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News from the Capitals

News from the Capitals #44


In Belgium this week, pharmacists have received the approval to issue sick notes following rapid COVID-19 positive tests for school children. Prior to this, only general practitioners could issue these notes, but it is now even being considered for absences from work. The motivation behind this remains on the objective of not overburdening the healthcare system. It was further noted that the health authorities continue to underline the importance of getting the autumn COVID-19 booster dose.


Last week, Article 49 paragraph 3 of the French Constitution was high on the news. This article would allow a bill to be voted without debate by engaging the responsibility of the Government. The oppositions tabled motions of no confidence and surprisingly , the far- right party voted the motion of no confidence tabled by the far left-party.

Unfortunately, these two political forces failed in overthrowing the Government, as 50 votes were needed for the Government to resign. The Conservatives refused to vote on the motions of no confidence tabled.

The motion of no confidence of the far-left parties voted by Marine Le Pen’s party embarrassed the leaders of the left-wing parties. The MEP and former presidential candidate, Yannick Jadot, denounced the strategy of Jean-Luc Mélenchon’s party of wanting to unite all the oppositions against the government.
Moreover, last night the Prime Minister Elisabeth Borne triggered once again the article 49 concerning the expenses of the social security financing bill.
Last night, in a long interview, Emmanuel Macron called the majority MPs to work with the conservatives and denounced in the meantime the other opposition parties as “disordered and cynicists”. The President wants to pursue an increasingly liberal policy and strengthen immigration legislation. In particular, he indicated that the pension reform will be implemented from the summer of 2023, with the retirement age rising from 62 to 64 in 2031


On 20 October, despite massive criticism from all sides of the health care system, the draft of the Financial Stabilization Act was passed with the votes of the traffic-light-coalition in order to compensate for the expected 17 billion EUR deficit of the statutory health insurance. Federal Health Minister Karl Lauterbach defended the law by stating that benefit cuts could be avoided, and contributions would only increase by a moderate 0.3 percentage points.

Pharmaceutical companies, however, criticized the increase of the manufacturer’s discount for patent-protected drugs by 5% and the 20% combination discount on the reimbursement rate for drugs with new active ingredients. In addition, the adjusted changes to the pricing of new medicines based on the Medicines Market Reorganization Act (AMNOG) as well as the lowering of the sales threshold for orphan drugs to 30 million EUR is perceived to impact free pricing and negatively influence R&D of medicinal products in Germany. Physicians have protested against the abolition of extrabudgetary remuneration for the admission of new patients. There has also been further criticism from pharmacies and the health insurance funds.

In the Coalition Agreement 2021, the current government agreed on the introduction of controlled dispensing of cannabis to adults for consumption purposes in licensed shops. This is intended to control quality, prevent the passing on of contaminated substances and ensure the best possible youth and health protection for consumers. The Federal Government will consider the framework of international and European law in its implementation. Cannabis and tetrahydrocannabinol (THC) will no longer be legally classified as narcotics. Cannabis for human consumption, medicinal cannabis and commercial hemp will be completely excluded from the scope of the Narcotics Act. It will be possible to purchase and possess cannabis of up to a maximum quantity of 20 to 30 grams for personal consumption in private and public spaces; private cultivation will be permitted to a limited extent.

The largest opposition party, the CDU/CSU, as well as pediatricians and other doctors criticize the legalization sharply and demand at least a graduation of the cannabis release according to age. They criticize that there is still no solution on how to prevent the distribution of legally acquired cannabis to young people under 18.


During the European Anti-SLAPP Conference, Poland was branded as SLAPP State of 2022

Since Law & Justice (PiS) took power in Poland in 2015, the media and the judiciary branch have been under constant assault from the government. Institutions have been gradually subordinated to the political will of the ruling party, while independent or critical media have been under pressure towards compliance. For example, in 2021, the Lex TVN constituted a bill that strived to ban media where more than 49% of stakes are held by foreign entities.

SLAPPs refer to Strategic Lawsuits Against Public Participation designed to incapacitate any media that expresses criticism towards the government. The Conference likely constitutes a meaningful albeit small step to fight for RoL at the European level in the backdrop of the European Commission drafting the SLAPP Directive.

On energy, it can be said that the crisis is shaking Poland’s shift away from fossil fuels

As the prices of energy rise in consequence of the Russian invasion of Ukraine, Poland struggled to maintain the momentum of its push away from fossil fuels. Coal in particular constitutes the backbone of the Polish energy sector. In 2021, 70,8% of electricity came from coal, which still dropped from 86,6% in 2010.

The Polish Electricity Association (PKEE) commissioned a report from Ernst & Young Poland (EY Poland), which found that although Poland gradually curbs its reliance on fossil fuels, the transition away from coal faces expenses of up to €135 billion by 2030.

Although the Ministry of Climate and Environment adopted the Energy Policy of Poland until 2040 (EPP2040) on 2 February 2021, which strives for establishing up to 23% of renewables by 2030, the ongoing energy crises shook Poland’s sustainable energy-related ambitions. Since the beginning of 2021, the reliance on coal appears to have increased, despite its prices rising threefold.

With regards to health, Poland doubled-down on oncology research and calls for action. Indeed, throughout October, Poland appears to have politicized oncology. Breast cancer has in particular been reveiving considerable attention. For example, during the inauguration of the campaign “BreastFit. Kobiecy biust. Męska sprawa. (BreastFit. A female bosom. A masculine affair.)”, Dr. Agnieszka Jagiełło-Gruszfeld from the Maria Sklodowska-Curie National Research Institute of Oncology shared that in Poland, acute breast cancer is becoming a chronic disease. Also, the study “Chcemy Cię usłyszeć (We Want to Hear You)” authored by Dr. Katarzyna Pogoda and Dr. Joanna Kufel-Grabowska, revealed that breast cancer accounts for 23% of all malignant cancers in women.

