In advance of the European Parliament elections this month, we asked all political parties a series of questions on issues of concern to Irish community pharmacies, which will be discussed and decided upon, at EU level. The responses are provided in this article.
Voters will go to the polls to decide the configuration of the Irish delegation in the European Parliament on 7 June. A record number of 74 candidates will be on the ballot papers in the constituencies of Midlands-North-West, South and Dublin. The chosen candidates will fill Ireland’s 14 MEP seats, with four seats in Dublin, and five apiece in Midlands-North-West and South.
The IPU Review asked all political parties a series of questions on issues of concern affecting community pharmacy. We asked the same questions of all parties and received replies from Fine Gael, Fianna Fáil, Sinn Féin the Labour Party and Aontú. Their replies in full are printed across the following pages.
COVID-19 has put health on top of the EU policy agenda. Do you think the EU should continue to keep health as a priority? If so, in which area do you think a cooperation at EU level is most needed?
Is fearr an tsláinte ná na táinte. Without good health, everything else becomes more difficult, if not impossible.
COVID-19 highlighted both the challenges facing Europeans but also the resilience of the Irish people and that of our fellow Europeans. The outbreak of COVID had a devastating impact on Europe and the world and caused a tragic loss of life across the continent. It showed, however, how important it is for us to work together to overcome challenges.
The COVID-19 vaccines were clear examples of this — researchers working together at an EU level, vaccines being manufactured in Member States and at an EU level, the sharing of knowledge, working together on research, the development and introduction of new medicines and vaccines, and the advancement of med-tech are all areas on which we can, and should, work together.
The new European Parliament will shape the EU pharmaceutical legislation. What do you think the new legislation should include to improve the quality, safety and most importantly the availability of medicines?
Building on the strategy from 2020, the EU should prioritise a number of issues, including speedier access to new medications for all citizens in all Member States, and the availability of medications, ensuring supply chains are strong enough to avoid shortages and safeguard security of supply.
In addition, we need to examine how we in Ireland can work with our European neighbours to ensure equality of access. While recognising the cost of developing new medicines, we need to find better ways of ensuring treatments — which are often life-enhancing and life-extending — reach patients faster.
It is encouraging that the EU has proposals on the table and Fine Gael MEPs will work to ensure their implementation for the benefit of people in Ireland and the EU as a whole.
How do you see the role of community pharmacists in providing high-quality health care to European patients and in contributing to the sustainability of health care systems?
Pharmacies — or chemists as such businesses were more widely known until recently — have always been at the heart of communities in Ireland. The local pharmacist is a source of knowledge and reassurance for people and helps people to proactively manage their health. The COVID-19 pandemic re-affirmed the role that pharmacies play and highlighted that pharmacists can play an even greater role.
While health is a national competency, we can learn from and build on the experiences of other countries where pharmacies play an expanded role in healthcare. As members of the European People’s Party, Fine Gael MEPs have access to wider networks across Member States as well as the opportunity to help shape European law at the earliest stages.
The newly elected members of the European Parliament will contribute to shape the digital transformation of healthcare systems. What do you consider the main challenges and the main opportunities for digitalisation in health care?
As a country, we have secured some notable achievements in the digital transformation of healthcare. Ireland’s National Integrated Medical Imaging System (NIMIS), for example, is one of the largest of its type in the world. With fully digital radiology services, waiting times have been reduced and care is provided in a timelier way.
We’ve also secured achievements in the rollout of electronic health records in maternity hospitals as well as the introduction of electronic prescriptions.
However, we need to build on this progress. We need to speed up the transformation to electronic health records with unique identifiers that would provide doctors and healthcare staff with immediate access to a person’s health records.
Challenges achieving this include a strong ICT system as well as safeguards to ensure the integrity and safety of private data. However, the challenges can be overcome, and the benefits would be immense for each patient.
What do you think the EU can do to tackle the silent pandemic of antimicrobial resistance?
Antimicrobial resistance is one the gravest threats facing the global population. The transformation brought about by antibiotics cannot be overstated — it’s one of the reasons why life expectancy rates have increased so dramatically over the last century or so. However, there has no been no major discovery of a new antibiotic in more than 35 years or so.
There are a number of steps we can take which Fine Gael MEPs will strive towards.
Firstly, we need to try and preserve the power of existing antibiotics by ensuring they are used only when absolutely necessary. Secondly, we need to support and fund research into new potential antibiotics but also into new approaches to treating infections. Thirdly, we need to ensure our healthcare services — and other related services — are designed and run in a way that strives to minimise infection. And fourthly, we need to approach antibiotics from as wide as possible point of view, from their use in medicine to their use in agriculture to their use in other settings.
