Aceti (Salutequity), 'more NHS funds but treatment waivers increase compared to 2019'

Although the financing of the National Health Service has gone from around 114 billion euros in 2019 to over 124 billion in 2022, reaching 134 billion in 2024, the level of renunciation of care by citizens who would have needed it in 2022 (Istat data ) has worsened compared to the pre-pandemic period: from 6.3% in 2019 it went to 7% in 2022 (+0.7%). The regional differences in 2022 are also significant: they go from 12.3% of people giving up treatment in Sardinia to 9.6% in Piedmont, and down to 4.7% in Campania. Furthermore, what is worrying is the fact that this health care indicator, like many others, is not currently used by the Ministry of Health to verify the performance of the Regions in their ability to concretely guarantee the essential levels of health care to citizens. We are talking about the New Lea guarantee system, a system for monitoring and evaluating the work of the Regions, used by the Ministry of Health to assign each year the 'Lea score' which is also functional for the disbursement of part of the national health fund. This is the photograph taken by Salutequità in the latest report 'Evaluate well to guarantee fairness. Recommendations for equity in the New Guarantee System (NSG) of essential levels of assistance'.

The report was presented today in Rome during a national seminar in the presence of multiple stakeholders, experts and decision-makers, with the aim of making the right to health increasingly effective and enforceable in all Regions. Approved in 2019, the Lea's Nsg entered into force in 2020, but its indicators today are too few – we read in the document – and weak, and this makes it already old and outdated by the reality of the facts: out of 88 indicators, only 22 (a quarter) contribute to assigning the score to the Regions ('core' indicators). This is why Salutequità has produced its second report on the subject, developed together with 15 patient associations, scientific societies, managers of healthcare facilities, healthcare professionals – Aiop, Aisc, Aism, AMD, Amici, Apiafco, Apmarr, Card, Diabete Italia, Federsanità Anci, Fimmg, Fnopi, Sifo, Sit, Uniamo – and created thanks to the unconditional contribution of the Servier Group in Italy.

“The Nsg – states Tonino Aceti, president of Salutequità – should be a flexible instrument capable of constantly adapting to the health priorities of citizens and to those of the health policy of the NHS, which are constantly evolving, starting from the innovations envisaged by the Pnrr, from Ministerial Decree 77/2022 and the tariff decree of the new LEAs. This means being able to count on a dynamic system for updating the indicators, which are currently inadequate to measure the reality experienced by citizens, as well as relating to a NHS of the pre-pandemic period”. The objective of the work is “to propose shared recommendations to perfect and modernize the new Lea guarantee system, with a view to greater equity in access to healthcare. Without greater and better controls on the assistance provided by the Regions, in the face of the billions of euros allocated for the NHS – Aceti warns – are not going anywhere. Not to mention that the hypothesis of assigning more autonomy to the Regions, without simultaneously providing for a strengthening of the control role of the State to guarantee the unity of the NHS, risk further exacerbating the significant inequalities that exist.”