Abstract

The National Institute for Clinical Excellence (NICE) and the Commission for Health Improvement (CHI) were both introduced in the NHS plan of 1998. Six years on, CHI is dead but NICE is conquering the world. NICE worked but “nasty” (as CHI was initially known) failed—perhaps because it wasn't nasty enough. NICE may prove to be one of Britain's greatest cultural exports, along with Shakespeare, Newtonian physics, the Beatles, Harry Potter, and the Teletubbies. Cynical about government and trained to be sceptical, the BMJ was cautious in its welcome to NICE (BMJ 1999;318: 823). We believed that a body was needed to lead on rationing …

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