To save the national health service we need to intervene immediately with a structural reform. In fact, the resources allocated so far are not enough. The Regions are in difficulty. And care is not equally accessible to everyone everywhere. This is why the 75 Scientific Societies gathered in FoSSc (Forum of the Scientific Societies of Italian Hospital and University Clinicians) yesterday in Rome launched an appeal to the government to strengthen the hospitals and allocate other resources before it is too late. After years of “irresponsible cuts” to healthcare, a real change of direction is now needed: in 2024, the financing of the National Health Fund stands at only 6.4% of GDP, and a further decrease is estimated at 6.3% in 2025 and 2026, until it drops to 6.2% in 2027. And the comparison with other European countries is not comforting: «From 2012 to 2021 – specifies Francesco Cognetti, coordinator of the Forum – the increase for Italy is was only 6.4%, compared to 33% in Germany, 24.7% in France and 21.2% in Spain”.
THE REPORT
For patients who need treatment it essentially means risking not finding a free place in the departments and having to wait for days on a stretcher in the emergency room (so-called boarding). And the reason has been known for some time: there are at least 100 thousand ordinary hospital beds missing and 12 thousand intensive care beds. In ten years, then, some facilities (9 percent, or 95 in total) have even closed their doors, going from 1,091 in 2012 to 996 in 2022, thus forcing patients to travel further. To complicate the matter, there is also the shortage of healthcare personnel: by 2025, 29 thousand white coats will retire. 21 thousand nurses will also leave: already in the emergency rooms there is only one for every 25 patients.
THE RISKS
And if it is true that the Pnrr plans to reserve 8.3% of the funds provided for healthcare, on balance the resources allocated to hospitals are dedicated only for technological updating and scientific research, but for structural and staff or for the acquisition of new staff, the money must be looked for elsewhere. Then there is the chapter on the essential levels of assistance (Lea), i.e. the fundamental care that should always be ensured from North to South. Unfortunately, however, as Cognetti recalls, «12 out of 20 Regions do not guarantee not only totality, but not even the minimum sufficiency. In fact, the majority has values below the threshold in at least one of the three macro areas examined: prevention, local assistance and hospital”. And at this point, people either move to other regions or give up on treatment. It goes without saying that, due to a lack of resources, the introduction of the new LEAs – published in August 2023 – was postponed to 2025. And in the meantime, the Forum denounces, “the Regions should also shoulder the considerable burden of the new services”. With the consequence that “the poorest, in particular those subject to a repayment plan, cannot do so”. Furthermore, additional resources are also urgently needed to prevent the onset of diseases. The percentages of citizens who participate in oncological screening are approximately 40% for mammography and Pap tests or HPV tests and less than 30% for colorectal screening. Yet, the European Union calls for reaching the level of 90% membership for all three programs by 2025.
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