Fine Gael candidates for European election 2024
Dublin:
Senator Regina Doherty
Midlands-North-West:
Nina Carberry
Maria Walsh, MEP
South:
Seán Kelly, MEP
John Mullins
COVID-19 has put health on top of the EU policy agenda. Do you think the EU should continue to keep health as a priority? If so, in which area do you think a cooperation at EU level is most needed?
While the delivery of health services should be carried out by national governments, working collaboratively on public health measures across the EU can improve health outcomes for all. We support a limited sharing of competences with the EU in the area of public health. For example, screening for rare diseases should be rolled out at EU level to ensure all children are screened for the maximum number of diseases in order to receive early treatment, as well as to map the prevalence of rare diseases across the EU. This will support the development of innovative treatments.
We also support increased cooperation on cross-border health threats. This will assist Member States in their preparedness in the case of another pandemic. Cooperation should include joint procurement of medical products, particularly medicines in short supply.
COVID-19 laid bare the need for Member States to stress test the resilience of their health systems. Tests should be carried under criteria set at EU level to ensure the highest standards. A digital platform should be established to facilitate exchanges on epidemiological data and best practice between the Member States. This platform would allow the Member States to take stock of mobilisation capacities and essential medical products.
Finally, there must be equal access to medical treatment across the Member States. The EU should create a comprehensive pathway for treatments from development to access, which balances innovation and affordability and reduces delays for patients. The pathway must provide access to complex therapies, such as Advanced Therapy Medicinal Products, that can only be delivered in a few specialised centres throughout the EU.
The new European Parliament will shape the EU pharmaceutical legislation. What do you think the new legislation should include to improve the quality, safety and most importantly the availability of medicines?
On the 26 April 2023 the EU Commission published its proposal to revise the general pharmaceutical legislation — this is in the form of a Directive and a Regulation. This is the first full revision of the pharmaceutical legislation in over 20 years and is significant to all stakeholders involved in the medicines’ ecosystem.
The aim of the pharmaceutical revision is described as ensuring access to affordable, available medicines, while maintaining the competitiveness of the EU pharma industry sector, combating antimicrobial resistance, and providing for compliance measures which reinforce environmental protections (the ‘3 A’s and 3C’s’).
Ireland is currently deliberating these legislative proposals with national stakeholders to inform the national position. The Department of Health is the lead Government department tasked with responding and engaging nationally and at EU level, as the proposal is negotiated by all EU-27 and progresses through the ordinary legislative process.
Belgium, during its Presidency, have confirmed that they will focus their efforts in January and February on shortages/security of supply. They will then move to deliberate on the theme incentives during the planned Working Party meetings taking place in March.
To recognise the importance of this EU file, the Minister for Health established the Cross Government and Cross Agency Pharmaceutical Strategy Working Group (PSWG) to support the development of Ireland’s response to the proposal from a national perspective and facilitate this position to be informed by a whole of government view.
The PSWG continues to meet to discuss this package regularly and is actively involved in considering the detail of the proposed package of legislative measures, ensuring a well informed and balanced Irish position.
The Department of Health conducted a consultation exercise on shortages with key external stakeholders from various backgrounds at the end of 2023 to help in informing the national position and this will feed into the Irish negotiation mandate.
Furthermore, the Department has recently completed a consultation on incentives and again this information will feed into the preparation of an Irish position. To determine what the new legislation should include to improve the quality, safety and most importantly the availability of medicines, the Minister and his officials in the Department will take into account the views of all stakeholders. It is essential that this is a collaborative approach. It is also vital that the Irish position is fully considered, and a balance is found that ensures improved access to medicines to patients in Ireland while also addressing industry concerns.
It is nonetheless important to stress that the pharmaceutical industry is a major contributor to the European economy, and we need to support its competitiveness.
How do you see the role of community pharmacists in providing high-quality health care to European patients and in contributing to the sustainability of health care systems?
We fully recognise and appreciate the significant role community pharmacists play in the delivery of patient care. Community pharmacy is often one of the most accessible avenues to receiving such care and provides a vital link in our healthcare service by ensuring the safe supply of medicines to people.
Medicines are the most common healthcare intervention, and the use and complexity of medicines are increasing. Pharmacists are the healthcare professionals optimally placed by virtue of their training to ensure the rational and safe use of medicines by patients.
We also acknowledge the vital role that community pharmacy will play in the development and implementation of future healthcare service reform in providing high-quality healthcare to European patients and in contributing to the sustainability of healthcare systems.
The newly elected members of the European Parliament will contribute to shape the digital transformation of healthcare systems. What do you consider the main challenges and the main opportunities for digitalisation in health care?
