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European brief - January 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:

  • Brexit update
  • Labelling of alcoholic beverages
  • Reducing the dietary intake of trans fatty acids
  • BMA joins call to action on the employment of people with chronic diseases
  • HTA (Health Technology Assessment) legislation proposed


Brexit update

Following the European Council’s confirmation that sufficient progress had been made in phase one of the negotiations (the Withdrawal Agreement) in order to allow phase two negotiations to begin (the transitional period and the future relationship between the UK and the EU), and its publication of supplementary negotiating directives, we have been working with European partners to ensure that resolution of the medical profession’s interests are expedited.

To this end, our partners in the CPME (Standing Committee of European Doctors), UEMS (European Union of Medical Specialists), UEMO (European Union of GPs) and EJD (European Junior Doctors), along with several other pan-European medical organisations, have written to Michel Barnier, the EC’s (European Commission) Chief Brexit negotiator to advise that:

  • Priority be given…to ensuring that the same certainty (ongoing mutual recognition of professional qualifications) is provided to the thousands of medical students, studying outside their country of origin, who have yet to secure their professional qualifications.
  • Every effort…(be) made to ensure that some form of such mutual recognition be maintained in the future relationship, alongside successful tools supporting its implementation, and securing patient safety, such as the alert mechanism.
  • It is imperative that solutions, including the provision of clear long-term frameworks, are found to ensure that such medical academics pursue their research in Europe.
  • (With regard to Northern Ireland) it is crucial that significant additional, practical detail about the future border arrangements be provided at the earliest possible opportunity. Failure to provide such clarity may impact upon the recruitment and retention of doctors in the Irish border region with an attendant negative impact upon the provision of healthcare services throughout the island.

With Bulgaria assuming the Presidency of the Council of the EU (from January-June 2018), the BMA has also written to the Bulgarian Health Minister to request that such concerns are prioritised during his government’s Presidency. Both this letter and that sent by the CPME et al. to Michel Barnier are available upon request.

In further recognition that the concerns of the medical profession are being factored into the EU’s Brexit planning, Jean-Claude Juncker, President of the EC, has boosted hopes of preserving EU funding for cross border health initiatives between Northern Ireland and the Republic following Brexit.

Speaking in the EP (European Parliament) during a debate on the ‘Future of Europe’ with the Prime Minister of Ireland, Leo Varadkar, and with reference to the next Multiannual Financial Framework (MFF) – which sets out the EU’s annual general budget – he was unambiguous about the EU’s commitment to resolving the challenges facing Ireland. He said:

  • When it comes to the issue of Ireland in these [Brexit] negotiations, Europe is united. It is all for one and one for all.
  • I see no more important use of our new budget than guaranteeing and financing the peace process in Ireland. This is an unconditional European commitment. This is what the Commission will deliver with our proposal for the next Multiannual Financial Framework in May.

Whilst we welcome such robust language, we will continue to work closely with our European partners to ensure that such commitments are delivered upon, and the plethora of other challenges facing the medical profession are dealt with during the Brexit process.


Labelling of alcoholic beverages

Ahead of the upcoming (due March 2018) self-regulatory proposal from the alcohol industry, which a leaked document suggests will mainly comprise of off-label suggestions such as QR codes, bar codes, web links or other online options), the BMA’s partners in the CPME, UEMS, UEMO and EJD have written to the EC to advise that such an approach would be insufficient in tackling alcohol related harm.

Instead, they recommend that the alcohol industry should also be subject to existing mandatory requirements for producers to list both the ingredients and nutritional information provided per 100ml on their products’ labelling. A copy of this letter is available upon request.

Should the EC deem the industry’s proposal to be unsatisfactory, it will launch an impact assessment to review further available options – both regulatory and non-regulatory. The BMA will continue to work with our European partners to seek to ensure that the regulatory option is chosen (see item below).

Reducing the dietary intake of trans fatty acids

Following related meetings with staff representatives from the Bulgarian Permanent Representation to the EU, and ahead of an upcoming (6 February) expert-level conference on healthy nutrition in Sofia, the BMA has written to the Bulgarian Health Minister.

We have, requesting their support for the development of legislative measures to reduce the intake of IPTFAs (industrially produced trans fats) and the introduction of a mandatory requirement to label alcoholic beverages.  

In addition, the BMA has responded (see bullet points below for a summary) to an EC public consultation on the potential impacts of actions taken in the EU to reduce the dietary intake of IPTFAs in the EU:

  • industrial trans fats content in food should be limited through a legally-binding measure of 2% of the total fat content of the food
  • regulating FTA content will protect all socio-economic groups from the negative health effects of TFA intake
  • there is strong evidence that consumption of TFAs increases the risks of cardiovascular disease and some evidence that it increases the risk of the component features of the metabolic syndrome and diabetes

Following an analysis of all data received, the EC will complete its final impact assessment before deciding on what course of action to pursue. The BMA will continue working with its European partners to attempt to secure the adoption of the aforementioned legislative measures.

BMA joins call to action on the employment of people with chronic diseases

The BMA is one of 38 organisations, including the CPME, to have developed and endorsed this call to action. The joint statement calls "upon the European Commission, the European Parliament and EU Member States' Governments to recognise the central role that health and well-being play in building strong and sustainable social market economies and an effective, productive and healthy workforce". It urges these bodies to do so by:

  • investing in prevention and earlier detection of chronic diseases
  • improving the integration of care to strengthen chronic disease rehabilitation, recovery and
  • employment
  • putting in place a favourable environment including financial/non-financial incentives and adequate policies to support employment, return-to-work or retention at work of people with chronic diseases
  • ensuring appropriate training of employers on the issue of chronic diseases and working conditions and promoting chronic disease awareness at the work place

The call for action will be presented to MEPs and other key decision makers at an event in the EP on 20 March 2018.


HTA (Health Technology Assessment) legislation proposed

The EC has published a proposal to determine the added therapeutic value of medicines and medical devices at EU level to help countries avoid duplication of these assessments.

With regard to the problems identified, the proposal aims to tackle the following objectives:

General objectives:

  • Ensure a better functioning of the internal market
  • Contribute to a high level of human health protection

Specific objectives:

  • Improve the availability of innovative health technologies for EU patients
  • Ensure efficient use of resources and strengthen the quality of HTA across the EU
  • Improve business predictability

Operational objectives:

  • Promote convergence in HTA tools, procedures and methodologies
  • Reduce duplication of efforts for HTA bodies and industry
  • Ensure the use of joint outputs in Member States
  • Ensure the long-term sustainability of EU HTA cooperation

The BMA is analysing this proposal and will be working with European partners, as necessary, to ensure that its progress into legislation reflects the interests of the European medical profession.