On December 11, UEMO was featured in a public meeting held by the European Medicines Agency (EMA), represented by Tiago Villanueva, who expressed its views on the rush for a COVID-19 vaccine and its implications for patients.
The meeting came two days after the EMA suffered a cyber attack involving incognito access to the regulatory submission for the Pfizer and BioNTech’s COVID-19 vaccine candidate, which EMA’s chief Emer Cooke on her introductory speech.
EMA held this virtual meeting to explain the processes for the development, evaluation, approval and safety monitoring of COVID-19 vaccines in the EU, including EMA’s specific role, to all interested parties.
The meeting also gave the opportunity to the public and stakeholder groups to speak and share their needs, expectations and any concerns. The agency said this feedback will be considered by the agency and other European medicines regulatory network in the decision-making process.
The basic health service has always been prioritised in preventive work. As early as in the 1940s we had our network of maternity and childcare instruction clinics. The Finnish mortality rate in maternity and perinatal groups is very low, even inside the European Union (EU). As the family doctor system emphasised the availability of medical care, at least in its beginning, there was a fear of preventive care decreasing. Fortunately this did not happen. Basic healthcare has taken responsibility for most of the preventive activities. The family doctors have understood the significance of this work for the welfare of the citizens. More than half the Finns already belong to the family doctor system, so the availability of the medical care has improved and there are no more queues for general practitioner (GP) consultation. Medical care takes place mostly in the hours of consultation and home visits are rare. There is a home care system in our health centres where nurses, together with the family doctor and with social care home helpers if needed, try to support very sick people in living at home. Home visits of doctors are still very rare, but the aim is to increase them in the future. Our system is also more focused on hospitals than any other systems in the EU, but this will be changed. Our family doctors function in health centres comprising several doctors, with x-ray and laboratory services produced by the health centres themselves at their disposal. Finland is very sparsely populated and particularly in the north of the country the health centres function more like hospitals. There are no common borders for the developing functions, even with expertise, so there are many healthcare units where the GPs operate more as if for specialised care. In more crowded areas, the health centres and the hospitals will increasingly co-operate, unified by the lab and x-ray functions, when the data systems develop and the same unit can serve both health centre and the central hospital.In developing healthcare, the pressure of increasing costs is high and the quality requirements have emerged. There are more and more investigations done to solve the overlapping and interpenetrating functions of hospital care, basic healthcare and social care. The evidence-based care has come where the medical care is always based on evidence. There are regional medical programmes increasing the quality and emphasising the differentiation, improving the co-operation and data chains. The regional care programmes are done in co-operation with specialists, GPs and nurses.Several quality programmes and projects have been started. Instead of regional care-taking programmes, the thinking is moving towards care chains, especially including the problems of interfaces. The aim is to improve the status of patients, offering high quality care and good co-operation between health and social care systems. The patient should always be in the right place to be taken care of and so the economic gain would be clear. The real time data change is obligatory for good care.Our healthcare system is based on strong basic healthcare in the health centres. The availability of services can be more important than the right to choose the doctor. The GP’s position as a gatekeeper has been emphasised and the family doctor system has made it possible. In the doctors salary system the availability of medical services has been emphasised, meaning that only a part of doctor’s income is salary: the rest is comprised of fees for service and fees for capitation. The fee for service system will direct the activities of the GP and emphasise preventive activities, especially in the last salary contracting movement.
