by Luciano Fassari
These are some of the shots that emerge from the new NHS Yearbook relating to 2022 just published by the Ministry of Health which, compared with the same report from 10 years earlier, highlights how the Health Service has slowly changed its face with territorial assistance in difficulty and supported largely starts from the private sector. Little progress in integrated home care while the trend in healthcare personnel appears to be reversing and growing again even if compared to ten years earlier it marks -4,500 units. YEARBOOK 2022 – YEARBOOK 2012
08 APR –
Here’s how the face of the NHS has changed in the last 10 years. There are fewer and fewer hospitals, more and more private facilities and an area increasingly lacking in family doctors, paediatricians and continuity of care doctors. Furthermore, after the boom in acute care beds in 2020, the year of the outbreak of the pandemic in 2022, the cut continued. There are fewer and fewer staff compared to 10 years ago but fortunately a reversal of the trend has been noticed in recent years. This is the photograph that emerges from the new statistical yearbook of the NHS of the Ministry of Health relating to 2022. And so by comparing the same report relating to 2012, the clarity of the numbers reveals the forced diet followed by the various governments that have followed one another in the last decade have subjected the NHS which in 10 years has found itself with 95 fewer hospitals, an increasingly strong private sector burden and public territorial assistance at a standstill with progress in integrated home care which however is still not affected by the boost given by the Pnrr .
Let’s start with hospitals. In 10 years, 95 have been closed, 9%. In 2012 between public and private ones there were 1,091 while in 2022 they dropped to 996, with a more marked cut for public ones (67 less in 10 years).
Facilities for specialist outpatient care are also decreasing: there were 9,268 in 2012 and they dropped to 9,085 ten years later. Territorial Residential assistance is growing, but only thanks to the private sector, which compared to the 6,526 structures present in 2012 will have 8,045 in 2022 (just 15% are public). The same trend applies to semi-residential local care facilities, which see the number of facilities growing: there were 2,787 in 2012 and 3,126 in 2022. The same applies to Rehabilitation which went from 1,027 facilities to 1,180. The numbers for other territorial assistance are also growing, in this case with the public taking center stage
But what is most impressive is that the cuts affected the public sector which in 2022 includes 42.7% of total structures compared to 46% 10 years earlier.
Less and less staff compared to 10 years ago but the trend seems to be reversing. In 2012, the NHS counted 629,713 units compared to 625,282 in 2022. However, this figure was up compared to the 603,856 in 2019, the year that preceded the pandemic.
Bed spaces, after Covid we start to cut again: Compared to 10 years ago, just 7,183 beds have been cut between the public and private sectors, including ordinary hospitalizations, day hospitals and day surgeries. Thanks to 2020 when with the outbreak of the pandemic there was a large increase in places. But it should be noted that in just two years, after the hardest moment of Covid, over 30,000 were cut: in 2020 there were 257,977 beds compared to 225,469 in 2022.
The number of clinics is also decreasing: 1 in 10 have been closed (there were 2,467 in 2012 compared to 2,161 in 2022). The number of mental health centers is also down (it was 1,574 ten years ago and has become 1,496 in 2022).
Fewer affiliated doctors. Family doctors went from 45,437 in 2012 to 39,366 in 2022 (-6,071). Paediatricians are also decreasing (-694 in 10 years for a total of 6,962 units in 2022). Continuity of care doctors (formerly on call) are also slowing down, from 12,027 in 2012 to 10,671 in 2012 (-1,356).
Administrative diet. The local health authorities went from 145 in 2012 to 106 in 2022.
Integrated home care (ADI) is growing. In 10 years, the number of people assisted has practically doubled: from 633,777 patients in 2012 to 1,244,891 in 2022. What makes it worse, however, are the hours dedicated to each patient: in 2012 there were 22 hours compared to 18 hours in 2022.
Emergency room. In 2022 there will be 17,208,251 visits to emergency rooms (292 visits per 1000 inhabitants), or approximately 3 million fewer visits compared to 2012 when there were 20,916,353 with an average of 350 visits per 1,000 inhabitants. In 2022, there were 1,318,953 visits to pediatric emergency rooms (143 visits per 1,000 inhabitants up to 18 years of age), a number slightly lower than the 1,447,039 visits 10 years earlier (on average 144 visits per 1,000 inhabitants).
Focus Covid. The allocation of ordinary inpatient beds intended for patients affected by the Covid-19 virus continues to decrease.
In accredited public and private structures the percentage of Covid departments stands at 10% of the total.
Inside there are 23,342 beds, which represent 11.5% of the total number of ordinary hospital beds. The monthly trend of Covid-19 beds actually used shows a decreasing trend in the first half of 2022, and then stabilizes in the second half of 2022. The maximum differential between 2021 and 2022 is in the month of April, with a gap of 13,973 beds.
Luciano Fassari
08 April 2024
© All rights reserved
Other articles in Studies and Analysis
