 I'd like to move to point number five. It's a debate on health union, on a health union for Europe, and its regions. I would like to invite Commissioner Stella Kiriakides, Commissioner for Health and Food Safety, to join us in the stage. You want to sit here? Thank you so much, Commissioner, for taking the time to be with us. Without further delay, I would like to give you the floor on this debate. I think 10 minutes. OK, I'll count on your efforts. You have the floor for 10 minutes, and thank you so much for taking the time to be with us. Thank you. Thank you so much. It's a great pleasure to be here, ladies and gentlemen. I will definitely try to limit myself to 10 minutes. Mr. President, please interrupt me if I go over time. I want to really stress how important it is for me to have the opportunity to be here with the Committee of the Regents, to have a debate on health. A topic which, over the last three years, I think we have all seen how its importance has changed at the level of the EU. And because of the pandemic, we saw of the importance to have affordable, effective, and resilient health systems. But more importantly, we need to have health systems which are accessible to all. And this is what the European Health Union that we have been building is all about. It is about improving the resilience of Europe's health systems. It's about protecting the health of European citizens. And it's about equipping ourselves and member states to better able to be protected against future pandemics. And you, as the Committee of the Regents, is the voice of many of our citizens, of all our citizens. And so I'm really happy to be here to be able to update you on the key aspects of the European Health Union. And if I may be allowed a little personal note, I have a friend and colleague sitting in the audience from Cyprus, Eleni Lukaidu. And I have heard so much about the work done here that it's a pleasure, really. And I know how important it is to be the voice of our citizens. Your Committee has played a most important role in our efforts to respond to COVID. And I want to thank you for your support. Three years ago, you proposed essential points for the creation of an EU health emergency system. And your request was fully in line with our plans to set up a European Health Union and to propose a new health security framework. For many that may remember, when we started speaking of a European Health Union in 2020, I heard from so many people saying, you cannot speak of this, health is a member state's competence, and of course it is. But we were able within the treaty to put certain pillars into place that will change the realities of health. And of course now the member states, all of us together are working towards this. We have already four pieces, key pieces of legislation that have been adopted and are in place as a response to your concerns. We have reinforced the European Medicines Agency, EMA. We have reinforced the mandate of the European Centre of Disease Prevention and Control. They did a great deal of excellent work in the pandemic, but we needed to reinforce them structurally. And we established a new authority for health emergency and preparedness called HERA. We have adopted a new regulation on serious cross-border health threats to health in order to have coordinated action and more than that, so that no region is left behind. The pandemic has put a spotlight on really the complex nature of supply chains and the importance of building EU's strategic autonomy in the area of medicines and medical devices. And many of you may remember that we had the shortage of masks that we were dependent on other parts of the world. And what we saw following this was what we can do when we're working together. And the best example of that is the EU vaccine strategy. We were able to vaccinate European citizens for COVID-19, all at the same time, no matter which member state they lived in. And this shows the power of what we can do when we work together. We also have joint purchasing of therapeutics, of protective equipment and of stockpiling. And now with our new authority, HERA, we are better prepared. We work closely with member states, but also globally with all our international partners to strengthen our rapid response and preparedness. We need to be able to be prepared and react, not react after the event. I also want to take this opportunity, if I may, to thank you for the support of Europe's beating cancer plan. This is the first ever comprehensive plan we have to tackle cancer. Of course, member states are fully on board with this because ultimately the regions have the primary responsibility for healthcare. But we are also able to facilitate the cross-border collaboration so that they can exchange expertise and empower the health force. We have set up now the first EU network which will link comprehensive cancer centers so that we exchange information of expertise across member states. We are setting up an inter-speciality cancer training program for all the main oncology professions. And for the first time, this was launched in February, was the launch of the European Cancer Inequalities Register. The importance of that is not in order to highlight the differences and, in a sense, name and shame any regions or any member states. The important of that is that it allows us to use this unprecedented funding we have for the cancer plan of 4.1 billion euro to target where we need to support, both across member states, but within member states, where the regions need it most. And this is the way you tackle inequalities. You cannot have a European Health Union which does not have equal access to services, whether it's prevention, diagnosis, and treatment. Another important pillar of the European Health Union is that of medicines. And I have a fundamental belief, a fundamental conviction, that every citizen across the EU deserves to have timely and equal access to medicines no matter where they live. We have proposed a bold and ambitious reform of the pharmaceutical legislation after 19 years. And what we are doing this is to deliver innovation but also to