Polly Toynbee says, "NICE is one of Labour's best inventions". Proof if ever it was needed that NICE has to go. It is is a truth self-evident to all Guardian readers that whatever Polly Toynbee says is automatically antithetical to all right-thinking people. When Polly pontificates we know what side to take.
I don't suppose Polly has ever sat in on a NICE appraisal so as usual she is talking about something of which she has only theoretical knowledge. I have sat in as an expert witness on five occasions. On almost all occasions NICE has got it wrong at first, though sometimes they have managed to correct their view on appeal.
There are several things wrong with the way NICE goes about their work. First: certain members (though not all) of their committees have an extreme prejudice against pharmaceutical companies. They naturally assume that the company is dishonest. I have even seen committee members accuse expert witnesses of being in the pay of Big Pharma and being made to withdraw the assertion under the threat of legal action.
Second: the choice of their own 'expert witnesses' is sometimes bizarre - eschewing people who have researched and written about the problem in favour of local generalists who have no reputation in the field.
Third: their research is done by health economists and 'teenage scribblers' - young graduates who just review the literature without any experience of treating patients or of the great variety of clinical situations that present themselves. These people have no 'feel' for either the disease or its treatment.
Fourth: despite the assertion that 'post-code prescribing' is a great sin, it is actually extremely sensible. For example, there National Guidelines on sickle cell screening for mothers. This is extremely sensible in Camberwell where there is a very high incidence of people of Afro-Caribbean descent, but very stupid in Bournemouth where almost everybody is 'oppressively' white. In Bournemouth, the major health problem is care for the elderly - especially of Alzheimer's disease. The denial of drugs for early cases was much more unfair in Bournemouth than, say, somewhere like Derby, where the geriatricians have so few old people to look after that they look after people in their 50s.
This new government is committed to localism and I thoroughly approve. Having sat through endless reorganisations I am certain the the NHS was best managed in the period prior to 1974 when local authorities could still influence decisions about the provision of services. If you believe in getting the best health service you can in your local area (which is what most people want - they couldn't care a fig for the problems of people in Glasgow who smoke, drink and feast on deep-fried Mars bars - unless they are Glaswegians), then these new moves to disempower NICE can only he welcomed.