The provision of digital health solutions is a fundamental enabler for the reform of the health service. Digital health solutions played a key role during the COVID-19 pandemic with solutions developed to facilitate monitoring and managing the spread of infection as well as the administration of vaccines when they became available. Many other digitally enabled services were deployed such as digital COVID certificates, electronic referrals from GPs for those who needed testing and electronic transfer of prescriptions to reduce close contacts and support social distancing. From this one example alone, we know the opportunities presented by digitalisation in health care. Other areas that will be revolutionary in this regard include improved patient care, efficiency and cost savings, data-driven decision making and improved collaboration and communication.
At the same time, we also know that the potential for cyberattacks, and therefore privacy and security concerns, are to the forefront of the challenges that digitalisation poses. Addressing this and other challenges while leveraging the opportunities of digitalisation in healthcare requires collaboration among policymakers, healthcare providers, technology vendors, and patients to ensure that digital technologies are implemented ethically, securely, and equitably to improve healthcare delivery and outcomes for all.
What do you think the EU can do to tackle the silent pandemic of antimicrobial resistance?
Antimicrobial resistance (AMR) is the ability of micro-organisms to survive or grow despite antimicrobial agent that normally inhibits or kills that micro-organism. AMR is responsible for more than 35,000 deaths every year in the EU, with annual healthcare costs and productivity losses estimated at €1.5 billion.
In 2019, the World Health Organization declared antimicrobial resistance as one of the top ten global public health threats facing humanity. In July 2022, the Commission and the Member States, identified AMR as one of the top three priority health threats. This is, therefore, something that we must take seriously and work with EU partners to overcome.
While the EU’s Member States have made important strides in recent years in developing and implementing national action plans on AMR, gaps still remain. Analysis by the OECD suggest that top priorities for the EU include evaluation and monitoring of the implementation of national action plans; integrated and expanded surveillance of AMR in bacteria from humans, animals and the environment; and investing in effective cost-saving interventions, such as antimicrobial stewardship programmes and infection prevention and control (IPC).
These actions should also complement those in the EU’s One Health Action Plan against AMR and build on these by continuing to incentivise new vaccines, treatments (including new antibiotics) and tests while maximising access to existing resources such as antibiotics with low availability; target antibiotic consumption and AMR in long-term care facilities; establish a system to share and promote the implementation of best practices to tackle AMR; and renew focus on international co-operation on surveillance and regulation, including with non-EU/EEA partners.
Fianna Fáil candidates for European election 2024
Dublin:
Barry Andrews
Midlands-North-West:
Niall Blaney
Lisa Chambers
Barry Cowen
South:
Billy Kelleher
Cynthia Ní Mhurchú
COVID-19 has put health on top of the EU policy agenda. Do you think the EU should continue to keep health as a priority? If so, in which area do you think a cooperation at EU level is most needed?
The new European Parliament will shape the EU pharmaceutical legislation. What do you think the new legislation should include to improve the quality, safety and most importantly the availability of medicines?
How do you see the role of community pharmacists in providing high-quality health care to European patients and in contributing to the sustainability of health care systems?
The newly elected members of the European Parliament will contribute to shape the digital transformation of healthcare systems. What do you consider the main challenges and the main opportunities for digitalisation in health care?
What do you think the EU can do to tackle the silent pandemic of antimicrobial resistance?
Sinn Féin candidates for European election 2024
Dublin:
Senator Lynn Boylan
Cllr Daithí Doolan
Midlands-North-West:
Michelle Gildernew MP
Chris MacManus MEP
South:
Kathleen Funchion TD
Senator Paul Gavan
COVID-19 has put health on top of the EU policy agenda. Do you think the EU should continue to keep health as a priority? If so, in which area do you think a cooperation at EU level is most needed?
Yes, Labour believes health must be a priority of the next European Parliament and Commission work programme. The EU must protect universal access to quality healthcare and social care as a fundamental right. We want a European Health Union to manage future pandemic responses, protect universal access to care and treatment, and to support and defend public healthcare at a national level.
The new European Parliament will shape the EU pharmaceutical legislation. What do you think the new legislation should include to improve the quality, safety and most importantly the availability of medicines?
We need fair and transparent pricing of medicines that prevents shortages and supports innovation, and access to new treatments for rare diseases.
The S&D group of which a Labour MEP would be a member, was lead negotiator on the recent pharmaceutical package regulation. We advocated for enhanced medicine access while tackling pressing issues like shortages and antimicrobial resistance. This legislation update is crucial not only to fortify our healthcare infrastructure but also to bolster our collective resilience against future health crises.