make sure that this innovation reaches patients. This reform for ourselves is based on the three As, on the concept of accessibility, of affordability, and of availability. This is one of the most significant, I think, pillars of the European Health Union and this is now being discussed in the European Parliament. Another pillar is the European Health Data Space. And all these, if we look at what we have put forward to the European Health Union, I want you to see it as a toolbox because each pillar comes to complement each other. So if you have a Europe's beating cancer plan, you also need pharmaceutical reform so that cancer patients have access to treatments wherever they live. But you also need to have sharing of health data. And the European Health Data Space will allow the sharing and the access of data. This will transform the lives of patients and doctors in the regions of the EU for the better. And this is especially true for border regions and remote regions, including medical deserts. To do this, of course, we ensure that all electronic health records are, respect our data protection. And we provide significant funding to the member states in order that they can be able to roll this out. I think the sum is about 810 million euro. Member states have already earmarked over 43 billion euro for health investments and reforms in their national plans. I will end, but I cannot not refer to what day it is today. And today is mental health day. And I think it's important that we highlight mental health. And today, following the COVID-19 pandemic, the climate crisis, the war, and I saw the interest, the discussion you had, not only about the Russian invasion of Ukraine and we know what impact that has, but the recent unacceptable barbaric terrorist attack of Hamas in Israel. All this has led to many mental health challenges for many of the European citizens. And in June, we adopted for the first time, as a commission, the first comprehensive approach to mental health. And we're working already with member states, with stakeholders, the committee of regions, in order to be able to put forward our flagship actions. So I will end here. I want to thank you again for your support of the European Health Union. We are putting the pillars in place and we will move forward. But ultimately, what we have all done working together with the member states, the parliament, stakeholders, and yourselves is we have a paradigm shift, a paradigm shift where health is at the top of the political agenda in the EU and we need to look at it in terms of equity for all European citizens, no matter where they live. Thank you for the opportunity to be here. I didn't look at the time. 24 seconds over. That's perfect. Thank you so much, Commissioner Stella Kiriakidis, for your reflection and for your statement in this meeting of the Committee of the Regents, the Plenary Session. Now I would like to give the floor to our member, Birgitta Sacredeus, for two minutes. Well, it's so good to hear that it's on the top, on the agenda now at the Commission, the health issues. Because health is wealth and health, if you are healthy, you will also have a good regional development. And the CUR was very early in writing an opinion when the COVID came. In spring 2020, we wrote an opinion about health emergency mechanism, where we wanted to have that you should coordinate the EU actions and you should support to assist national, regional and local health care. And yes, you did. You got the EMA, you got the ECDC, and you also put up the HERA that we very much welcome. And also, the pharmaceutical package is so important and will be more important in the future because we know it's a shortage sometimes with medicine, so we all have to stick together and work there together. And I also want to express that we are happy to, since 2016, we work together with WHO and we also work with non-governmental organizations. And there I want to stress what you already said, that the cancer plan is so important and thank you for what you have done in the field of cancer. And I'm from Sweden and I hope that we can share good ideas from each other because I think that there we are in a good position and we work together to people, that people with cancer should also have a good life after and especially also children with cancer, we can work even more. Thank you. Thank you. I'm the one who thank you. Member Guardiola Martín, you have the floor for two minutes. Muchas gracias, Presidente. Estimada comisaria, depresión, ansiedad, trastornos relacionados con el estrés, con las adicciones, trastornos de la conducta alimentaria, conductas suicidas. Estoy segura de que conocen de cerca algunos casos, bien porque los han padecido en primera persona en su familia o bien porque saben de esos casos entre amigos o compañeros de trabajo. Por muy comunes que sean, los problemas de salud mental siguen siendo grandes olvidados en las agendas políticas. Hoy es el día de la salud mental y hablar de ellas es un paso importante. Me consta que esta preocupación alcanza todas las regiones aquí representadas por lo que hemos de estar unidos y adoptar medidas valientes. En España y en particular en las regiones donde el reto demográfico es mayor, como ocurre en Extremadura, faltan especialistas sanitarios en algunas ramas como psiquiatría. Actualmente ya disponemos de una red asistencial transversal para atender a los pacientes y vamos a fortalecerla con más recursos. Estamos trabajando en un hospital de día de salud mental en la ciudad de Cáceres y en un nuevo plan estratégico de salud mental. Hay una gran diversidad de factores interrelacionados en el origen de los trastornos mentales, pero me gustaría poner el foco en el uso irresponsable de las nuevas tecnologías porque afecta especialmente a niños y adolescentes. Los suicidios por ciberacoso van en aumento y es un problema que atañe al conjunto de la Unión Europea. No normalicemos el uso dañino, seamos conscientes, demos visibilidad y tomemos medidas. Está en nuestra mano. Muchas gracias. Thank you. Now the floor goes to member Karsten Uno-Pietersen for two minutes. Thank you. Madam