Alan Williams A NICE man

1
Alan Williams A NICE man

• David Taylor
• Professor of Pharmaceutical and Public Health
  Policy,
• School of Pharmacy, University of London
• Presentation for the Alan Williams memorial
  seminar
• Barcelona December 1st 2005

2
This contribution

• Memories of meeting and talking with Alan
  continuing a discussion
• Understanding his contribution from a (limited)
  personal perspective
• Welfarism versus extra-welfarism, population
  health versus individual happiness?
• The political economics of health and health care
  what NICE (and health economics) is not saving
  the NHS from suffering

3
NICE

• Alans life and work led directly to the
  creation of NICE, and the pursuit of
• A comprehensive framework for healthcare
  prioritisation, underpinned by an explicit set of
  ethical and rational values to allow the relative
  costs and benefits of different areas of NHS
  spending to be assessed in an informed way.

Jeremy Bentham
4
Health economics, the pharmaceutical industry and
the state

• The early growth of health economics was in part
  driven by pharmaceutical industry interests in
  marketing new medicines
• The institutionalisation of health economics has
  in part been driven by state interests in
  controlling the use of new medicines

Edwin Chadwick
5
The Individual in a Population

• Welfarism or extra-welfarism what to QALYs
  really tell us about value and justice?
• Regardless of what Alan worked so hard to
  achieve, is his legacy being used to justify NHS
  bureaucracy at the expense of individual welfare
  and innovative enterprise?

John Donne Ask not for whom the bell tolls -- it
tolls for thee For God's sake hold your tongue,
and let me love
6
Questions for the future

• The utility of things and knowledge over time
  guessing the real value of RD
• The costs of scale guessing the opportunities
  foregone as a result of managerialism and
  population based decision making in the NHS
• Understanding the political economics of health

Alan Williams
7
I remain naively (and even defiantly) optimistic
about the power of argument to improve the world,
although it is often a very slow process, and
since my hourglass is running out, I am perhaps
over-optimistic in hoping that some of this will
happen in my lifetime. Alan Williams in the
Epilogue to What could be nicer than NICE? OHE,
2004