Colm Burke (Fine Gael) | Oireachtas source

I thank the Commissioner for his presentation. I know that it is a great challenge to deal with health care issues across the European Union because there are various traditions and ways of dealing with issues. I wish to talk about a cross-border health care issue. I was a Member of the European Parliament from 2007 to 2009. I headed up the European People's Party group on the Committee on the Internal Market and Consumer Protection. I am, therefore, very familiar with this topic and I am greatly concerned about Brexit. There is cross-border health care provision between Ireland and the United Kingdom. Our biggest issue when the United Kingdom leaves the European Union will be trying to build the same connections with other countries in Europe. Has this issue been considered? As Dr. Andriukaitis is a heart surgeon, he will know that every year more and more there is sub-specialisation. It applies no matter what area of medicine one considers, whether it be orthopaedics or heart surgery. Has this issue been assessed to see how we can improve co-ordination in accessing health services, especially for those in smaller countries with rare medical conditions?

In smaller countries it is unviable to have someone that has sub-specialised. Let us say four people have a particular complaint in this country and, therefore, it would be unfeasible for the expert to operate out of Ireland.

I wish to talk about co-ordinated medical training. Ireland is very much tied to the UK in terms of medical training. The UK has been very dominant in terms of medical training in, for example, Nigeria, Pakistan and the Sudan. As a result a number of doctors from those countries work here because their medical training is very much tied to the UK model. Has a unified medical code and training process in Europe been considered?

I wish to discuss the European Union's working time directive. I have received complaints from medical practitioners, particularly from those who work in hospitals. As much as 90% of trainee doctors comply with the working time directive. Many of them have complained that they have not gained the expertise that they require as a result. Let us say a person starts his or her shift at 8 p.m. He or she will be busy for the first three or four hours but he or she will not gain experience in the remaining hours. The hours must also be worked over a shorter period. Four or five years ago people worked 60 or 70 hours a week but might literally not work in real terms. They were a presence in hospitals but they did not have real work due to everything being in order. What is Dr. Andriukaitis's understanding of the working time directive in EU countries? How do trainee doctors acquire the necessary skills if they do not put in the hours?

I would like to discuss co-ordinated research. As much as 70% of the people who conduct research, especially people from outside of the European Union, end up working in the US. Europe does not seem to have a co-ordinated approach to medical research. The 28 member states should get their own people to conduct research and bring in external experts. We allow an awful lot of research to be based in the US and, in turn, the US dictates the market and everything else. Has this matter been considered?

I wish to comment on the final topic mentioned by Dr. Andriukaitis. Are we likely to see countries, especially smaller ones, grouping together to get cheaper prices for drugs? Will such a policy be implemented fairly fast? Larger countries like Germany and France are well able to negotiate better prices with the big pharma companies. Smaller countries, like Dr. Andriukaitis's home country of Lithuania, Ireland and other smaller countries do not have the same bargaining position.