Commissioner, we used to say that health is not a real competence of the European Union. After the COVID-19 pandemic, we do not say it anymore. And for this reason, in the PES group, we really think that we have to give you credit for the impressing work accomplished these last years. But here, in the left side of this political assembly, we also think that it is still not enough and that the European Union should go further. We are not alone. One of the main conclusions of the conference of the future of European Union was to ask more European competences for health, to declare a European health state of emergency in case of a new pandemic or to assist our national health system through stress tests. I would like also to remind you that regions are key pillars for health in Europe. Pandemic preparedness plans will not work without regions. Pandemic preparedness plans will not work without cross-border dimension. So we would like to ask the European Commission to respect what the European Parliament and the European Committee of the Regions voted on serious cross-border health threats and necessary better involvement of local and regional authorities. We know that a report on the state of preparedness is under preparation and that the European Commission is consulting member states only. This is not the right approach. Health is a regional competence in more than 17 member states. We want to be formally involved to these discussions from now. So to conclude, a necessary better involvement of local and regional authorities and formally involvement in discussions from now. Thank you for your attention. Thank you. Member Isildo Gomes, you have the floor for two minutes. If we look at our vision in terms of health, we can see that regions and municipalities are the best facilitators to keep the Europeans in good health conditions. Whether through public services they provide, sports facilities they develop, or the role they play in the supply of quality food and healthy for everyone, and in particular for the poorest. Health should be in this broader sense. In this context, the regions and municipalities are the best ally of the European Commission to create a healthy society. Health is also one of the main engines of resilience in our territories. The regions and municipalities have been in the vanguard of the European response during the COVID-19 pandemic. It is for this reason that we would like to make sure that health indicators reflect better on the regional and local panel of vulnerabilities developed by the CCI. This inclusion is a good way to identify deficiencies and resolve them. It will also be a way to include better health issues and public health services in European policies. For example, we could imagine a specific goal of cohesion policy to address the problems of vulnerability with health as one of its main components in our regions in order to build a more resilient Europe for the future. What do you think of this type of proposal for the next programming period after 2027? Thank you for your attention. Member Kate Finney, you have the floor for three minutes. Thank you, President, and thank you, Commissioner, for joining us. I'm glad that you mentioned it is World Mental Health Day and to see that you're wearing your green ribbon and not to take away from the other topics that you've spoken about, but because of the day it is, I will focus on mental health for my contribution. I don't need to burden you with stats that you're already familiar with, but I think we do need to agree that mental health is not currently being well-served across the Union. There is a saying that your health is your wealth, and that is true for societies as much as it is people. Poor mental health, like other illnesses, cuts across all sections of society, and for many, particularly men, it is still viewed as a taboo topic, which makes it no surprise that over half of people with mental health issues have not received professional help. There is no other area of healthcare where we would tolerate a statistic like that. Poor mental health is particularly acute in minority groups and within the young LGBTIQ community who suffer poorer mental health and physical health outcomes due mainly to discrimination and stigmatisation. In Ireland, 11% of the travelling community die by suicide that is one in 10. Members of the travelling community are seven times more likely to die by suicide than those in the general population. And because of this, my local authority have tailored a programme to work with young traveller men in relation to their mental and physical health. Travellers in Ireland do not have a natural predisposition to poorer mental health. The poor mental health in this group can be linked to the fact that in 2019, the EU Agency for Fundamental Rights found that Irish travellers suffer some of the worst discrimination and poverty of any ethnic group in Europe. And on top of this, 80% of the travelling community are unemployed and this links Commissioner with the agreement earlier on in the week between the EU Health and Employment Ministers to examine precarious work practices and to boost public systems to safeguard mental health in the workplace, again highlighting your commitment to the cross-sectoral approach to this topic. In my council, we also offer targeted mental health interventions for older people who frequently suffer poor mental health due to loneliness and we have seen promising results from a pilot social prescribing programme which we intend unrolling out permanently. To conclude, you are right that we need to take lessons from the COVID pandemic and reflect on the fact that when we came together with common purpose, it worked. The need is there for this common approach in mental health, but this cause needs real political will at every level and the cities and regions, those closest to the citizen need to be involved both in the planning and the rollout. Thank you, Commissioner. Thank you. Member Adam Banasak, you are the floor for two and a half minutes. This is a permanent crisis management for COVID-19 and not for the current systematical