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If the treatments are not provided within the scheduled time (within 72 hours for the most urgent up to 120 days for the programmable ones) the local health authorities will have to guarantee the citizen a sort of “row cut” passepartout ensuring the service intramoenia (freelance profession in hospital) or through an accredited private individual with agreed rates. This is perhaps the most important measure for citizens contained in the plan to reduce waiting lists that the Minister of Health has worked on Orazio Schillaci and on which the prime minister Giorgia Meloni they want to play the last remnant of the electoral campaign.
The push and pull with the Mef for the resources counted
There has been a back and forth over the plan for a month with the Mef which has raised a wall on the resources available, so much so that the landing in the Council of Ministers will come through an unpacking: a decree of 7 articles – here the measure is at stake ” cut the line” – and, this is the news, a bill of 14 articles to be approved in a longer time with the measures for which coverage will have to be found (from tax relief on overtime to bonuses and sanctions for hospital managers) . «We want that if a citizen has to have a test, a CT scan, for example, within 72 hours, it will be paid for by the Health Service. it would be truly epochal”, underlined Schillaci yesterday. While the Regions with the coordinator of the Health councilors Raffaele Donini they protest: “We were not involved, let’s start again by working together on the measures.” The last knots will be resolved with the first green light for this package of measures, starting with the “voucher” which according to estimates by health technicians could have an impact of over a billion: Schillaci aims to immediately include it in the mini-DL also because it will in any case a ministerial decree will define the modalities within 60 days.
Weekend visits and exams and unique regional Cups
Also in the decree law it is foreseen that visits and exams will also be carried out on Saturdays and Sundays and other measures are introduced (these at zero cost) starting with the activation of the national platform at Agenas to monitor the waiting lists performance by performance in real time. An Inspectorate will also be created at the Ministry of Health which will monitor the correctness of the management of the lists, indicating possible sanctions and with its staff who will have “administrative police and judicial police functions”, being able to make use of the Guardia di Finanza and Nas. The obligation is triggered to create a single regional or intra-regional Cup “with all the services available” from the public and private sectors (which today only partially happens). Private individuals who fail to do so will have their contract cancelled, while it becomes a requirement to obtain accreditation for those who do not yet have it. Also in the legislative decree, in addition to the more stringent checks on the abuse of intramoenia by doctors who must not “exceed ordinary activity”, should include – but here too there are the latest discussions with the MEF – the exceeding of the spending ceiling on hiring of doctors and nurses: in 2024 it will grow by 15% of the increase in the Health Fund, while from 2025 it will be replaced by standard needs. The spending ceilings for the purchase of services from affiliated private individuals will be adjusted (again with the MEF permitting), after the increases already foreseen in the last budget.
The personnel measures in the bill
The bill will instead include the measures for which coverage will have to be found more calmly given the longer time needed to approve a law in Parliament: in particular these are interventions on personnel, such as the 15% flat tax on overtime staff (today taxes for doctors are at 43%) or the increase in the hourly rate (100 euros) for outpatient specialists up to assignments (10 hours a week) for specialists. Also in the Bill there will be bonuses (10% increase in performance pay) and sanctions (which go up to the revocation of the assignment) for managers of healthcare companies in the management of waiting lists, but also measures to cut unnecessary medical prescriptions for visits and tests that overwhelm the National Health Service.
