The National Institute for Health and Clinical Excellence (NICE) should “ideally” be able to complete Health Technology Appraisals (HTAs) within three to six months rather than its current average of around 18 months, under the proposals to speed the Institute’s processes set out in Professor Lord Ara Darzi’s Next Stage Review of the National Health Service (NHS), Lord Darzi has told Parliament.

The Institute’s annual budget is expected to triple to around £90 million as a result of Lord Darzi’s recommendations, and members of the House of Commons Health Select Committee, who are conducting an inquiry into his report, asked him this month what effects the extra funding would have on NICE’s processes.

Lord Darzi replied that NICE chairman Professor Sir Michael Rawlins and chief executive Andrew Dillon had both told him that the increased resources would expedite the approval of drugs, but he did not believe the suggestion, by Independent Member of Parliament (MP) Richard Taylor, that NICE approval could now come within “a very few weeks” of a new drug’s launch, was achievable. “Let us not forget that every decision NICE comes up with has to have a public consultation, because that is part of their process and their appraisal, and that will be maintained,” he said.

Lord Darzi did however agree that expediting NICE’s processes will have a “tremendous impact” on the debate over whether patients should be able to pay top-up fees to receive drugs which are not available on the NHS. He pointed out that top-ups are a separate issue but added: “if we had a much more pro-expedited process in getting the drugs through, yes, it will have a major impact.”

But the problem of delays is not just about money, he stressed to the Committee. Even before a new product is launched, the evidence base for it needs to be building within NICE, in partnership with the industry. “Even before the drug comes out, we need to capture that intelligence,” he said.

Faster NICE processes will also enable the UK to improve on its current poor performance against international standards in the take-up and diffusion of new drugs, he added, but emphasised the need for the NHS to be pro-active in the uptake of new technology. “One thing about health care,” he told the MPs, “is that things happen at tremendous speed. We need an NHS that is exploiting these technologies to the advantage of their patients, and that does not mean it is always more expensive…in the nature of these things, they are much more cost-effective.”

Reminding the MPs that his Review “is all about rewarding excellence and quality,” Lord Darzi pointed out that, internationally, NICE is widely recognised and imitated, and is “something we should also be very proud of in this country.”

He also defended the new NHS Constitution against some strong criticism from the MPs, particularly Conservative MP Peter Bone’s claim that the document is “purely New Labour spin” with “no real practical benefit whatsoever.”

“If you describe telling patients what their rights and responsibilities are as ‘Labour spin,’ then we have a problem,” Lord Darzi responded. The Constitution brings together already existing rights and responsibilities in one document “to really empower patients,” he said, and disagreed with Mr Bone’s view that as it does not require hospitals, Primary Care Trusts (PCTs), etc to fulfil certain obligations – with the right of recourse to the courts if they fail to do so – the word “constitution” would seem to be “not wholly accurate.”

In fact, said Lord Darzi, the Constitution does contain legal rights, “including a new right for choice, and I think that is the most transformational change.”

NHS chief executive David Nicholson told the MPs that, in drawing up the NHS Constitution, “what we did not want to do was to create something that became a lawyer’s charter…we wanted it to be declaratory. The document’s establishment of patient rights, such as the right to receive NICE-approved treatments in cases where their clinician says that they should, “begins to change the nature of the relationship between the citizen and the NHS, which I think is really a powerful message,” he said.

- The Committee’s inquiry into Lord Darzi’s Next Stage Review of the NHS will continue after Parliament returns from its summer recess on October 6, and it expects to publish its findings before year-end. This report is based on an uncorrected transcript of an evidence session held on July 17, and neither the witnesses nor Committee members have had the opportunity to correct it.