4.34pm – Saturday 27 April 2024
The Court of Auditors was not needed to understand that Trentino’s healthcare system is in extremely difficult conditions. Of course, the economic data also helps us to confirm what we have been saying for some time: the sea of healthcare is stormy – the difficulties are objective and not all attributable to the current management – but the Trentino boat has been without a captain for some time. The one who recently took the helm stalls and once again reiterates that many issues, such as the reopening of the Cavalese birth center, he inherited from the previous administration, as if he did not sit on the council and had not supported those measures. Too comfortable.
If now that he has the mandate to manage Trentino’s healthcare system, he decides to review some positions to return to governing it, Councilor Tonina should know that we are available for discussion, with proposals of merit to protect the health of citizens and to safeguard public healthcare, which is accessible and universalistic.
On some important issues that emerged from the Court of Auditors’ report, we want to reiterate our position once again.
Birth points. Unfortunately, the data confirms in an increasingly dramatic way the unsustainability of peripheral birth centers. Not only from an economic point of view (of course, also from that given that they cost four times more) but above all from the point of view of the service that can be guaranteed. What quality and safety do token doctors (who are now the majority) guarantee without continuity and inclusion in the organization? And the same also applies to the staff hired who progressively lose expertise due to seeing too few cases.
Even the councilor seems to have understood this when he says that it is the doctors themselves who recommend going to the main centers to give birth. To persist in not looking at reality and keeping birth centers open that don’t work 60% of the time is senseless, inappropriate and unsustainable. President Fugatti continues with the instrumental narration of the service for the valleys which must remain open at all costs. If this logic were followed then, why aren’t stroke units and cardiac intensive care units opened in every valley?! In healthcare, it is not possible to follow only a criterion of proximity, but it is necessary to guarantee the appropriateness of services, safety and quality of care, which depend on the case history.
For our valleys we need to invest, but in services that guarantee a better quality of life with respect to priority needs: in the healthcare sector in local services, in outpatient services for chronic conditions, in frequently used diagnostics, in emergency rooms capable of providing answers effective, with anesthetists 24 hours a day; more generally in timed public transport, in community cooperatives, in multi-services, in care of the territory.
Private growth. The increase in the share of health expenditure allocated by the Province to services and hospitalizations in accredited private facilities cannot be belittled as the councilor does by saying that it is a minimal share of the budget allocated to healthcare and that we are not Lombardy. If it is true that in our country the accredited private sector is far lower than that of other Regions, can the councilor explain to us why the ISTAT data processed by GIMBE describe our Province as the territory in which families spend more than in any other territory of the country in private health spending.
Evidently Trentino is no longer able to provide adequate answers through its SSP – including an accredited private individual – and people have to pay out of pocket for out-of-pocket services, which the SSP is no longer able to guarantee. If we do not return to adequately funding the public healthcare system, we will not be able to retain professionals and re-attract those who are in the private sector. And this determines direct costs for users which leads the weakest groups to give up treatment, a very serious thing that will have incalculable individual and social costs. And then we talk about investing in prevention…
Waiting lists. We have underlined it several times, now the Court of Auditors also reiterates it: the situation of the waiting lists is more serious than it appears, because numerous prescribed services escape the monitoring of the waiting lists, given that many people, faced with of eternal waiting turn directly to the private individual.
This is clearly seen from the record expenditure borne by Trentino families and from the considerable increase in income from intra-moenia freelance work. If on the one hand there is a lack of doctors in the public sector who should be re-attracted by the private sector, on the other hand it is first of all necessary to move services from intra moenia to the ordinary regime with salary increases for doctors, so as not to pass the costs on to the users, and Furthermore, there is a need to better manage waiting lists, something in which there is room for efficiency.
It’s time to make choices, Councilor Tonina, not to continue to procrastinate. Concrete actions are needed both on the issues just highlighted – investment in staff, containment of the private sector, management of waiting lists – and on investments in prevention, socio-health integration and reorganization of territorial and community assistance, starting from quantifying the personnel needs necessary to start community homes and hospitals and strengthen home care, something that APSS has not yet done. Well, perhaps the councilor should reflect on this…
*
Paolo Zanella
Council of the Autonomous Province of Trento (Democratic Party of Trentino)
 * TRENTINO HEALTH: “THE COURT OF AUDITORS WAS NOT NEEDED TO UNDERSTAND THAT THE SECTOR IS IN EXTREMELY DIFFICULT CONDITIONS”){kind=link}