A NICE day in court

The National Insitute of Clinical Excellence (NICE) is facing a court action because of it's refusal to authorise the routine use of certain drugs to treat Alzheimer's disease. This is an interesting new development in the provision of free healthcare in the UK. Success in the court action would have major implications for many other clinical areas in the event of a service being withheld or withdrawn. It is the ulitmate expression of patient choice. Maybe in the future we might see court actions about the failure to provide physiotherapy. However. there's one problem with physiotherapy. When it comes to courts there will be few areas of physiotherapy practice which have sufficient evidence to justify their use. Which is an interesting parallel with another piece of news from the last few days; nationally there is pressure on ante-natal classes, some being reduced and even some services being withdrawn. Tise has the potential to affect physiotherapists as they are often involved in delivering the service. However, if someone decided to go to court over the withdrawl of classes they would be sadly disappointed with the outcome. As with other areas of physiotherapy I suspect there is a lack of hard evidence that these classes make a major difference to what happens later and it would be hard to prove that their reduction has any major impact as long as there is still a sufficient packageof care in place.