“The private sector with an agreement could be the solution and we could also do more and go for example at 150 km/h but we have to go slower because the budget is limited”
“A warm napkin”. As Fabrizio Pregliascodirector of the specialization school in hygiene and preventive medicine at the University of Milan and medical director of the Ircss Galeazzi Sant’Ambrogio Hospital in Milan, comments with Affaritaliani.it the measure launched today by the Council of Ministers to try to cut healthcare waiting lists.
“This measure does not have a significant impact and this is demonstrated by the fact that they have split the provision in two with a bill and at the moment therefore there is no increase in economic availability. And above all the key point is the operational and concrete aspects that affect the appropriateness of the application. There is a need for an overall reorganization with so many requests but the system is bogged down because family doctors and community homes are not involved. It is necessary to influence the origin of requests for inappropriate visits and govern them in different ways.”
Another negative point of the government’s measure, according to Pregliasco, is “the control of Agenas (National Agency for Regional Health Services) over local health authorities and hospitals”. In this way the regions and the control of the territory are bypassed. However, for example, the central cup is doing well as it can better manage the offer and redistribute it across the territory, even if in some cases the availability of the various visits is far from the place of residence. But it is a way to optimize resources. On average there are 10 visits with the public service and 50 with the private one, a more equitable distribution is needed. The private partner could be the solution and we could also do more and go for example at 150 km/h but we have to go slower because the budget is limited and if we finish it in August then we can no longer carry out visits and interventions with the system national health system and therefore private services remain”, concludes Pregliasco.
Healthcare: what the government bill provides on waiting lists, point by point
The legislative decree passed this morning by the Council of Ministers contains “urgent measures to reduce waiting times for healthcare services”. Here’s what it provides in detail. Article 1 – The national platform for waiting lists used by the Ministry of Health has been established at Agenas: the objective is “to have for the first time punctual and real monitoring of waiting times for the provision of health care”. The national platform is aimed at communicating with the regional waiting list platforms. This new monitoring system aims to overcome the current one which does not allow us to know the supply of services compared to the demand. Article 2 – To strengthen the monitoring and control activities of the National Health Care Verification and Control System established in 2005, a Health Care Verification and Control Body was created, reporting directly to the Ministry of Health.
This body verifies the correct functioning of the waiting list management system and the operational plans for the recovery of the lists. He is authorized to access all types of healthcare facilities to verify and analyze emerging dysfunctions following the control of booking diaries upon notification by citizens, local authorities and user trade associations. The Body can acquire documentation and request clarifications and feedback to which the health companies and the Regions involved are obliged to respond, also electronically, within 15 days. Article 3 – For the first time there is the obligation of a single regional or sub-regional Cup with all the services available from the public and private affiliated sectors. To date, in the regional Cups the affiliated private individual is either not present or is only present to a minimal extent: for this reason the contract with the accredited private individual who does not include the services in the public Cups is expressly foreseen to be null and void; for those who are authorized but not yet accredited, the connection with the public Cups becomes a requirement for the issuing of institutional accreditation. If the services are not provided within the times established by the current priority classes, the companies guarantee the citizen the service through the use of intramoenia or accredited private individuals.
Prohibition for healthcare and hospital companies to suspend or close booking activities. The Cup must activate a system to recall the citizen and request confirmation or cancellation of the reservation made, at least within two days before the provision of the service, to avoid the phenomenon of services booked and not carried out. Article 4 – Visits and diagnostic tests also on Saturdays and Sundays, extending the time slot. To avoid excesses in intramural activity, to the detriment of institutional activity aimed at reducing waiting lists, it is expected that in each hospital the hours of freelance activity must not exceed the ordinary hours. Article 5 – Spending on personnel is increased by a total amount equal to 15% of the increase in the Health Fund compared to the previous year. In essence, compared to today, the spending ceiling is less stringent for 2024 and from 2025 it will be abolished and replaced by another mechanism which is not binding but linked to company planning based on a standard requirement for healthcare personnel . The law meets the repeated requests of the Regions to remove the restriction on hiring. Article 6 – Action plan for the strengthening of health and socio-health services in the seven regions of the south recipient of the National Health Equity Program 2021-2027: initiatives to make investments in technological infrastructures, infrastructural adaptation and technological strengthening of mental health departments , family counseling centers and screening points, modernization and implementation of IT, technological and diagnostic equipment, training of health workers. Article 7 – Flat tax at 15% of the additional hourly services of healthcare professionals involved in reducing waiting lists.
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