbations. This means I can discuss my treatment sensibly – and quickly – with my GP. I really don’t need Baroness Young and her prodnose Commission making things difficult for all concerned. Sadly, for I believe every chronically sick person has an obligation to know as much as possible about their illness, for their own benefit as much as anything else, I know I’m in a minority.

However, a CQC spokesperson said: ‘We expect providers always to comply with NICE guidelines and other national guidance unless they can show a good reason to vary from them.’ That is an insanely dangerous idea, because the bean-counters at NICE have only one aim – to reduce costs. Patient welfare is nowhere on their agenda. Also, some of NICE’s recent decisions have been hugely controversial, and not a few guidelines run contrary to accepted clinical opinion, as is the case with the treatment of osteoporosis.

Until the time comes when NICE gets it right every single time – and that’s probably impossible – and stops focussing on penny-pinching, there is no justification for making their guidelines law. None at all.


3 thoughts on “NICE rules – literally…

  1. Hi Ron,

    brilliant article, slowly becoming a fan! As I’ve said before its a pity that some millionaire doesn’t take up the cause and start an effective case against these guidelines. The judicial review against the guidelines were a fallacy and more likely the resulting decision was based on politics rather than sound judgment.

    Great blog which I will now begin to follow more closely.


    • Hi Lee,

      Always good to hear from a fan! Must check out your blog, too.

      Just got back online after a 5-week absence, so I’m playing catch-up with my comments. Not to mention reams of email. Should be a bunch of new posts is a day or so, though.


  2. Ron, just stumbled across you. Haven’t bothered to look up M.E/CFS for about 2 years, because nothing ever seems to change, just try to manage my own way. Just been dumped by boyfriend who is a vegan tree hugger, who loves animals but cant believe there is anything wrong with me. Gp, very pleasant but thinks Im psycologically flawed and general aquaintances who assume I have a huge dose of lazyitis.The post I am replying to is old and we all know NICE is just there to cut costs, and surprise, surprise Me/CFS is not really taken seriously. You have to be careful what you wish for but a few months in our situation may open their blind eyes and deaf ears. I will read more of your posts, I like your slightly militant attitude (first impressions) without sounding patronising well done because what you are doing must take up loads of your precious energy. Yours Faithfully Maureen Smith, Cornwall.

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