“We are 50 doctors who have met again 50 years after graduating from the Catholic University of the Sacred Heart of Rome. We have been witnesses, having practiced in hospital, university and local services, of the entire span of the healthcare reform of the 1978”. “We have followed the evolution and evolution of the National Health Service”, “rise and decline”. In the meantime “Italian society has changed”, aged. But “the increase in health needs receives different and too often inadequate responses depending on the region in which the patient lives”. And “the implementation of differentiated autonomy could further aggravate this already unacceptable situation”. It is the outburst that a group of ‘senior’ white coats from the Italian health system entrusted to an open letter, “to the institutions, to public opinion, to all the parties involved”, which contains around fifty signatures, of specialists in every sector, from gynecology to pulmonology, from geriatrics to oncology, from pediatrics to psychiatry, from endocrinology to immunology, based in various cities in Italy.
The experts’ concern? That even now we are “trying to treat the symptoms” and not the disease, “the root of the problem”. And this is how “we try to reduce the problem of waiting lists, without succeeding”, explains to Adnkronos Salute one of the signatories, Salvatore Di Giulio, a long-experienced nephrologist who was director of the Transplant Department of the San Camillo of Rome, now retired. Di Giulio summarizes the main contents that emerged from the comparison between these specialists who shared the years of university education. “It’s an outlet, of course, and we are neither the first nor the last. But it also wants to have a proactive purpose”, he points out.
And in fact the letter ends with a proposal: “That, without distortions and speciously partisan controversies, the political, social and trade union forces decide to “call a sort of States General of the NHS, a new ‘Constituent Assembly’ of all the actors involved, which indicates concrete and lasting solutions for the correction of the system. It would be guilty, towards all citizens and in particular the new generations, if the NHS falls apart due to laziness and/or particular economic interests”. A new outcry for the National Health Service, which arrives less than 2 months after the initiative which saw 14 important Italian scientists as protagonists, including Nobel Prize winner Giorgio Parisi, in defense of public health. “We signatories of this letter – explain the senior doctors – do not want and cannot remain silent in the face of this negative trend and, even if we no longer hold decision-making positions, we feel obliged, on the basis of our long experience gained in the most varied fields of medicine, to denounce the lack of coordinated initiatives which, even in times of limited economic resources, is forcing citizens to pay for many medical treatments themselves”.
“All of us – says Di Giulio, 75 years old, who after a ten-year period in Paris led his long career in Italy in the public sector, until his retirement – have invested an extra commitment, in addition to that of healthcare alone, in the construction of an efficient and effective public health system”. The white coat gives some examples, drawing on his personal history and recalls the goals achieved in those years, for example how we managed to “create the transplant center of the San Camillo and Spallanzani hospital in Rome”. And he offers some illustrative numbers, which – he explains – give an idea of the parable that the NHS is experiencing: “When I arrived at San Camillo in 2000 there were only 16 dialysis places, some of which were not working, when I retired in 2015 there were 44. Unfortunately today only 30 are functioning due to a lack of nursing and medical staff.” Many doctors have retired like Di Giulio, “and since 2015 they have not been replaced while the needs have increased exponentially”.
The problem for the expert is also this: “There is currently no program for the assessment of health needs, to adapt the organization of the national health system to real needs”, but “we are only trying for political reasons to respond to the demand for health, which in turn generates waiting lists”, which “are only a symptom of the disservice in the national health service”. For the head nephrologist, “the current decree being prepared to reduce them introduces misleading concepts”, he reflects. “Some of these concepts, derived from the world of insurance companies, transposed into the health service create an unfair, incorrect filter”, in his words. “The analysis of health needs – he observes – would highlight the serious regional differences in the national health service much more clearly than waiting lists”.
According to Di Giulio, another element that contributes to misrepresenting the real situation is that “there are at least 4.5 million people who give up treatment because they cannot afford it financially and others who resort to healthcare paid for out of their own pocket. Today I work in a private clinic and I see it personally. The debate must go beyond the emergency solution, the ‘fix’ can only be: how to pay for more CT scans in the private sector”. What is worrying, continues the doctor’s reasoning, “is that not only are these differences that we see tolerated at a national and regional level, but that for example in the next European elections there is no program of any party that indicates a project of uniformity European Union for the various healthcare systems and I understand the differences, they exist”.
“What strikes me – he concludes – is the lack of patient subjectivity in political life. A strike by air traffic controllers has more effect than the discomfort of patients, who are not represented by anyone. We see complaints pouring in from many quarters, it is true. Ours is also a complaint. There is no place in which we can sit down and discuss the search for a real solution National Health Service, like the one that inspired our Republican Constitution. In short, we who have invested many of our energies and years of our lives in the NHS do not want everything that has been built to be destroyed. Everyone, in every sector of the State and society, in all the institutions that have a say in the matter, must work hard to ensure that this does not happen.”
#Healthcare #Appeal #letter #doctors #NHS #sick #treat #symptoms
