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News from the Capitals

News from the Capitals #65

France

The Minister for Education, Gabriel Attal, has announced a ban on the wearing of the Abaya and Qamis by schoolchildren. This measure is the result of lengthy consultations with school directors, who are facing an increase in the wearing of these garments. They see this as a serious breach of the principle of secularism, which has been the legal framework in schools since 2004. 

The decision was taken under pressure from Emmanuel Macron, who this year decided to make education his priority. Over the past few days, Emmanuel Macron has been giving many media interviews to talk about bullying at school and secularism in schools. According to the Ministry of Education, 267 schoolgirls were refused entry to their school on the first day because they were wearing abayas. The Conseil d’Etat, which has jurisdiction over administrative decisions, has given its opinion on the legality of the Education Minister’s measure this Thursday and confirmed the measure as legal.  

In the sector of health, the Ministry of Health, Aurélien Rousseau, has extended the powers of pharmacists to prescribe antibiotics and vaccines. Pharmacists can now prescribe antibiotics for cystitis and angina. Nurses can also vaccinate patients under certain conditions, according to the list of diseases published by the Ministry of Health. This measure has long been awaited by healthcare professionals who wish to share certain skills with general practitioners, whose numbers have been falling in recent years.

UK

General Politics 

A focus of this week’s PMQs, the government is facing severe criticisms for a ‘concrete crisis’ facing schools and potentially other UK public buildings, such as hospitals and military estates. One hundred school buildings so far have been forced to close after it has been highlighted that they are built of RAAC, dubbed ‘aircrete’, a substandard material used to build hundreds of public buildings from the 1950s to 1990s, and thought to have a 30-year lifespan. The material is prone to collapse with little warning, and the current government has been warning of this risk since as far back as 2018. More recently, a 2021 review by the Department of Education outlined the urgent need for action. However, public spending on education is at the lowest it has been since 2009. The Education Secretary was caught in a related scandal after an interview recording on national television was released in which she swore, accused colleagues of not working, and claimed she had done a ‘good job’ in her role. Potentially thousands of public buildings will be affected- Labour leader Sir Kier Starmer has accused Rishi Sunak of being a ‘cowboy builder’. This is potentially another major blow to the Conservative campaign, especially depending on how far-reaching the issue is.  

Healthcare 

The Department for Health and Social Care (DHSC) has launched a consultation in response to a report by the Independent Medicines and Medical Devices Safety (IMMDS) Review, which has cited concerns over potential conflicts of interest due to a system of payments in which medical professionals receive funding from med-tech companies such as research grants, training events and reimbursement for work such as testing and consultancy. The consultation asks for feedback from all relevant stakeholders about a proposal to introduce mandatory reporting requirements on payments, including for those producing ‘borderline substances’ i.e. food and dermatological products specifically marketed as assisting patients recovering from medical conditions.

Germany

Medicine Supply in Winter 2023/2024 

With autumn and winter approaching, pharmaceutical experts are sceptical and at a loss as to how the supply of certain medicines can be ensured.

Last week, in response to a demand by Federal Health Minister Lauterbach for more stockpiling of medicines, pharmaceutical wholesalers announced that the stocks of important medicines would last “less than two weeks” and that the desired stockpiling would hardly be possible. Last winter, during a large wave of infections, fever and cough medicines for children were only available in limited quantities. The Federal Ministry of Health (BMG) tried to counteract this by passing the law to combat drug supply bottlenecks and improve supply (ALBVVG). 

With the most recent urgent medicines list and its procurement, the BMG had bypassed the advisory board for supply and supply shortages set up by the ministry itself, in which all participants in the production and distribution of medicines were assembled.

Experts see the establishment of more production sites as the only way to long-term supply security. Although production in Europe will be 20 to 30 percent more expensive. However, the talks at the EU level about subsidies for production sites, simplified approval procedures, simplified decentralised clinical trials, and shortened deadlines would only be at the beginning, but faster and more prudent action would be necessary.

However, the implementation of the measures now in force around hospital pharmacies, such as the eight-week supply of intravenous drugs and antibiotics (among other drugs), is causing difficulties. Some hospitals, for example, consume one pallet of the electrolyte Sterofundin per day. Meaning they then would need 56 pallet spaces to store this infusion solution alone. Some hospital pharmacies are said to have already rented external rooms or even buildings for this additional storage space.

Germany’s Pact to Modernise the Country?

During the general debate in the Parliament, Chancellor Olaf Scholz responded to the opposition’s criticism of the coalition’s work with a proposal for a new direction: In his speech, the SPD politician invited the states, municipalities as well as the democratic opposition to a “Germany Pact” to modernise the country. 

The pact should make Germany faster, more modern, and safer, said Scholz. “Too much has been put on the back burner in recent years,” Scholz criticised. “The citizens are tired of this standstill. And so am I,” he stressed. “We need a national show of strength. So let’s join forces.” The citizens wanted orientation and not “shadow boxing” and feuding government parties, Scholz said. His offer is also addressed to Friedrich Merz, the leader of the largest opposition party, Scholz emphasised. 

To speed up authorisation procedures, the federal and state governments should develop a comprehensive package of measures and launch it before the end of the year. The energy supply should become “clean, safe, and affordable”. In addition, the Chancellor wants to digitalise the planning and approval process and simplify housing construction. 

Previously, opposition leader Merz had massively criticised the Chancellor and his government for their policies. However, Merz wants to take the Chancellor’s offer seriously and explore ways of working together.

