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European brief - February 2019

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
  • Welsh minimum unit pricing plans submitted to the European commission
  • MEPs call for a solid post-Brexit agreement on cross-border  health

Download the latest brief


Brexit update

With the future of Brexit still uncertain, and the EC (European Commission) publishing the next stage of its No Deal planning, we continue to work with our European partners to ensure that stakeholders on this side of the channel are fully cognisant of the risks that Brexit poses to their medical professions and patients.

Accordingly, and with the support of MEPs Julie Ward and Karine Gloanec Maurin, Co-President to the EP’s (European Parliament) Intergroup on Common Goods & Public Services, we hosted an event Brexit: The impact on the EU27’s Healthcare Services in the EP on 27 February.

Attendees, including MEPs and diplomats from across Europe, heard from Prof. Dr Frank Ulrich Montgomery President of the CPME (Standing Committee of European Doctors), who stated that:

British medicine is European medicine. We want to keep our British colleagues on board. CPME remains convinced that there are technical and legal solutions to enable doctors’ mobility and cooperation on health post-Brexit. We therefore appeal to negotiators on both sides to show the political willingness to protect health, with pragmatic and sustainable agreements.

Dr Denis McCauley, a General Practitioner and district coroner from County Donegal on the Irish border, representing the IMO (Irish Medical Organisation) presented the particular challenges that Brexit would pose to the provision of cross-border healthcare services in his locality and concluded by stating that:

I’ve grown up beside an ever-changing border and now practice medicine on that border. The only certainty about Brexit is uncertainty in healthcare provision.

In addition, we continue to meet with MEPs – including Mairead McGuinness, first Vice-President of the EP and MEP for the border counties of Ireland - from across the political spectrum to help deliver a solution which doesn’t threaten the continued provision of such services.

Further details about our extensive work on this key issue are available here.


MEPs say, "Let doctors prescribe cannabis-based medicines"

The EP’s Plenary (full session) has adopted a resolution which calls on the EC and national authorities to draw a clear distinction between medical cannabis and other uses of cannabis.

In addition to urging them to address the regulatory, financial and cultural barriers which burden scientific research, MEPs called on them to properly fund research and for member states to allow doctors to use their professional judgement in prescribing cannabis-based medicines.

When effective, the resolution proposes that these medicines would be covered by health insurance schemes in the same way as other types of medicine.

As such regulatory developments would have huge implications for the BMA, and with the potential implications of Brexit very much in mind, we will be monitoring the progress of this file and working with our European partners to ensure that the medical profession plays an integral role in its development.


Welsh minimum unit pricing plans submitted to the European Commission

The Welsh government’s proposed legislation - The Public Health (Minimum Price for Alcohol) (Minimum Unit Price) (Wales) Regulations 2019 – to introduce MUP (minimum unit pricing) for alcohol has been submitted to the EC’s Technical Regulation Information System for review by interested stakeholders.

Given the alcohol industry’s tenacious objections – subsequently ruled to be unfounded – to the Scottish government’s efforts to introduce similar legislation, it is expected that they will seek to prevent the implementation of the Welsh plans via objections on EU legal grounds.

Accordingly, and with the regulations seeking to “tackle alcohol-related harm, including alcohol-attributable hospital admissions and alcohol-related deaths in Wales, by reducing alcohol consumption in hazardous and harmful drinkers”, we will be working with European partners to ensure that the views of the medical profession are, once again, given precedence over those of industry, whatever the outcome of Brexit may be.


MEPs call for a solid post-Brexit agreement on cross-border health

The EP’s plenary has adopted a resolution on the implementation of the Cross-Border Healthcare Directive which asks the EC “to negotiate a solid agreement with post-Brexit UK on health, devoting specific attention to cross-border rights for patients and the functioning of the ERNs (European Reference Networks).”

With regard to the ERNs, its stresses “the importance and added value of EU-wide mobility of healthcare professionals, during both their education and professional careers, and of their particular role in improving knowledge and expertise on rare diseases.”

MEPs also called on the EC and member states “to work together to assess, realign and simplify reimbursement procedures for patients receiving cross-border care” and, with particular relevance to cross-border healthcare provision in Ireland, for them “to deepen cross-border healthcare cooperation, in an efficient and financially sustainable manner, including by providing accessible, sufficient and understandable information, in order to secure the best possible care for patients.”

As the relevance of all such initiatives to the BMA will be dependent upon the outcome of the Brexit process, we will be monitoring the progress of these files and intervening, where required and with the support of our European partners, to ensure that the association’s interests are taken into account.


EU Plans for European electronic health record exchange

The EC has published a recommendation on a European Electronic Health Record exchange format.

In addition to calling on member states to ensure secure access to electronic health record systems at national level, it sets out a framework – see key points below - for the development of a European electronic health record exchange format in order to achieve secure, interoperable, cross-border access to, and exchange of, electronic health data in the EU:

  • a set of principles that should govern access to and exchange of electronic health records across borders in the Union
  • a set of common technical specifications for the cross-border exchange of data in certain health information domains, which should constitute the baseline for a European electronic health record exchange format
  • a process to take forward the further elaboration of a European electronic health record exchange format

With member states asked to work with the EC to “support the further elaboration of the recommended baseline of health information domains and specifications for a European electronic health record exchange format, through a joint coordination process”, and with the possible implications of Brexit in mind, we will be working with our European partners to ensure that the medical profession plays an integral role in such processes.


European platform on rare disease registration launched

Marking Rare Disease Day on 28 February, the EC launched a new online knowledge-sharing platform to support better diagnosis and treatment for more than 30 million Europeans living with a rare disease.

With vast amounts of data on patients with specific conditions currently scattered across Europe in about 600 'registries' – databases that hold information on patients with specific conditions, data is not collected EU-wide and there are no shared standards to analyse the information that is available on rare diseases.

The new European Platform on Rare Diseases Registration will bring this data together and support the quality research necessary to enhance diagnosis and treatment outcomes - helping to improve the lives of patients and their families.

As the UK’s involvement in this new platform will be dependent upon the nature of Brexit, we will be working with both domestic and European partners to ensure that such resources will be available to the BMA’s membership whatever the outcome.