#EAPM - Hold the front page! Belgians bash oldies and #Brexit takes a beating

Well, perhaps Theresa May no longer sees it as a gift, and the EU-27 certainly don’t, so we await what they have to say later this week about her love letter to Donald Tusk requesting a short extension till the end of June, assuming she can get her deal through Parliament.

The Speaker of the House of Commons certainly bowled a bouncer to leave the UK prime minister batting on a sticky wicket when he explained that bringing back, in essentially the same form, a proposal that has already been comprehensively voted down in the same Parliamentary session by MPs, would breach a convention dating back to 1604.

John Bercow doesn’t look that old, so he must have looked it up.

By whatever means the Speaker reached his conclusion, Mrs May and her squabbling cabinet are not overly impressed with the move, although it arguably has a funny side.

To wit…apparently, asking the British public to vote a second time on a very tight decision, with two years-plus of new knowledge and experience about Brexit’s real implications, is an affront to democracy. However, bringing back essentially the same deal for MPs to vote on for a third time after two crushing defeats is OK.

The Irony Meter just crashed through the roof…

Oldies, not goldies

So, to Belgium… and a real tale of woe from the country where it has been revealed that 40% of Belgians would cut health care for the elderly given the chance.

According to Le Soir, four-in-ten citizens who are worried about the sustainability of the social security system say they back “no longer administering expensive treatments that prolong life to those over 85 years old”.

Meanwhile, 17% would administer a slap to those falling ill through personal choices such as smoking tobacco and being obese (apparently ‘a personal choice’), saying they back the refusal of payments in such cases.

This hardly supports the idea of access to the best healthcare available for all EU citizens, which is a basic and fundamental human right, or should be.

No assurance over visitors’ insurance

Going back to the UK, Health Minister Stephen Hammond this week pledged that retired Britons living in the EU would have their health-care costs covered for a year in a no-deal scenario. 

London has asked the EU-27 that current reciprocal arrangements continue until the end of 2020 in the event of a no-deal, in order to "minimize disruption”.

Hammond explained that: ”This would mean that we will continue to pay for healthcare costs for current or former UK residents for whom the UK has responsibility who are living or working in or visiting the EU and EFTA states, where individuals are not covered by the EFTA Citizens’ Rights Agreements.”

Other member states need to agree to that and, if they don’t, then the 12-month pledge kicks in.  The minister also said that anyone forced to come back to the UK for health reasons will have access to the National Health Service.

Hammond has, however, been a little more circumspect with regards to the rights of Europeans in the country. While he has said that their healthcare rights will be protected in a no-deal scenario if they are “living lawfully in the UK on exit day,” he avoided any mention of rights for European or EFTA visitors to Britain who may need emergency care.

This is currently provided under the European Health Insurance Card.

Huge gaps in cancer care

EAPM’s events this year will cover all aspects related to the above developments and issues, and the December Congress also has a special session on cancer.

According to the World Health Organization, new cases of cancer globally are expected to increase by 70% over the next 20 years, from around 14 million to 25 million.

In Europe, the battle against cancer needs to be fought at EU level -and this may be aided by the fast-growing field of personalised medicine, with its goal of giving the right treatment to the right patient at the right time.

Few national cancer plans incorporate personalised medicine as this new science was in its infancy when most NCPs were established. EU member states may need support in developing their NCPs to incorporate biomarker testing as an essential and standard part of best clinical practice. 

Britain certainly needs to get its act together in other respects of cancer care as things are already going badly wrong, with one-in-six centres having fewer consultants than they had in 2013. Meanwhile, vacancies have doubled.

Some posts have been empty for a year or more, and the information revealed in a Royal College of Radiologists’ report shows that Britain’s clinical oncology workforce is understaffed by 18%, and this is expected to rise to 22% by 2023.

The report added that, without investment in staff, it would be difficult to introduce innovations, including immunotherapies. This is hardly optimal given that, in a Europe with an ageing population, more people will get cancer down the line simply as an inevitable result of living longer.

What has become clear during the emergence of personalised medicine, with all the new technologies underpinning it, is that there is a need for investment in healthcare professionals to bring them up-to-speed with modern methodologies, and therefore ensure that the necessary skills are out there in the marketplace. 

This is as true, if not truer, in oncology as in any other sphere.

On top of this, smarter use of resources needs to be brought to bear to future-proof health-care systems, which are creaking under the strain of more people with chronic diseases and a lack of hard cash.

Trial and error

Over in Italy, the country’s drug regulator AIFA put out its own report highlighting that, between 2015 and 2017, 885 “deviations” were detected from 197 inspections into good clinical practice. 

It called 79 of these critical, 347 major and 459 minor.

AIFA pointed out that clinical trial guidelines are intendedto guarantee participants’ protection and data reliability, but there have been management failures, poor patient records and failures in drafting clinical study reports.

EAPM has long said that the clinical trial paradigm needs to change, while clinical practices need to be modernized.

There are plenty of topics to be discussed at the Alliance’s events in April and December, and at the very least we can all work towards creating better news than has emerged this week.

With luck and a fair wind, Brexit may have been decided by the April conference, but nobody in Brussels is placing any bets.