Dr. Vytenis Andriukaitis:

I thank the Chairman and Members of Parliament. Once again, we woke up to terrible news this morning. My heart and my thoughts are with the victims of the Manchester attack. We also think of the families of the victims in France. It breaks our hearts. It is very painful for all of us, but we will show our solidarity in the face of this terrible terror. Once again, we will be ready to come together and show our solidarity, especially in such a turbulent time.

I am very happy to be in this House for a second time. At the beginning of my mandate I started to visit national parliaments. I achieved my goal of visiting all the capitals in two and a half years. I visited all 28 member states, capitals, national parliaments and Governments. I took the opportunity to have discussions with non-governmental organisations, industry, unions and youth organisations, and I am happy to say that today I understand much more in terms of what is happening on the ground.

It is a pleasure for me to be with the members today. In two and a half years our work has been to promote jobs growth and Jean Claude Juncker's investment agenda. In that respect, I would like to raise again the question of the economy, especially, I am sorry to say, the health economy. I am very happy to have two portfolios, namely, public health issues and food safety, both of which help us to keep people as healthy as possible for as long as possible, guaranteeing the possibility to fight against risk factors, to reduce risk factors and to provide safe food. It might be much better to provide more healthy food, but we will discuss today our options in that regard.

I started with three Ps - promotion, prevention and protection, and of course promoting good health by encouraging health communication and physical activities, as well as supporting healthy living and working conditions.

I remind members of the common obligation to prolong our average life spans by two years and to have the goal of healthy ageing. Can one imagine achieving healthy ageing without the possibility of introducing evidence-based public health instruments and moving forward by keeping an eye on promotion, protection and prevention? This is evident from the first slide.

On the second slide, it is very important to see the relevant instruments. Today, the main risk factors are alcohol, tobacco, salt, sugar and trans fats. Of course, there are mental health factors and anti-stress measures to be considered. The slide refers to pricing policies and marketing policies and it alludes to how to reduce problems. Availability and consumer information, especially product labelling, are instrumental. It is a matter of how to provide evidence-based public awareness and school-based education. All these instruments are in our hands. I am very happy to learn, in having good debates with the members' Government, that it is providing such a Bill addressing alcohol and that it is making it possible to address childhood obesity and providing instruments to guarantee the possibility of fighting against tobacco. We are happy to support Ireland and promote its activities to help it achieve its ambitious goals.

May I consider tobacco? I know very well that Ireland is on the way towards fully transposing the tobacco products directive adopted in 2014, thanks to the Irish Presidency. In 2013, the Irish Presidency was very successful. There was keenness at that time to introduce a tobacco products directive. Today, there is a good opportunity for member states to decide how best to introduce the directive into their law. Ireland is championing this. Timely transposition of the directive was achieved and ambitious tobacco control measures were taken on plain packaging. I thank Ireland for this. It is a really good example. Today, three countries - France, the UK and Ireland - have introduced plain packaging. We know very well that 21% of Irish people smoke, which is below the EU average of 26%. Of course, it would be good to achieve much more. I very much welcome Ireland's proactive approach, for which I am thankful. I am ready to disseminate Ireland's good practices around all member states.

The second issue concerns obesity and alcohol. I acknowledge Ireland has many problems with binge drinking among young people. At age 15, some 16% of Irish boys and girls have been drunk at least once, with immediate negative health effects and a risk of future addiction. I, therefore, welcome Ireland's continued commitment in this area, such as the action plan on youth drinking.

We need a stronger approach to promote nutrition and physical activities. Obesity is increasing across the EU, and Ireland is no exception. More than one in three European schoolchildren are overweight or obese, putting them at great risk of type-2 diabetes or cardiovascular diseases late in life. Promoting healthy lifestyles and introducing preventive measures do not need to be expensive but they require political will.

Policy makers have an opportunity and responsibility to add important values in this respect. I am a big fan of supporting all Ireland's steps in this direction. Of course, I know very well that we had a good conversation with the Government about that to see how to move forward and achieve some new steps.

I draw attention to the health care system and sector. Today, I know that Ireland is on the way to presenting new primary health care reform, drawing attention to possibilities to improve primary health care and to see primary health care colleagues as gatekeepers in this very important area. Of course, the community-based approach is a very big one. We provided information about health at a glance in all 27 member states. Today, we are on the way to presenting a schematic of the analysis in the field of health and the state of health in the EU. We will, together with the Organisation for Economic Co-operation and Development, OECD, present such a report at the end of this year. It will be very useful for members of parliaments to read those reports and see how to improve our national health care systems. I know that the Oireachtas will see possibilities to strengthen financial management and also possibilities to introduce e-tools and use ICT platforms to encourage the health care system to be more efficient.

Our aim is to develop expertise on performance assessments of health systems, to build country-specific and cross-country knowledge to help inform policies at national and European level. This is designed to inform and support and not to make recommendations because it is very clear that one must follow subsidiarity. Subsidiarity is to allow member states to provide their own instruments, but we are ready to assist, help, advise and propose good practice examples from different countries. This case is very important to draw attention to health technology assessment issues, because it is about access to more than treatment. It is about possibilities to help people achieve effective treatment. Also, as members of the committee know, it is also a possibility to co-operate in clinical trials, inviting researchers, industry and the pharmaceutical industry to gather and to see how to assess what innovation is, how it is caused, which economic and social consequences there are, which medical consequences there are, and how to see possibilities to achieve socially acceptable prices.

