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European brief - October 2018

Read our monthly European brief to get an overview of the key EU legislative and policy developments which impact the medical profession, as well as the work being carried out by the BMA to ensure that those developments align with our members' interests.

Topics discussed in this month's briefing, include:

  • Brexit update
  • Regulating transfats
  • EU protection for whistleblowers

Download the latest brief


Brexit update

Factoring the European Council’s conclusions (see below) on the progress of the Brexit negotiations, and Austria’s assumption of the Presidency of the Council of the EU into our planning, the BMA is continuing to work with partners and politicians from across Europe to safeguard the future of the medical profession and the patients it serves:

  • The European Council welcomed the further progress made on parts of the legal text of the Withdrawal Agreement. However leaders highlighted that important aspects still need to be agreed.
  • EU27 leaders expressed their concern that no substantial progress had yet been achieved on agreeing a backstop solution for Ireland/Northern Ireland.
  • The European Council (Art. 50) stressed that work had to be accelerated with a view to preparing a political declaration on the framework for the future relationship. This requires further clarity as well as realistic and workable proposals from the UK as regards its position on the future relationship.
  • Finally, the European Council renewed its call upon member states, EU institutions and all stakeholders to step up their work on preparedness at all levels and for all outcomes.

Work to secure the ongoing MRPQ (mutual recognition of professional qualifications) also continues at the domestic level with the BMA participating in an event - 'Supporting Europe's professionals: securing the future of MRPQ' – alongside the Royal Institute of British Architects, the Law Society, the Royal College of Nursing and the British Veterinary Association in the House of Lords on Tuesday 3rd July.

Read more about our extensive work on this key issue


European Health Funding 2021-27

The EC (European Commission) has recently adopted its proposal for the EU 2021-2027 budget, including the ESF+ (European Social Fund Plus) which merges several other programmes, of which the EU Health Programme is amongst the most notable.

ESF+’s health strand is intended to support public health policies and access to medical products whilst focusing on the following key areas and priorities:

  • Improve crisis-preparedness, management and response in the EU to protect citizens from cross-border health threats
  • Strengthen health systems, by supporting the digital transformation of health and care, developing a sustainable EU health information system, and supporting national reform processes for more effective, accessible and resilient health systems addressing, in particular, the challenges identified in the European Semester (see next item for further information)
  • Support EU health legislation
  • Support integrated work, i.e. ERNs (European Reference Network) HTA (Heath Technology Assessment) and implementation of best practices for the promotion of health, prevention and management of diseases


European research funding 2021-27

The EC has officially launched Horizon Europe, its research and innovation funding programme for 2021-27, which has a 3 pillar structure:

  • Open Science will be supporting excellent science through the European Research Council, Marie Skłodowska-Curie Actions and research infrastructures
  • Global Challenges and Industrial Competitiveness will take forward the societal challenges and industrial technologies
  • Open Innovation will focus on scaling up breakthrough and market-creating innovation by establishing a European Innovation Council who will offer a one-stop-shop to high-potential innovators

Horizon Europe’s health strand has a budget of over €7bn and will fund six major topics:

  • non-communicable and rare diseases
  • tools, technologies and digital solutions for health and care
  • health care systems
  • health throughout the life course
  • environmental and social health determinants
  • infectious diseases

With the UK’s impending departure from the EU, doubtlessly in mind, the proposal includes new rules for ‘third countries’ (the UK’s future status) with participation subject to bilateral negotiations between such countries and the EU.

‘Third countries’ will be free to choose whether they take part in the whole programme or just in some selected areas, whilst the EU’s financial support will be equal to the contributions paid by participating countries.

There is also clarification regarding the UK’s participation as one of the aforementioned third countries, with Horizon Europe intending to “extend association to include all countries with excellent R&I capacities and no longer confined to a particular part of the world’.

Given the extent to which collaborative projects involving both UK and EU researchers deliver better outcomes than those conducted without such cross-border working, the BMA will be working with its European partners to help deliver the optimal outcomes for medical researchers across Europe.


Labelling of alcoholic beverages

Following last month’s meeting between a delegation – including the BMA – from the European medical profession and the EU’s Health Commissioner, who was broadly supportive of our view that the self-regulatory approach presented by the alcohol industry would be insufficient in tackling alcohol related harm, lobbying has been refocused on those other parts of the EC likely to input into this process.

