Monday, July 03, 2006

Political pressure exerted to change NICE resport

Evidentally, the NICE report generated shock waves in the British government even before it was published. The British National Health Service (NHS) has been promoting birth at birth centers and at home in an effort to lower costs. In addition to showing that homebirth probably increases the risk of neonatal death, the NICE study also showed that birth centers increase the risk of neonatal death. Dr. Crippen directs our attention to an article in yesterday's Sunday Telegraph.
Nice's draft guidance, which included a recommendation for all pregnant women to be told of a "trend towards a reduction in perinatal mortality" in hospitals, was submitted to the Department of Health nearly a fortnight ago.

Several days later - and ahead of its publication on June 23 - it was altered by Andrew Dillon, chief executive of Nice, after concerns were raised by the Department of Health. To the fury of his own experts, who felt that their message was being diluted, the wording was changed to: "There may be a risk of lower perinatal mortality" in hospital.

A source told The Sunday Telegraph: "There was an angry phone call between Andrew Dillon and representatives of the guideline development group.

"Concern over the safety of mothers and babies in midwife-led units was watered down. Many of the group felt this was totally unacceptable, but, because they are bound by confidentiality clauses, they cannot speak out publicly."
This revelation has both a political and scientific dimension. NICE is an independent organization and the government committed a political blunder in trying to supress the NICE conclusion. The scientific dimension is important, too. The government did not insist on the inclusion of additional scientific information that might have changed the conclusion. That's because there is no contradictory scientific information on this point. They simply pushed for a change in the conclusion.

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