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Exorcising the positivist ghost in the priority-setting machine: NICE and the demise of the ‘social value judgement’

Published online by Cambridge University Press:  11 February 2021

Victoria Charlton Open the ORCID record for Victoria Charlton [Opens in a new window]  and
Albert Weale
Victoria Charlton*
Affiliation:
Department of Global Health & Social Medicine, King's College London, London, UK
Albert Weale
Affiliation:
Department of Political Science, University College London, London, UK
*
*Corresponding author. Email: [email protected]
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Abstract

The National Institute for Health and Care Excellence (NICE), the UK's primary health care priority-setting body, has traditionally described its decisions as being informed by ‘social value judgements’ about how resources should be allocated across society. This paper traces the intellectual history of this term and suggests that, in NICE's adoption of the idea of the ‘social value judgement’, we are hearing the echoes of welfare economics at a particular stage of its development, when logical positivism provided the basis for thinking about public policy choice. As such, it is argued that the term offers an overly simplistic conceptualisation of NICE's normative approach and contributes to a situation in which NICE finds itself without the necessary language fully and accurately to articulate its basis for decision-making. It is suggested that the notion of practical public reasoning, based on reflection about coherent principles of action, might provide a better characterisation of the enterprise in which NICE is, or hopes to be, engaged.

Keywords

Health care priority-settinghealth technology assessmentNational Institute for Health and Care Excellencepractical public reasoningresource allocation
Type
Perspective
Information
Health Economics, Policy and Law , Volume 16 , Issue 4 , October 2021 , pp. 505 - 511
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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