The more information that patients are given about the treatments they can and cannot receive through the National Health Service, the less likely they are to go to court, the annual conference of the National Institute for Health and Clinical Excellence, held last week in Birmingham, was told.

The law has an important part to play in setting boundaries for good decision-making in cases where public authorities are seeking to allocate scarce resources in the NHS, according to Yogi Amin of law firm Irwin Mitchell. There is no room for poor decision-making where lives are at stake, and the courts are recognising the balance that must be struck, Mr Amin said, and went on to point out that the right to life, and prolonging it, are enshrined in the law.

Broadcaster Jenni Murray also stressed the need to be honest about the realities of healthcare provision to the public. She said it was “supremely arrogant” to assume that, while all the speakers and delegates attending the NICE conference were capable of grasping these realities, the public was not.

People do generally understand when told they will not benefit from a particular treatment, agreed Ian Gibson, MP, chairman of the All-Party Parliamentary Group on Cancer. Open and transparent processes at NICE should help here, he said, and suggested that the public should be permitted to attend the Institute’s meetings as observers. NICE should also join with other organisations in its decision-making process, Dr Gibson added, and he agreed with a questioner that, given the costs of new drugs, a public debate was needed on what is really needed.

Richard Barker, director-general of the Association of the British Pharmaceutical Industry, said he supported making the process as open as possible and that the debate could be widened if there was broader understanding of the issues. However, he emphasised, the public cannot do NICE’s job.

Cooksey's recommendations welcomed

Dr Barker welcomed the recommendations contained within Professor David Cooksey’s review of UK health research and stressed the need for the industry and NICE to work together for the sake of patients.

The Cooksey Review calls on NICE to participate at an early stage in the clinical trial process, with the aim of moving new treatments in to the NHS more quickly and cheaply. Professor Colin Blakemore, chief executive of the Medical Research Council, said he hoped this would lead to the pharmaceutical industry bringing increased levels of clinical trial activity to the UK. The UK has “huge advantages,” in this field he said, adding: “we’re ahead of the game.”

- The NICE annual conference was also told that, two weeks previously, Professor Sir Michael Rawlins had been reappointed as the Institute’s chairman for a third term. Sir Michael has held this post since NICE was established in 1999. By Lynne Taylor