The legendary August silly season in medialand isn't all a waste of space. Ironing shirts one Friday evening, I caught a sensible debate on Channel 4 News about the priorities ahead for the National Institute for Clinical Excellence. It would have been hard to imagine hearing it in busy March or May - even on a bastion of telly excellence like Channel 4.

Sure enough, next day the weightier papers reported the launch of NICE chair Professor Michael Rawlins' first target lists for clinical evaluation, those 23 wide-ranging assessments of drugs, devices and - don't forget - best practice. They range from the use of proton pump inhibitors for dyspepsia to Glaxo's new anti-flu drug. NICE's guidelines won't be compulsory, doctor, but you'd better have a good explanation...

The launch came amid upbeat official guidance that, if only the NHS can get rid of what was described as 'obsolete and ineffective' treatments, it might be able to double the share of the budget spent on new ones. There was even the suggestion that the NHS might be able to double the money it spends each year on new treatments, from 3 to 6 per cent.

That was the bit which made me uneasy. It wasn't so much that it smacked of excessive optimism. Nothing wrong with that, though Nye Bevan thought in 1948 that spending£400m a year on the NHS would soon yield a dividend in the form of healthier voters and falling spending.

No, it was the apparent faith in the rationality of a consumer society in which common sense competes with credulous sentimentality, science with Mystic Meg.

But NICE is not an instrument of the democratic will, but of expertise - an instrument, moreover, created at arm's length from ministers. If Professor Rawlins' team recommends again, say, the costly use of beta interferon to treat multiple sclerosis, Frank Dobson - or the August duty minister - will be able to say, 'Sorry guv, nothing to do with me.'

It is not New Labour's only use of this technique. The most conspicuous example is Gordon Brown's handing over responsibility (for which read 'blame') to the Bank of England for monetary policy.

As an interesting comparison, on the very day that NICE had its first big outing, a body called the Office of the Schools Adjudicator ruled that three London comprehensives with selective policies - there's a contradiction in terms for Mystic Meg to explain - must modify them.

Ministers distanced themselves from the ruling because, as everyone knows, New Labour stands for educational excellence. You can almost hear similar noises coming out of Richmond House if Professor Mike talks tough about£10,000-per-year beta interferon, can't you? Mr Dobson will insist that the government is not rationing and will trouser the savings.

But NICE will also face public pressures to hand over the pills. In the list of 23, for instance, I noticed Ritalin, the drug used to curb hyper- activity among children.

Its use is virtually epidemic in the US. I know - I used to live there and the medics recommended it for one of our kids when he was about eight. Even now I break into a sweat at the thought of our narrow escape from the liquid cosh.

Most of us are increasingly risk-averse, but we stumble into fearsome risks of which the Ritalin culture is one. That is not to say that Ritalin doesn't have its uses among deeply disturbed or dysfunctional children. It's just that, in an age when science and Mystic Meg jostle for our attention, the temptation is for busy parents with demanding sprogs is to grab at a panacea.

Ditto stroppy grandparents, though it is human nature to be even more concerned for the future, which means children. In the week in question, we also saw new research, from America naturally, suggesting that children aged under two should watch no television at all and their elders only do so under supervision. So much for the Teletubbies doing the nannying.

All the same, it could be worse for Professor Mike. Unlike the Court of Appeal he has not yet been asked to rule on the efficacy of sex-change operations on the NHS in Lancashire. Is it only a matter of time?