Pricing issues are very high on the agenda. We know very well that health technologies today cost more and more money. If one compares it to our phones, they are cheaper and cheaper. On the other hand, our medical equipment has higher and higher costs. How do we address those issues? We know very well it puts pressure on our public finances and the resilience of health care systems. We need to have a single way to co-operate, provide methodologies and to have instruments on how to assess those technologies and discuss issues about costs and economic effectiveness. We need to have a permanent mechanism at EU level for health technology assessment. As the members of the committee know, we have European Union co-operation on health technology assessment. Ireland is very active here. We see possibilities to move in such a direction and are ready to present our final results of the impact assessment at the end of this year. We will elaborate at a gathering of all member states on a concept of a permanent mechanism of health technology assessment.

Today, we have joint actions from time to time, but this co-operation is not stable. We need to move forward.

Another very important issue is the cross-border health care directive. I want to raise the possibility of using cross-border health care instruments. All countries must have national contact points. We all have problems with patient waiting lists and it would be good to raise awareness among patients. Yesterday, I had a meeting with some doctors who raised questions about this and why more people did not know about the cross-border health care directive, which is in place. The national contact points must provide information on, for example, how to reduce waiting lists by using the opportunities for treatment in different countries. I can only see one way to do this and that is for countries to co-operate. The European reference networks, which were launched in March this year, are a very good example. Here in Ireland, there are European reference centres which belong to 24 pathologists. It would be good use the tools and e-technologies available to encourage governments to provide more European financial instruments so that by the end of 2018 the European reference network is a workable network.

We need to use the connecting Europe facility money, Structural Funds, and Horizon 2020, all these different resources, to encourage countries to co-operate and to find opportunities to present virtual consultation, virtual possibilities to provide diagnoses and treatment, and to use e-prescriptions, patients records and patients images. It is a very important area. It would be good to do our best to fulfil our obligations in practice by 2019. I am one of you - the members - and we are together in one team. We have a good opportunity to build new ties from 2017 and to build more coherent European networks, thereby guaranteeing that people with rare and low prevalence diseases can achieve treatment in proper time. This is very important.

The next issue relates to the circular economy package. This is about food waste, the agriculture sector and the possibility of introducing national action plans to tackle food waste. I had a meeting with Irish activists, FoodCloud people and slow food activists, in Ballymaloe. They are very active in the area of food waste. We waste 88 million tonnes of edible food every year.

In Ireland, approximately 1 million tonnes of edible food is wasted every year. It means we have a lot of problems in terms of reducing it. Our target is to halve food waste to 45 million tonnes by 2030. It is up to us but there are many possibilities to use our resources properly, feed our animals, provide food for those in need and, of course, to change regulations to reduce the regulatory burden and provide methodologies of how to measure food waste in all chains of food production. We are ready to move forward in this direction because we have established the European Union Platform on Food Losses and Food Waste. There is an obligation on us to measure and monitor food waste, provide guidelines to facilitate food donation, optimise safe use of food in feed and promote better understanding and use of date marking. We established the EU food platform last autumn and in June, there will be a second round of the food waste platform and we will discuss these issues with all the operators and NGOs. As the committee knows, we have obligations to achieve our sustainable development goals.

Let me stress a few points on a very important topic, which will be very high on the agenda here. Yesterday, we had meetings with the Minister of State at the Department of Agriculture, Food and the Marine, Deputy Andrew Doyle, and the Minister for Health, Deputy Simon Harris, and discussed these matters. Animal and plant health issues will be big in light of Brexit. We will have to deal with those questions because they are very complex and technical but we must find possibilities as to how to achieve a result.

As the committee knows, prevention is better than cure in this area. This is also true in respect of human life. We will be proactive in fighting crises and in implementation. The new animal health law adopted at the end of March 2016 will bring significant improvements to the existing European Union animal health legislation, contributing to long-term competitive sustainability. Implementation of the new law is a lengthy and complex task, requiring a series of Commission Acts detailing measures to better prevent and eradicate devastating animal diseases. These acts will also support the use of modern technology in disease surveillance and detection.

We also have a new plant health law, which helps us to ensure we are best prepared to deal with future outbreaks of plant pest and also that our territory remains properly protected from the entry of non-native pests. The new regulation will introduce more proactive rules for early detection and eradication and more tools and actions to allow the EU to adopt a more proactive policy against the entry of pests from other countries. It will harmonise the rules concerning certification of plants and plant products and specify the responsibility of producers to the EU legislation authorisation.

We have many important topics on our agenda. Health is a very difficult area in all political sectors. It is very difficult to encourage member states to fulfil their obligations. The Lisbon treaty asked us to be very comprehensive and to have a more holistic approach. It is very easy to use these words but it is very difficult to implement them in real life. I thank the committee.