Managing Wicked Problems:The National Institute for health and Care Excellence and the Depoliticisation of Health Care Rationing

This paper considers how recent British governments have sought to deal with the ‘wicked problem’ of health care rationing. It argues that since 1999, politicians in Whitehall have managed this conundrum by depoliticising it. They have created an arm’s length body (the National Institute for Health and Care Excellence) and have transferred responsibility for this issue on to non-elected experts who enjoy autonomy to make decisions concerning which treatments should be made available on the NHS. This paper asserts that this depoliticisation strategy has been successful, although such an argument depends on a particular interpretation of ‘success’. It concludes by highlighting some political costs that accompany this particular governing approach.