#EAPM – Update: Who holds the trump cards for Europe’s and the UK’s top jobs?

| June 6, 2019

Well, the dust appears to have mostly settled on the matter of Trump meeting the Queen of the Commonwealth and, despite some hilarious banners protesting against Donald Trump’s state visit to the UK, there was at least some appropriately serious and stirring stuff as the 75th anniversary of the D-day landings were commemorated in Portsmouth and Normandy, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

But how seriously the US president took his Downing Street discussion with the prime minister, the soon-to-depart Theresa May, we will probably never know.

But we do know that he’s very big on May’s possible replacement Boris Johnson and Trump’s good mate Nigel Farage.

Speaking of the latter, Our Nigel has flatly denied that his Brexit Party will cosy up with Italys Deputy PM Matteo Salvinis League in the European Parliament.

Farage’s spokesman said the Englishman “will plan to rebuild” his own EFDD group, originally made up primarily of the now-basically-pointless UKIP party, plus the Italian 5 Star Movement.

Of much more interest is the ongoing to-ing and fro-ing over who will get Europe’s ‘top jobs’ in the European Commission and, of course, the Parliament.

EPP Spitzenkandidat Manfred Weber this week got himself re-elected as group leader, which should bolster his chances of claiming the title pf President of the European Commission (although he’ll have to persuade French President Emmanuel Macron first, so don’t hold your breath).

As it stands, no party has a majority in parliament post-elections and a lot of wheeler-dealing is going on with the Greens and Socialists likely to play a role, but the ALDE+ group in danger of being sidelined.

If the latter happens, former Belgian premier and European Parliament stalwart Guy Verhofstadt may be thwarted in his long-standing aim to head-up the Strasbourg and Brussels chambers.

Weber said of the EPP (which won the most seats, of course): “We are unitedThe EPP is simply ready to immediately start with a very compromise-oriented style” to build a parliamentary majority. They are certainly united in wanting the German to replace Jean-Claude Junckerand have Chancellor Angela Merkel’s not-inconsiderable backing.

For their part, the liberal faction are not sure what they do want, but absolutely know who they don’t want – Weber.

So, here we go again on the five-year merry-go-round. Yes, the same one that gave the top job to a man nobody really wanted last time out. Yep, Juncker.

Health matters

Anyway, we could go on forever about all this stuff (and the media obviously will), so we’ll move on to health-related matters, beginning with briefly reminding readers of two important EAPM-led meetings coming up this month.

Against the backdrop of all the political manoeuvring EAPM has plenty on its own plate, not least the two roundtables in the Brussels seat of parliament.

These commence on 19 June, with MEPs in the Members Salon, to enable all present – deputies old and new – to gain a better understanding of the issues involved in personalised health care.

A second, technically minded round table, with member state representatives on Real World Evidence and HTA ,will take place the day after (20 June) and be structured around an initial framework-setter, followed by various case examples.

A vital part of EAPMs role has always been engagement with EU health attachés and MEPs, as well as continuous involvement in ongoing discussions in our arena. 

The long-running STEPs (Specialised Treatment for Europes Patients) interest group of MEPs, will continue, no doubt with some new faces added in the wake of the EU elections.

Prior to these meeting, of course, is the EHA Congress in Amsterdam, which runs from 13-16 June. Like we said, it’s busy already…

Meanwhile, it looks as though financial health programmingin the EU budget will be boosted by almost €1.5 million next year. And €13.2 billion in payment commitments will wind up with Horizon 2020, which will be up 6.4% on 2019, according to aCommission draft.

Of course, it all still has to be agreed between the European Council and Parliament.

Cross-border healthcare and ERNs

The European Court of Auditors has been having a busy time of it, as a report just issued has underlined that while cross-border healthcare remains marginal in comparison to healthcare delivered domestically, in some situations, the most accessible or appropriate care for a patient is available in a Member State other than their home country. 

The report noted that the Cross-Border Healthcare Directive “facilitates closer cooperation in a number of areas: notably the cross-border exchange of patients’ data and access to healthcare for patients with rare diseases”. 

The Courts report noted that “the concept of European Reference Networks for rare disease is widely supported by EU stakeholders (patients’ organisations, doctors and healthcare providers)”. 

No denying that its a great idea. However, “the Commission has not provided a clear vision for their future financing and how to develop and integrate them into national health-care systems”. 

When it comes to cross-border initiatives for rare-disease patients, the specificities of such diseases led the Council of the European Union to single out co-operation in this field as “as a unique domain of very high added value of action at Community level”.

Networks were launched in 2017 for different classes of rare diseases. Each receives €1 million funding over five years from the EU Health Programme. The Commission also finances patient registries and support activities for the ERNs as well as the development of IT tools, notably through the Connecting Europe Facility.

The EU is currently considering the future of the European Reference Networks for rare diseases. “EU citizens still dont benefit enough from the ambitious actions set out in the Cross-Border Healthcare Directive,” auditor Janusz Wojciechowski has said.

Investing in health 

A Commission Export Panel on investing in health this week listened to two draft opinions, on value  and task shifting in health care. These should be rubber-stamped by the end of the month.

The first opinion recommends that member states develop a long-term strategy to reallocate resources from health interventions that have a low value to those with a higher one.

This should encourage health-care professionals to invest in increasing the healthcare value for patients. The idea is also to give patients a greater role in decision-making about their own health. Hallelujah!

However, Jacques de Haller, who is a former president of the European doctors’ organization CPME, has said that science should remain at the heart of decision-making when involving patients. 

He made the fair point that many people believe in now-disproven vaccines myths, adding the possibly more patronizing point that medicine should be practiced “by people who know and who have studied medicines.” So much for a patient lifestyle input.

The second opinion zoomed-in on how tasks can be shifted between-and-among health-care workers or from workers to patients or machines, to ensure that the healthcare sector’s scarce manpower is put to best use. 

Martin McKee, a professor at the London School of Hygiene and Tropical Medicine, said he felt that there exists little evidence to back the rigid demarcation that exists between tasks performed by doctors and nurses in particular situations.

There is also a lack of evidence about shifting tasks, he added. The opinion backed more research.

And finally…

The European Medicines Agency (EMA) has this week released draft guidance in respect of how medicines-device combinations (which are human medicines that contain a medical device) are to be regulated under the EUs new medical device regulation.

The EMA has highlighted which device types will be required to receive a marketing authorisation with a “CE” mark or a “declaration of conformity,” or be seen by a notified body. 

That’s all for now. Enjoy the upcoming weekend!

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