Spain 

Minister Miñones Outlines Healthcare Innovation Strategy for Spain

Jose Miñones, Spain’s Health Minister, shared his plans for healthcare innovation at the Spanish Pharmaceutical Industry Meeting. He committed to using a mix of legislative and non-legislative measures to ensure equitable and timely access to innovative treatments. He also proposed keeping older, therapeutically valuable medications on the market to foster competition. Miñones emphasized three key goals: maintaining medication supply, ensuring fair treatment access, and sustaining the healthcare system. He urged the immediate development of solutions to address medication shortages, particularly in pediatric antibiotic formulations.

Additionally, during Spain’s EU presidency, he emphasized the importance of advancing digitalization and health data regulation, promoting public-private collaboration. Miñones also mentioned progress in the Open Strategic Autonomy (OSA) project and its potential inclusion in the upcoming EU leaders’ summit in Granada. He highlighted the growth of pharmaceutical investment in Spain and the robust mechanisms for patient treatment.

Netherlands  

In the Netherlands, just before the parliament recess, our current fell leading to new elections. 

On Tuesday 5 September, the NOS released an article speculating the results of the upcoming election in the Netherlands in November 2023.

In a remarkable turn of events, Pieter Omtzigt’s New Social Contract (NSC) has catapulted to the top spot in the latest Peilingwijzer poll, making it the largest party with an estimated 26 to 32 parliamentary seats. NSC is a newly formed political entity that has gained substantial support in a short time.

Close on its heels are the VVD with 22 to 27 seats and the recently forged alliance of PvdA/GroenLinks, projecting 22 to 26 seats. In a distant third place is the PVV with 12 to 16 seats, followed by the BBB with 11 to 17 seats.

The decline of established parties like D66 and CDA is noteworthy. D66, led by Sigrid Kaag, once celebrated 24 seats after the 2021 elections but now faces a sharp decrease to just 6 to 10 seats. Similarly, the CDA, which held 15 seats in the previous parliamentary elections, is expected to secure a mere 2 to 6 seats. The ChristenUnie, currently with 5 seats, maintains stability with 4 to 6 seats.

BBB, the BoerBurgerBeweging, has experienced a rollercoaster ride in these polls. While their current projection of 11 to 17 seats is a significant gain compared to their single-seat status before, it is noteworthy that earlier in June, they were almost on par with the VVD at 23 to 29 seats but have since seen a substantial decline.

This sudden shift in political dynamics suggests that the upcoming November 22, 2023 elections in the Netherlands are poised to be highly competitive, with emerging parties like NSC challenging the traditional political landscape dominated by parties like VVD, PvdA/GroenLinks, and D66. These developments will undoubtedly shape the future of Dutch politics and governance. 

On Healthcare

Currently, there are many protests regarding elderly care in the Netherlands

The concern is mainly that there is not enough money and that if the system continues like this elderly care quality will drastically decline in the coming years. Activists talk of a snowball effect where worsening work conditions will lure people away from the job resulting in even more shortages in staff. 

The response of Minister Helder of long-term care and sport reacted by announcing in June that she would not provide financial assistance to the 27 elderly organizations in Groningen, Drenthe, and Friesland, citing that significant additional funds have already been allocated for restructuring elderly care. The period from 2023 to 2027 has already been allotted an extra 1.65 billion euros. The minister emphasizes the need for a shift towards enabling individuals to sustain themselves at home for longer, prompting people to prepare accordingly. 

However, some, like Roeli Mossel, argue that the pace of this transition is too rapid and advocate for removing budget cuts to allow for a more gradual process of collaboration with the minister to bring about these changes.

Greece 

Greece plans to Upgrade its Ambulance Centres

The Greek National Centre for Emergency Care (EKAB) will be undergoing a comprehensive restructuring aligned with international standards, as part of the planned new National Health System (NHS). The primary objective is to enhance its responsiveness to citizens’ calls by deploying specialized and well-trained ambulance crews. This overhaul aims to close the operational gap between EKAB and the international average, emphasizing key improvements in connectivity with hospitals and emergency departments, faster response times (reduced from 7 to 10 minutes), and broader national coverage, with a goal of 1 ambulance per 20,000 citizens compared to the current ratio of 1 per 36,000 citizens.

The transformation plan, approved by the Minister of Health, Michalis Chrysochoidis, revolves around five pivotal axes. Firstly, there is a significant reinforcement of personnel with the recruitment of 800 new permanent positions for ambulance crews and the immediate hiring of support staff. Secondly, mandatory educational programs will enhance staff training, including Prehospital Trauma Life Support and Skills Training. Thirdly, a full digital upgrade of the organization’s systems is underway to improve incident recording, criticality categorization, ambulance routing, and real-time monitoring through a “Control Tower.” Fourthly, the vehicle fleet will undergo an upgrade, involving the supply of new ambulances over two years and the modernisation of existing vehicles. Lastly, the air transport model will change, with additional air transport bases created across the country to expedite primary transports directly from the incident scene to hospitals, a critical factor in saving lives.

Neo-Nazis in Distress

The neo-Nazi party, Spartans, which managed to secure a presence in the Greek Parliament despite legislative barriers meant to prevent the participation of convicted criminals, is now experiencing a dramatic disintegration. During the June elections, the party openly acknowledged that a portion of its electoral success was owed to the influence of Ilias Kasidiaris, its convicted and imprisoned deputy leader, recognizing his pivotal role in their performance.

However, merely two months later, Spartans find themselves embroiled in an unprecedented power struggle. Party leader, Vassilis Stigas is determined to maintain his leadership, while a parliamentary group openly challenges his authority, supporting their imprisoned leader. This internal party confrontation has escalated beyond the party’s boundaries and is now drawing attention from the sphere of Criminal Justice. The Supreme Court prosecutor is actively investigating allegations regarding the flow of money within the party, signaling a significant turning point in the party’s turbulent journey.

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