The use of incentives to improve health
The Citizens Council provides NICE with a public perspective on overarching moral and ethical issues that NICE should take into account when producing guidance. Made up of members of the public, broadly representative of the adult UK population, the Council operates through a "citizens' ju...
| Corporate Authors: | , |
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| Format: | eBook |
| Language: | English |
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London
National Institute for Health and Clinical Excellence (NICE)
2010, [2010]
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| Series: | Citizens Council reports
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| Subjects: | |
| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | The Citizens Council provides NICE with a public perspective on overarching moral and ethical issues that NICE should take into account when producing guidance. Made up of members of the public, broadly representative of the adult UK population, the Council operates through a "citizens' jury" style meeting, to explore and respond to a question set by NICE. At its May 2010 meeting, the key question for the Council was: "In what circumstances are incentives to promote individual behaviour change an acceptable way of promoting the health of the public?" 12 out of the 32 members present felt there were no circumstances in which incentives are acceptable and gave the following reasons: 1. A lack of supporting evidence2. The cost of incentive schemes, especially at the present time3. Their potential for abuse4. Incentives should not be needed to help people, particularly adults, to make decisions5. Much help is already available (e.g. through the benefits system, education and in primary care)6. Incentives are a reward for inappropriate behaviour7. Incentives raise concerns about the "nanny state"8. Incentives are not fair to those who make the right choices unaided, yet receive no rewards9. Incentives can have a negative effect on public opinion. The remaining 20 members felt incentives would be acceptable under certain conditions. Their reasons were: 1. Incentives must be tried before we can find out if they work! We also need to find out why they sometimes fail. When they are used, their outcomes should be followed up for at least three months2. Incentives help to show people that they are viewed as worthy of being helped3. Incentives are best when targeted. There are groups who need special help, for example, pregnant smokers and obese children. Our ultimate concern is for children.4. Incentives are best when used as part of a wider package, including e.g. other forms of help and support, and education. The caveats were: 1. Incentives should not be exchangeable for tobacco and alcohol2. People seeking to join incentive schemes should not do so unless they have decided they really want to change3. Time limits and safeguards are needed if private companies are involved4. Incentive schemes should allow for the collection of evidence5. Cash incentives should be last resort6. Personal contracts should be arranged with participants7. The behaviour of participants while taking part in the scheme should be monitored. Both groups offered additional suggestions to NICE. These are listed in the 'Decision time' section towards the end of this report |
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| Physical Description: | 1 PDF file (40 pages) illustrations |