Event Report on “Brexit, Medicine and Public Health”
By Ross Nugent (Dublin City University)
On 3 May 2018, the DCU Brexit Institute organized an event on “Brexit, Medicine and Public Health”. This event featured an opening debate between Baroness Suttie (Member of the UK House of Lords, European Union Committee) and Paulo Rangel (Member of the EU Parliament, Constitutional Affairs Committee), followed by an expert panel discussion. The programme of the event is available here. The following is a summary of the event.
Opening Remarks: Fergal Egan
The conference hosted by the DCU Brexit Institute on “Brexit, Medicine and Public Health” was opened by Fergal Egan, the General Manager of IQVIA. Mr. Egan began by emphasising the relevance of this event, and commended the Brexit Institute for its inclusion of international guests. He noted that Brexit is permeating every aspect of life, and that individual care should be a priority in the Brexit process. Healthcare is the State’s biggest expenditure, and economic turbulence could constrain the state’s ability to offset the impact of Brexit, he warned. He cautioned the Irish government and the HSE to hope for the best, whilst planning for the worst.
Opening Debate: Baroness Suttie
The opening debate was commenced by Baroness Suttie, member of the UK House of Lords and its European Union Committee. Baroness Suttie began by stressing how polarised the British public is, detailing the divide between metropolitan London and provincial England. She believes the window in which Brexit could be stopped is closing rapidly. She remarked on the relevance of the House of Lords in the Brexit process, given the government’s recent defeats. The House of Commons is unaccustomed to dealing with amendments from the Lords, and the amendment advocating membership of the Customs Union is likely to be the most contentious, she warned. Baroness Suttie described the lack of a coherent British strategy as “staggering”, and said that this scarcity of detail is stalling meaningful progress. She believes that the British government has simply been responding to European proposals, and engaging in crisis management. She summed up her work on the European Union Committee as comparable to peeling back layers of an onion – with each testimony, a new layer of complexity is revealed.
Opening Debate: Paulo Rangel MEP
Member of the European Parliament, and its Constitutional Affairs Committee, Paolo Rangel followed Baroness Suttie. The MEP remarked on the unity of the twenty-seven member states at this time of Brexit uncertainty, especially the firm consensus on the issue of the Irish border. According to Mr. Rangel, there is no single issue on which the member states are so aligned. He too lamented the lack of a coherent British strategy, despite Britain’s sophisticated civil service. He considers Brexit to be a “lose-lose situation”, the negative consequences of which are already being felt. Mr. Rangel outlined how Britain’s departure from the EU will upset power-relations within the union. Britain often voiced the concerns of maritime, or Atlantic, member states, and had the influence to do so. The MEP warned that Brexit will somewhat diminish this bloc, as Britain will no longer be present to challenge the prevailing Franco-German consensus. In conclusion, Mr. Rangel spoke of the important role the European Parliament is playing, and contrasted it with the diminished role of the British parliament.
Following the opening debate, Anthony Staines of Dublin City University launched the panel discussion. Dr Staines emphasised the uncertainty of Britain’s coming departure from the EU. He described efforts to manage Brexit as “damage limitation”, and warned that health does not feature on anyone’s agenda. He identified three likely scenarios; soft Brexit, hard Brexit and the worst-case scenario of the UK crashing out of the union. All of these will have negative consequences on healthcare, to varying degrees. Cross-border service delivery and specialised imports will be threatened by Brexit, and we must prepare for the worst.
His speech was followed by the second panellist: Justin Carty, CEO of IMSTA. He spoke about the impact of Brexit on medical devices, anything used in a medical environment that is not a drug. Mr. Carty said that the HSE’s priority must be patient safety, and that Brexit must not disrupt service delivery. He believes this will require a fully functioning system for the movement of MedTech products and a recognised regulatory regime for the authorisation of such products from day one. To ease the burden of Brexit, Mr. Carty advocates exemptions for medical devices from new customs and tariffs.
Following Mr. Carty’s speech, Rosarii Mannion of the HSE discussed the impact of Brexit on staffing. She considered Brexit a serious challenge to the staffing of the health service, as we are already emerging from a period of constriction. The HSE currently employs 110,000 staff, and is engaged in recruiting 4000-5000 staff at any one time, many of whom acquire their qualifications in the UK. Therefore, she stressed the need for mutual recognition of qualifications and skills.
Her address was followed by that of Eamonn McGowran of BESIN Healthcare. He dubbed Brexit a “two-edged sword”, as it presents opportunities as well as enormous challenges. He spoke of food for special medical purposes, the supply chains of which predominantly run through the UK. Mr. McGowran raised such questions as to whether EU products and UK products would require separate packaging and leaflets. He reiterated the need for mutual recognition, extending to the pharmaceutical industry, and the need for regulatory convergence. He called on the industry to be more ambitious in approaching the EU’s Horizon 2020 programme. He concluded by emphasising that healthcare is about patients and people, and that this should not be lost in the complexities of Brexit.
The final speaker, Rita Purcell of the Health Product Regulatory Authority, spoke about medicines regulation as one of the great success stories of the European project. She views the UK as a leader in the regulation of medicines. She warned against pharmaceutical companies taking a “wait-and-see” approach to Brexit, as some companies may be hesitating prior to incurring the costs of adjusting their business to the new Brexit reality. She said that a Mutual Recognition Agreement is possible, and is in both sides’ interests. However, a transition period is crucial to facilitating such an agreement, as it cannot be reached until Britain has departed the EU. As the seventh largest exporter of pharmaceuticals in the world, Ireland has a lot to lose should these issues be unsettled, therefore the protection of public health should be a top priority.