Since it was set up in 1999, the National Institute for Health and Clinical Excellence, or Nice, has rarely been out of the news. Turn to one newspaper and it is “the government’s drug rationing watchdog,” denying suffering patients access to drugs in order to save the NHS a few miserable pounds. Turn elsewhere and Nice is a brave attempt to bring rationality and best practice into the provision of healthcare.

When it opened for business (then just called the National Institute for Clinical Excellence) provision of healthcare in Britain was subject to a postcode lottery, with different drugs and treatments available in different regions (as it remains today). There was no way to evaluate what worked best, and there were often failures to speedily introduce new drugs and best practice. Nice was established to remove these inequalities and inefficiencies by providing “clear and robust advice” to NHS staff.

Since