Far from “large investments”: we are at risk of a healthcare desert

Far from “the largest investment in history for the health of Italians”, as Giorgia Meloni likes to say. The crisis of the health service that has been shattered by the pandemic will not be solved but worsened by the health policies of the right. This is supported by 75 scientific societies of hospital doctors of all specializations who held a press conference on the subject yesterday in Rome. During the Covid emergency – explained the coordinator of the Companies Forum Francesco Cognetti – the number of beds decreased from 257,977 in 2020 to 225,469 in 2022. The 1091 hospitals in 2012 were reduced to 966 in 2022, and two thirds of closures involved public hospitals. And then there is the question of money, on which the government often tries to play a shell game: “In 2024, the financing of the National Health Fund increased in absolute terms compared to 2021″ the doctors admit. «But it has decreased relative to GDP and eroded very substantially by higher inflation. Furthermore, these resources have largely been used for negligible contractual increases in staff, which are unable to contain the exodus of doctors.” So, in real terms, there is less money for health than before.

That money is not enough is demonstrated by the issue of essential levels of assistance, i.e. the essential health services that the Regions must guarantee to their citizens. The new LEA list has been ready for years, which increases the number of benefits to which every citizen is entitled regardless of their place of residence. But this year too the introduction was postponed to 2025 due to lack of resources. And now scientific societies fear the new push for devolution, with the possible launch of Differentiated Autonomy.

Also worrying is the lack of staff, which today forces local health authorities to hire specialists (those who have not yet fled abroad). «In the next 7 years – the doctors explain – there will be 30 thousand more doctors, but the times are too long». Therefore “urgent” interventions are needed: an end to limited numbers in faculties, salary increases for the most demanding sectors (emergency room and resuscitation, for which the competitions remain deserted) and a stop to the spending ceiling for staff, which leads to spending money for “coin-paying” doctors purchased under the budget item of “goods and services”.

Without these measures there is a risk of “health desertification”, also denounces the Cittadinanzattiva association which has been monitoring the services available to citizens for years. Yesterday he presented the data on the occasion of the eighteenth European Patients’ Rights Day. «Desertification» means that in some areas finding a doctor is already a challenge. And it’s not just a southern problem. At a national level there is one hospital gynecologist for every four thousand inhabitants, but in Caltanissetta only one for every 40 thousand. Even in the hospitals of the Bolzano province, however, there are two cardiologists in total, that is, one for every 224 thousand inhabitants (and not one for every six thousand, the Italian average). In Brianza there are 18 thousand citizens without a family doctor and the province with fewer pediatricians compared to the number of children is Asti. «The lack of services in the area, the shortage of some specific professional figures, the distance from health centers particularly in the internal, peripheral and ultra-peripheral areas of the country, represents an element of inequality in access to care and services that must be addressed through an alliance between institutions, health professions and citizens” comments Anna Lisa Mandorino, general secretary of Cittadinanzattiva. The doctors’ union Anaao-Assomed also joins in the alarm, denouncing territorial inequalities for social services: “in Bolzano 583 euros are spent per inhabitant, in Messina 53” says Pierino Di Silverio. “We risk social disintegration.” «The LEAs – he continues – would no longer be the responsibility of the Ministry of Health, but would fall under the competence of the Regions. This means that each Region could decide which services to provide free of charge and which not. We could arrive at the paradox whereby a given visit could be free in Lombardy and paid for in Calabria.”