policy of the UN in this area. That is why I appeal to keep mental health as one of the key priorities of the next cadenza. It is worth keeping the interest of mental health in order to be able to continue to seek solutions for common challenges in the field of mental health in the whole UN. I also appeal to update the report on the differences between mental health and mental health. The last one from 2014 has become unactual in many aspects. I would also like to emphasize that we should focus on real problems. The drug trade affects the social and economic stability of our countries. We see dramatic consequences that drugs have for young people. The background of the statistics about the background are terrifying. Finally, mental health is mentioned. For example, Poland, where almost twice the number of suicide attempts among young people has increased, probably also due to the pandemic. At the same time, we should be careful when it comes to the interference of the European Union in the competition of member states in some topics related to health. Let's focus on, although against the use of alcohol by young people, let's leave the member states to make decisions in the area of ​​ethics of such products as wine. The wine industry in many regions, especially in rural areas away from urban centers, could suffer and save many people's work. Wine is not drugs, it is not paper. Finally, I would like to emphasize the relationship between health and natural environment. The number of greenhouses, roadways or access to public transport could be very significant. Thank you very much. Thank you. You have the floor for two minutes. Madam Commissioner, after pandemic times, EU citizens have walked and now expect more from the European Union in terms of health policy. For instance, think about measures which were postponed on the delayed at that time. For instance, to regulate and train the pharmaceutical monopoles and the medical industry monopoles. Or other problem, the principles of the operation of social insurance need to be unified in the European Union. The collaboration between the public and private healthcare is very bad and just this problem is connected to the operation of the social insurance. The shaping of an efficient health union has the transfer of responsibilities from national to European level. I think it means the importance that of all the lessons from the health crisis we have to use and once more regulate the social insurance problems and the medical monopoles. Thank you. Thank you. Now member Erika von Kalban you have the floor for two minutes. We all have experienced how important this collaboration was, not only regarding the medicines but also the supply of patients. We in Schleswig-Holstein took people from other countries and others. That was living European solidarity. For me and for us as green it is important that we also together with a healthy environment and the fight against climate change. Because this collaboration is obvious when you see the rising number of heat deaths. And at the end of the session we have heard that at least surprised me that 10% of the deaths go directly or indirectly to the air pollution. I would like to point out a big role in the rural area. Our health supply depends on people. Doctors, nurses, nurses and therapists. We also need a good European cooperation with the training, with the recognition of connections and also with the support of people from outside the EU and a world-wide Europe. Thank you. Member Stefan Ilyer you have the floor for one minute. Thank you. Thank you. Thank you. Member Loredana Capone you have the floor for one minute. Thank you. Thank you. Thank you. Thank you so much. Member Anna Magyari you have the floor for one minute. Thank you. Thank you. Member Andros Karajanis you have the floor for one minute. You have the floor for one minute. Thank you. Member Igor Androvich you have the floor for one minute. You have the floor for one minute. Thank you. Member Florian Schutz you have the floor for one minute. You have the floor for one minute. Thank you. Member Oskar Sestak you have the floor for one minute. Thank you. Member Oskar Sestak you have the floor for one minute. You have the floor for one minute. Thank you. Dear colleagues, Commissioner Kiriakidis has to leave so we still have requests for the floor but I will give for the floor to comment in some of the concerns that were already expressed and the questions. You have the floor Commissioner. Thank you. I'm sorry but there was a change in your program a little bit later and I have an obligation to be at the European Parliament. I will try and pick up as many of the points that you have raised. Member Sagradeu started by saying that health is wealth and several of you I think it was also member Magir if I've got the name correctly mentioned the issue of medicine shortages and you're absolutely right it is an issue that has been faced with at many times across the European Union and we are taking specific measures and work to address shortages we all remember the last year and the shortages we have with antibiotics for the first time we're working towards having a list of critical medicines so that we are able to be better prepared we have a list of recommendations also to member states to take actions to avoid potential shortages for example of key antibiotics which you mentioned but more than that we're also working through HERA with industry because it's not effective to deal with shortages once they happen so what we're working towards is that companies need to notify if they're going to withdraw a medicine or if they're going to have issues with the shortage before it happens so we are able to work better with member states also members Agadeus mentioned that we need to do more in terms of medicines and I just wanted to share with you that what we have in the EU we have safe and effective medicines what we do not have is a single market for medicines and that is what all the patients deserve to have access for medicines when they need them because we talk about fostering innovation and the pharmaceutical companies