Professor Francesco Cognetti, in addition to being an internationally renowned oncologist, chairs the Forum of the 75 medical-scientific societies that have taken to the field to denounce the cuts that are putting everyone’s right to treatment at risk.
What prompted you to raise the alarm?
«In truth, we have been reporting the danger for at least two years, only now the situation has worsened. We started asking ourselves questions when faced with the data on Covid mortality among those infected, which in Italy was much higher than that of other European countries, with the exception of the United Kingdom and some Eastern countries.”
Ask the questions and what answers did you give yourself?
«That those numbers are the indicator of a crisis that is structural, because in just two years, from 2020 to 2022, we have lost 32,500 beds, while there is an exodus of doctors towards foreign countries or cooperatives of token operators which aggravate staff shortages resulting from a lack of university planning and a prolonged hiring freeze. Not to mention the financing, which from 2012 to 2021 in Italy increased by only 6.4% compared to 33% in Germany, 24.7 in France, 21.2 in Spain”.
But why, the Government says it has put more money into healthcare than ever…
«This is true but apparently, because behind those growing numbers there is actually money for the renewal of healthcare personnel’s contracts, which among other things have led to laughable increases, for doctors on average 150 euros per month who they don’t bring us much closer to the salaries of our European colleagues, who in some countries earn double. Then if we deduct the cost of inflation we discover that in 2024 in terms of actual spending capacity our NHS will take a step backwards compared to 2021 by 6.2%. And look, the Def says this.”
Yet we continue to repeat that we offer some of the best care in Europe. But it is so?
«Unfortunately not, because we are finding it increasingly difficult to guarantee adequate standards of assistance, as demonstrated by the fact that in 12 out of 21 regions, not even the totality, but not even the minimum sufficiency of the essential levels of assistance is guaranteed».
What will happen then with new therapies that are increasingly targeted and personalized but also more expensive?
«Already today there are unacceptable territorial inequalities in this regard. Innovative drugs, once authorized by AIFA in one region, are immediately included in the regional handbook, in others, to save money, perhaps you wait a year. This happens especially for important drugs, such as oncology ones. Then we are surprised that the exodus of patients from regions in difficulty towards those with more efficient healthcare is increasing. And I wonder how we can talk about differentiated autonomy in these conditions.”
According to Istat, waiting lists have pushed over 4 million Italians to give up treatment. How do you fight this plague?
«Not with the spot interventions proposed so far by the Government. We need to strengthen the public offer, even if we are not against integration with the private sector. But you can’t invest everything in this and then not hire. We need an overall reform of the system, which overcomes the current barriers between hospital and community care, which are anachronistic in a situation which sees an increase in elderly patients with poly-chronicity. Unfortunately, the Pnrr is not going in this direction because there is no connection between the new community homes and the hospitals.”
You denounce the cutting of beds in hospitals, but in the same structure there are departments that don’t know where to put patients and others where 3 out of 4 beds remain empty…
«This is true and we need to rationalize by merging where it is necessary to do so. Because there are, for example, surgeries that perform just 10 stomach cancer operations or 30 colon cancer operations and with those numbers the patient’s life is also put in danger. But the numbers say that there are no beds. We have 314 per 100 thousand inhabitants compared to 800 in France, 590 in France, 700 in Hungary and Romania. And if there is a lack of beds in the ward, patients requiring hospitalization spend days in the emergency room, thus risking worsening their condition, as many studies have already shown. Having cut beds and departments also encouraged a great escape of doctors.”
As?
«Limiting their possibility of making a career because even the primary positions have consequently been reduced. If we add to this the grueling working conditions and low salaries, the exodus is explained. Which we stop by paying our health professionals better and improving their working conditions. Difficult, but there are no other recipes.”
Tags: oncologist Francesco Cognetti Minimum care guaranteed Regions doctors run