Joint letters, reiterating the inherent weaknesses in the industry’s proposal and requesting that the EC act accordingly to tackle alcohol related harm, from the BMA’s partners in the CPME (Standing Committee of European Doctors), UEMS (European Union of Medical Specialists), EMSA (European Medical Students Association) and EJD (European Junior Doctors’ Association), were sent to those DGs (Directorate Generals) responsible for the internal market and agriculture.

Disappointingly, if not entirely unsurprisingly, the responses were extremely anodyne in nature and suggested that the issue is the entirely the responsibility of DG SANTE, the EC’s department for health.

Such claims are particularly difficult to accept when one notes that the EU’s CAP (Common Agriculture Policy), which falls under the remit of its DG for Agriculture, holds a dedicated budget for wine promotion spending €522m between 2009/13 and with €1,156m allocated for the 2014–18 period.

With the EC continuing to analyse the alcohol industry’s self-regulatory proposal, the BMA will continue to work with our European partners to ensure that the EU institutions are fully cognisant of the health benefits of the labelling of alcoholic beverages and the importance of the EU developing its alcohol policies completely independently of the alcohol industry.


Standardisation of health services suspended?

As a result of several years of concerted lobbying by the BMA and our European partners, CEN/CENELEC (European Committee for Standardisation) has finally accepted that its development of standards in healthcare services was being undertaken without the support of the medical profession or the EU.

Accordingly, CEN has decided to disband its healthcare services focus group and “acknowledges the fact that Services related to Healthcare are not a priority for the time being.” However, whilst this news is welcome, the issue is not completely closed with as CEN has retained the possibility of dealing with future initiatives regarding healthcare services within its Strategic Advisory Group on Services (SAGS).Accordingly, we will continue to monitor CEN’s activities and react as necessary should its work in this area be revisited.To recap, the European medical profession’s opposition to CEN’s activity in this area was based on the following rationale:

  • CEN’s work in this area is being undertaken without the support, or adequate consultation of, the European healthcare professions. It is axiomatic that such an approach, which ignores clinicians’ professional expertise, risks permitting the development of “standards” whose application will threaten patient safety across Europe.
  • This threat will increase exponentially should CEN’s plans to develop standards in “primary health care, non-specialized and specialized healthcare, ambulatory and hospital care, nursing homes, hospices, preventive health care, mental health services, dental services, physiotherapy, occupational health services, rehabilitation and pharmacies” come to fruition.
  • Taken to its logical conclusion, delivery of this strategy will create a parallel de facto regulatory system with CEN at its apex as the European regulator. Such an outcome would not only impinge upon member states’ ability to organise and deliver their health systems but threaten healthcare professionals’ ability to exercise their judgment, under the current self-regulatory system in many member states, in the best interests of their patients.


Reflections on EU health policy during Bulgarian presidency

The Bulgarian Presidency of the Council of the EU has presented a paper ‘Making the case for health’ and asked EU health ministers to advise which areas of health policy they believe that the EU should focus on for the benefit of member states.

The paper highlights the value of EU cooperation in specific areas of health policy while recognising that it remains a national competence.

It also highlighted how EU action promoting health is particularly useful when there is a cross-border dimension or when it facilitates the improvement of national measures based on the exchange of best practices.

Various areas where EU cooperation can be beneficial such as the exchange of best practices in the areas of prevention and non-communicable diseases, cross-border health threats, patients’ safety, AMR, eHealth and research were also highlighted.

Health Ministers also adopted their conclusions on Healthy nutrition for children: The healthy future of Europe which supports action to reduce the exposure of children to the marketing of foods high in energy, saturated fats, trans-fatty acids, sugar and salt.

The conclusions, which reflect BMA lobbying – including a letter sent to the Bulgarian Health Minister back in January of this year, invites national governments and the EC to act accordingly and target such marketing through any type of media, including online platforms and social media.

Whilst welcome, additional lobbying will be required to ensure that such well-intentioned statements are developed into effective policy, and where necessary, legislative measures.

Accordingly, we will be continuing to work with our European partners to ensure that such action is taken.



For further information on any of these news items, please contact Paul Laffin: [email protected]