Under S&D leadership, the package introduces measures to combat medicinal product shortages, including robust transparency and reporting requirements for manufacturers and wholesalers. Additionally, we’ve significantly enhanced communication and transparency towards patients and healthcare professionals, while encouraging innovation, particularly in rare diseases research.
The legislation emphasizes the prudent use of antimicrobials and the development of novel solutions to counter antimicrobial resistance. The S&Ds also put forward amendments to address patients’ needs, aiming to rectify the unacceptable disparities in access among member states. We advocated for greater transparency in pharmaceutical companies’ public funding, ensuring fair pricing and returns on public investments. Moreover, we pushed for the swift entry of generic medicines into the market, fostering competition and accessibility.
Drawing lessons from the COVID-19 crisis, this law streamlines the regulatory framework by expediting marketing authorisation and approving medicines, benefiting regulators and pharmaceutical companies alike.
How do you see the role of community pharmacists in providing high-quality health care to European patients and in contributing to the sustainability of health care systems?
Community pharmacists have a vital role to play in the delivery of healthcare, and Labour has advocated for a pharmacy based Minor Ailment Scheme and appointment of a Chief Pharmaceutical Officer.
The newly elected members of the European Parliament will contribute to shape the digital transformation of healthcare systems. What do you consider the main challenges and the main opportunities for digitalisation in health care?
Digitalisation would deliver significant efficiencies to the Irish healthcare system, but there has been a chronic failure to deliver on eHealth and electronic health records. Funding of €75 million was received by Ireland from the EU in response to the pandemic under the National Recovery and Resilience Plan for a suite of eHealth projects which must deliver real results. This included funding for investment in ePharmacy will include the deployment of new pharmacy systems within hospitals, which will not only provide better visibility of medications usage and costs but also enable the possible extension of these systems for use as ePrescribing tools across hospitals. Investment in ePharmacy may also include development of national drug files and delivery of ePrescribing solutions for the community. It is seen as a key enabler for integrated care as it makes it possible to manage the client pathway between different sectors and organisations within the health and social care space. This progress must be continued.
What do you think the EU can do to tackle the silent pandemic of antimicrobial resistance?
Antimicrobial resistance is responsible for over 35,000 deaths annually in the EU. Delivering new drugs and treatments is a challenge. Through the recent pharmaceutical package, the S&D sought measures to incentivise companies through milestone payments to support the entire antimicrobial development process and delink sales volume from contracts, addressing market failures.
The EU Commission has recognised the need for EU Action on AMR and the Parliament passed a comprehensive resolution on EU action to combat antimicrobial resistance on 1 June 2023 that should be strongly implemented. Another pathway for action is increased funding for R&D through Horizon and the FP10 post 2027 should be deployed to research new approaches to tackling antimicrobial resistance. As we learned from COVID-19, when sufficient resources are applied new treatments and vaccines can be more quickly developed and deployed. As the Parliament resolution proposed, it should be a funding priority in the next Budget cycle.
Further, in a vote on 23 June 2022, parties of the right (EPP, ECR, ID) refused to curb the massive use of antibiotics in commercial animal husbandry, which would minimise the risk of further antibiotic resistance in humans. The S&D voted for this restriction.
Labour Party candidates for European election 2024
Dublin:
Aodhán Ó Ríordáin
Midlands-North-West:
Fergal Landy
South:
Niamh Hourigan
COVID-19 has put health on top of the EU policy agenda. Do you think the EU should continue to keep health as a priority? If so, in which area do you think a cooperation at EU level is most needed?
Yes, health should remain a priority for the EU, particularly in relation to research. We are keen to ensure that innovation and the use of new technologies are integrated across health systems to improve outcomes.
The new European Parliament will shape the EU pharmaceutical legislation. What do you think the new legislation should include to improve the quality, safety and most importantly the availability of medicines.
Brexit in particular has posed a threat to the availability of medicines. We wish to ensure that the EU prioritises availability for medicines, especially those used for chronic illnesses.
How do you see the role of community pharmacists in providing high-quality health care to European patients and in contributing to the sustainability of health care systems?
In many communities across Ireland, a community pharmacist might be the only health professional readily available in a small community. We believe it is imperative that community pharmacists are properly funded and have workforce planning schemes in place to ensure continuity of services.
The newly elected members of the European Parliament will contribute to shape the digital transformation of healthcare systems. What do you consider the main challenges and the main opportunities for digitalisation in healthcare?
We consider privacy to be essential to any rollout of digital services for patients.
Aontú candidates for European election 2024
Midlands-North-West:
Peadar Tóibín TD
South:
Patrick Muprhy
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