Very long waits, distant hospital facilities, difficulties with the Cups and, too often, blocked booking agendas. For 9 out of 10 Italians, the NHS waiting lists are a nightmare. This is certified, if it were still needed, by a survey by Altroconsumo according to which out of 1,100 citizens interviewed, over 950 had difficulty booking a visit or exam with the NHS over the last year. The survey conducted on a sample belonging to ACmakers, the community that collaborates on the Organization's research, and focused on the problem of waiting lists, confirms a disheartening and highly critical picture, which does not appear to show signs of improvement. Italians, when things go well, are forced to go private and pay out of their own pockets but too many give up on treatment.
Most of the problems – according to Altroconsumo – were recorded with specialist visits (for 2/3 of the reports received): in particular, the most cited visits are ophthalmology (around 180 reports) and dermatology (around 100, mostly concerning mole control). Among the most reported tests: ultrasound scans of the abdomen, thyroid, breast and shoulder (around 150), magnetic resonance imaging, CT scans (around 100) and gastroscopy (around 25). In reality this list is not surprising: ophthalmological and dermatological examinations, gastroscopies and abdominal ultrasounds have always been the services that citizens pay the most out of their own pocket, booking privately, as also confirmed by the latest data from Agenas (National Agency for regional health services) on intramoenia activity, i.e. the private activity of public hospitals.
But what more specifically are the problems encountered? First of all, for 2/3 of those interviewed, the waits exceeded the emergencies indicated on the prescription, but also hospital facilities that were too far away, appointments not available due to closed bookings (which is also an illegal phenomenon). But not only that: Cups that are difficult to contact, prescriptions that expire, checks that are skipped.
The problem of excessive expectations – we read in the report – concerns the vast majority of those interviewed; it is impossible for many to have visits and tests within the times suggested by the doctor, even when there is an emergency indicated on the prescription (117). But it is striking that approximately 1/4 of these reports (263) concern the impossibility of booking a visit or exam due to closed diaries. That's not all: about a quarter of the citizens who had problems getting an appointment within the time prescribed by the doctor would have had to go to an inconvenient facility, sometimes 100 km or more away from home, because in their province the first place would be It was only available after many months. This happens because the so-called “territorial areas of guarantee”, in which the Cups can book services, can be vast. Although legitimate, for many it is a very serious inconvenience, if not an obstacle to treatment, and this practice disregards respect for that “principle of proximity and reachability” which is cited by the National Waiting List Government Plan.
Difficulties in contacting the Cup (Regional Single Booking Centre) are also frequently reported, given that more than 1/5 of those interviewed say they have had them, including very long waits, numbers always busy and the line dropping after having waited in vain. But unfortunately, there are no particular protections for waiting on the phone with the Cup.
The situation does not improve on the hospitalization front. Of the 1,100 interviewees – the survey reports – around 300 said they had been placed on the waiting list for hospitalization in the last two years. Just over half of the citizens were hospitalized on schedule; around 100 people however were not so lucky and around 50 are still waiting to know when they will be called. Among the reasons for the delays encountered: the lack of doctors, beds, the absence of the agenda for the next few months. In all the testimonies, however, the impotence of waiting without information shines through; half of the interviewees who reported problems ultimately decided to turn to private individuals.
“The crisis facing the NHS has been there for all to see for some time as it has been, over the years, seriously under-funded by all political forces and more recent causes have accelerated its collapse, primarily the Covid pandemic 19 – declares Federico Cavallo, head of external relations at Altroconsumo – What unfortunately remains constant is the inadequacy of the responses that politics have put in place from time to time. One fact applies to everyone: according to the latest BES report from Istat, in 2023 around 4.5 million citizens had to give up medical visits or diagnostic tests due to economic problems, waiting lists or access difficulties. This is 7.6% of the population: up from 7% in 2022 and 6.3% in 2019.”
And what is even more worrying is the fact that the trend of spending on healthcare – as a percentage of GDP – is expected to decline in the coming years, a clear sign of how the situation will certainly not improve, but rather worsen further. We , like Altroconsumo – adds Cavallo – we will continue to do our part by carefully monitoring the situation, acting in synergy with other entities committed to promoting the principles of a fair and universal public health service, such as the Gimbe Foundation, and making available to citizens information and tools useful for asserting one's rights, as provided for by the Constitution and Italian laws”.
The “serious state of health of the NHS requires profound reflection – underlines Nino Cartabellotta, president of the Gimbe Foundation – the impact of the weakening of public health on individual and collective health must also consider the socio-economic level of the population. The increase in number of families living below the absolute poverty threshold, if on the one hand it “stems” out-of-pocket spending – that which is paid out of one's own pocket – on the other hand it will increase the renunciation of treatment, worsening health and up to reduce the life expectancy of those “indigent” who art. 32 indicates as people to whom “free” care can be provided. “Undoubtedly, waiting times constitute one of the main critical issues of the NHS – concludes Cartabellotta – with which citizens and patients encounter serious inconveniences on a daily basis, such as the need to resort to private facilities or healthcare migration, to the point of giving up treatment, a problem that has always afflicted our NHS, but which has worsened in recent years due to the enormous quantity of services not provided during the Covid-19 pandemic. However, the measures to reduce the waiting lists envisaged in the latest maneuver were guided by a 'performance' logic, without any measures aimed at monitoring and reducing the inappropriateness of the services. Furthermore, the strengthening of the offer was effectively 'offloaded' onto the increasingly limited time of healthcare professionals. Finally, the update of the new national government waiting list plan, which expires in 2021, is still in progress”.
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