some of you spoke about that it's important that we keep them to be innovative and to be front runners in Europe because we need the innovation but that innovation needs to reach citizens no matter where they live and this is why we believe that the reform proposal we put forward puts a balance into this Agadeus my term spoke about sharing best practices in mental health and I just wanted to just tell you that we're already working on a project with that between member states to share better practices for preventing depression and suicide I in fact visited a centre in Madrid which deals with taking course for suicide prevention and member states can share best practices so that we are able to be more effective but we're going further than that we also have projects for training of professionals because it's important that we do that member Peterson I won't discuss about member states about health being a member states competence it is but we have shown all together what we can do and you spoke about the regulation of serious cross-border health threats and what it's doing at regional level there are many references in the new regulation to the regional and local levels and we need to work together because what we have seen with COVID is that diseases and infectious diseases know no borders and cooperation is regulated through the regulation on serious cross-border threats so that we are able to survey infectious diseases as they appear you are totally correct on the pandemic preparedness plans needed for every region and I look forward to working with you in this I heard of your of what you said about wanting to be involved in these consultations from very beginning I did note it now the important of regions in health there can be no health without mental health equity and access is fundamental I am not in any way saying that we have solved all the issues but what I am saying as commissioner for health and food safety is that we are working on a different paradigm shift in health over the last three years and this we are not doing alone as a commission the important partners in this process because you represent citizens and you are aware of what is going on in the most remote parts of Europe that we need to be able to to reach out to member I think it was member Feeney if I am correct spoke about mental health and the importance of making sure that we reach all parts of Europe implementation on the ground is key you are absolutely right and yes I am so glad that you mentioned it we need to look at stigma we need to look at minorities we need to look at the rights of LGBTQI plus people of the displaced, of the women of the refugees and we need to finally encourage people to say it is okay not to be okay and to ask for help member Banasak mentioned that President von der Leyen hardly mentioned health in her State of the Union speech President von der Leyen mentioned the European Health Union in her State of the Union speech in 2020 and this commission is we work all together and I can assure you that the President is focused on what we can achieve and everything that we have if we have achieved that's for you to judge this is collegial decisions and we all work together to working and I just wanted to say something because this needs to be understood when we are working on plans like Europe's beating cancer plan on the mental health comprehensive approach this is horizontal across the commission and across the college for Europe's beating plan we were 13 or 14 commissioners working towards it the same with mental health this is the only way that you can bring about change you need to be holistic and you need to be horizontal and on obesity because you mentioned it yes there is a specific part on obesity in in our Healthier Together initiative and we're working into supporting states this and it's also part of palm to folk strategy which is the other half of my portfolio member Korber said that citizens should expect more I expect citizens to expect more and I expect us to try and deliver and we should be there because we should be there for citizens but there were other point issues by member von Karber, member Ilje, good health care no matter where they live and I mentioned the cancer inequalities register that is an example of what we can do to see where there are inequalities so we can better support a member Kaboom mentioned something which I think I'm very glad that I heard this and it's the word because we need to be addressing all the issues we need to have science and good science and research behind them member Karajani spoke on loneliness loneliness is part of the portfolio of the excellent work done by Vice President Suitsa but I will say here that in our mental health approach Vice President Suitsa is very involved and we are also looking at the issues to do with the vulnerable and of loneliness is an issue and for two years we've been working on a project called loneliness in the EU I think that I have covered most of the points there was a point on gender and gender perspective is horizontal in all our policies and there was another point by member Androvich and on pharmaceutical reform and data and I wanted to tell you that part of the European health data space is what we are working on called my health at EU and what we are working towards is that all citizens no matter where they live in the EU will be able to have on their mobile phones their summaries their medical images they will be able to use their prescriptions so this really gives the citizen control of their health data no matter where they live in the European health union I hope that I have covered as many points as possible again I apologise that I have to leave you but I have to be at an event in the European Parliament on mental health it's a special day today I want to thank you for giving me this opportunity to be here and to hear from you this is a great opportunity to be back again thank you so much thank you we are the one who thank you for taking the time to be with us and I wish you all the best and certainly we will have another opportunity to exchange thank you