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NICE to consider bribing people to be healthy

Public asked to comment on incentive schemes for healthy behaviour

OnMedica staff

Wednesday, 19 May 2010

The Citizens Council of the National Institute for Health and Clinical Excellence (NICE) will focus this week on whether incentives are an acceptable means of promoting healthy behaviour.

The Citizens Council, a demographically diverse group that provides public input into the Institute’s work, has been asked in its meeting tomorrow and Friday to consider whether incentives – possibly financial – should have a role in encouraging people to live healthier lives.

Up for discussion are incentivising people to lose weight, adhere to medication or stay free from illicit drugs, and make other choices with "desirable" outcomes.

NICE says that incentive schemes are currently rare in the UK but trials in some health services have provided evidence for incentives being effective in some situations.

Speakers will present evidence to the Citizens Council on all aspects of the topic, before the Council discusses the issues in detail.

Sir Michael Rawlins, chair of NICE, said: "The contentious matter of whether incentives have a place in encouraging people to adopt healthy behaviour is exactly the sort of issue about which NICE wants the public’s viewpoint.

"This is a pertinent topic for NICE: previous clinical guidelines on psychosocial interventions for drug misuse have included recommendations on this approach, and it will be explored within various public health guidance topics such as smoking in pregnancy.

"Incentives can take a range of forms; some may be cash, vouchers for food or other items, or even donations to charity. They might also include giving individuals access to services that otherwise may not have been available to them.

"There is a question of whether this concept could be seen as simply rewarding people for doing what some may argue they should aim for anyway – such as losing weight, or stopping smoking. Others may believe that incentives are unfair to people who already make an effort to live healthily at their own expense.

"Another view could be that anything which helps break the cycle of 'bad habits' and replaces it with 'good habits' is important and should be tried. Or do incentives just encourage some people to 'play the system' and gain the benefit whilst not really improving their health behaviour?"

The Council’s views will be reported on the NICE website for public comment, before it submits a report to the Board of NICE setting out its findings.

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