The NHS cost watchdog is seeking public opinion on the use of incentives – including cash – to encourage healthier lifestyles across the nation in a bid to reduce the future strain on health resources.

The National Institute for Health and Clinical Excellence is currently exploring the feasibility and potential effectiveness of using reward schemes in various scenarios under a new tactic to help secure a healthier nation for the future.

It is envisaged that incentives such as cash or vouchers for food, goods and services might be offered to patients to lose weight, keep taking medication or stop smoking, for example, and, if successful, could offer a new weapon against an explosion of lifestyle diseases that could drag the NHS under.

According to a hard-hitting report by Foresight in 2007, by 2050, 60% of men, 50% of women and about 25% of all children under 16 could be obese at a cost of £45 billion year, while diabetes alone already costs the NHS a whopping £1 million an hour and, if the current trends continue, it is questionable whether the health service will be able to deal with the resulting fallout.

Trial incentive schemes – including those to encourage giving up smoking and Chlamydia testing - are already in place in some areas of the country and, according to NICE, evidence suggests that offering rewards for healthy behaviour could be effective in some circumstances.

However, there are complex issues surrounding such a policy, and so the Institute has asked its Citizen’s Council - a group of 30 individuals, reflecting the age, gender, socioeconomic status and ethnicity of the people of England and Wales, which provides the Institute with a snapshot of public opinion - to consider the concept at a meeting being held today and tomorrow.

“The contentious matter of whether incentives have a place in encouraging people to adopt healthy behaviour is exactly the sort of issue about which NICE wants the public’s viewpoint,” noted Sir Michael Rawlins, Chair of the Institute.

Divided opinion
“Using incentives may be seen as divisive in some fields,” he explained. Some people may have trouble accepting the notion of handing out rewards for behaviour that should be the norm anyway, while others my think incentives are unfair to those that are already making sure they live healthy lifestyles at their own expense. On the other hand, those in support of such a scheme might argue that any measures that help exchange bad habits for good ones are of value and should be considered.

“We are keen to hear from the Citizens Council on precisely this kind of difficult social values issue, as it will help provide guidance to our independent advisory committees when they are required to make recommendations involving this approach,” Rawlins said.