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At the heart of general practice since 1960

We should be a bit nicer to NICE

From Dr Rubin Minhas

Primary care CHD clinical lead

Medway PCT

When NIHCE (to use its correct acronym) developed a hypertension guideline reflective of broad medical consensus it came in for criticism, and now having

closely developed a joint guideline with the BHS it seems that it attracts further criticism (News,

23 March).

NIHCE is clearly in an invidious position, although it is heartening that the recent reaction to the joint BHS/NIHCE draft guideline at least signals healthily strong expectations of NIHCE.

Where does this leave NIHCE? Surely the answer is that if whatever it does it attracts criticism from one quarter or another, then it should at least do what is right.

Many GPs will identify with being placed in this difficult position.

But what is right? Having established a citizens council that relates the values of real patients and communities and informs its decisions, NIHCE has a greater legitimacy and far less self-interest than any of its critics.

There are many marginalised groups in society (the elderly and ethnic minority groups for example) whom NIHCE has allowed access to a level playing field when allocating resources who can attest to its merits.

NIHCE exists in an imperfect world and it seems we have all too slowly learnt that its original methods may have been more equitable than any alternative.

The author is a member of an Appraisal Committee of NICE ­ however, the views expressed are personal and not those of the institute

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