Overall, in a workshop on breast surgery hosted by the Holy Cross Cancer Center, Dr. Rafał Matkowski and Dr. Stanisław Góźdź warned that within a couple of decades, the number of breast cancer cases in Poland will roughly double from 18,000 to more than 30,000.

However, the rising politicization of oncology occurs amid the ongoing standoff between Poland and the European Union over RoL. Namely, as the government refuses to unshackle the judiciary branch, the European Commission freezes €24 billion in grants and €12 billion in loans from the National Recovery Plan (NRP) under the principle of conditionality.

During a press release on 21 October, the Polish Minister of Health Adam Niedzielski addressed financing for the Polish health sector from the NRP by declaring that even if the European Commission refuses to bestow the funds, the Ministry of Health will use the Polish Development Fund (Polski Fundusz Rozwoju).


Regarding the Spanish General State Budget of 2023, Congress is debating the amendments proposed by the different political parties. What the opposition parties have asked for, is to entirely return the bill and block the approval of the new budget. The budgets must be approved by the majority, of both Congress and Senate before the end of the year, otherwise the budgets of 2022 will be the ones that will be used in replacement.

Among the main issues that can compromise the approval of the same, we find: the renewal of the Judiciary Power, the Trans Law (Law of equality for the recognition of the rights of transsexual people), and the agreements made with the different Catalan and Basque Nationalist groups (which defend independence interests and greater autonomy of the regions). This week is (within the process of approving the budget), the most difficult since it is when the government must negotiate and win the support of most of the chamber.

After the mostly “positive” predictions of two weeks ago on the forecast of the growth rate of the Spanish economy by the IMF and the National Government, the AIReF (The Independent Authority for Fiscal Responsibility of Spain), has lowered expectations.The AIReF is an independent fiscal control body whose objective is to guarantee the principle of budgetary stability, as well as the financial sustainability of the country.

This body expects Spain to enter a technical recession almost immediately. The national gross domestic product (GDP), after registering growth “around zero or something positive” between July and September, will enter negative territory in the fourth quarter of 2022 and in the first quarter of 2023, thus chaining six consecutive months down. “This is the technical definition of recession,” recalled the director of the Macroeconomic Analysis division of Airef, Esther Gordo. It estimates that the Spanish economy will fall between 0.2% and 0.3% in the fourth quarter of this year, registering a similar decline in the first quarter of 2023. That means that Spain will not escape the economic forecasts shared by its European partners.

Spain is becoming the country of the “Eternal Summer”, due to the unstoppable effect of climate change. The cold and “autumn like” weather will be short-lived in Spain as temperatures will rise above 30ºC again in many parts of the Peninsula with November just around the corner. It will not, however, be the only country affected: Europe is again suffering a “thermal harness”, which will leave an unusual heat for the time throughout the continent. It is not ruled out that this is the warmest October in history with temperatures “more typical of summer”, up to 5 or 10 degrees above normal.

Latin America

Brazil is days away from holding the second round of the presidential election, where two political titans and bitter rivals will face off and could lead to another four years of far-right politics or the return of the left to the country’s top office. The elections are scheduled for Oct. 30.

In the first round, none of the 11 presidential candidates won an absolute majority, leading to a runoff between Lula, who won 48% of the vote, and Bolsonaro, with 43%.

It is very difficult to know specifically who will win in this second round. The only thing that is certain is that it is an election where two very different political models face each other and whatever its result is, it will most definitely create a very strong reaction on the part of the citizens.

United Kingdom

Another turbulent week in UK politics has culminated in the resignation of the shortest serving prime minister Liz Truss, just 6 weeks after her appointment, after she failed to recover from her unpopular ‘mini-budget’ announcement last month. After receiving the backing of more than half of the Conservative MPs and with no other candidate reaching the 100-vote threshold, Rishi Sunak is now Britain’s third prime minister in just 50 days. Sunak’s first day saw a major Cabinet re-shuffle, with the chancellor, Jeremy Hunt, retaining his position and Steve Barclay returning to the role of health secretary where he was over the summer before Truss took office.

With Barclay’s return as health secretary, we can expect him to pick up where he left off with continued priority for tackling the elective backlog and addressing inefficiencies in NHS spending. Barclay will be joined by Helen Whatley, who has been made Minister of State for Health and Social Care, replacing Robert Jenrick in the secondary care brief. Whatley has lots of experience of health policy, having previously been in this role and having sat on the Health Select Committee, though much of this time was dominated by Covid-19. Will Quince has retained his position as primary care minister.

Sunak’s re-shuffle has received criticism already following the re-hiring of Suella Braverman as home secretary just 6 days after she had to quit over breaching the ministerial code and leaking government documents and threatens to place his term under early pressure.


Last Friday 21 October the government presented a new draft law titled “Secondary care, medical education and other provisions”. The proposed draft law allows NHS doctors to be employed in the private sector as well, participating in the operation of the hospital at least twice a week. On the other hand, private doctors will be able to work part-time in hospitals. Moreover, the proposed bill also sought to create groups of hospitals by specialty, in which doctors will practice on a rotating basis with the aim of gaining more experience in their subject, as well as to give a tax-free allowance of 400 euros per month to those who work on the Emergencies Unit.

With regard to international relations, on 26-27 October, German Chancellor Olaf Scholz visited Athens in an attempt to enhance bilateral relations between Greece and Germany. On the agenda of the talks will be the energy issue, the war in Ukraine and the challenges to stability in the wider region, among them the attitude of Turkey. On the latter, Athens estimates that the German leadership has gradually moved from an initial attitude of maintaining equal distances to a position that favors the Greek demands.

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