The Minister of Health Orazio Schillaci is carrying out a decree to cut waste in the National health system and to rationalize resources in response to both the lack of doctors and nurses in Italian hospitals and the arrival of differentiated autonomy, which will be discussed in parliament next week and which will introduce new minimum levels of assistance.
In the upcoming decree, so-called unnecessary prescriptions will also be targeted: prescriptions for tests and medicines made without an actual need and which would cost the national health system 10 billion a year. This is often the result of defensive medicinean increasingly widespread approach in Italy.
Unnecessary prescriptions: the effect on waiting lists and healthcare
The Ministry of Health is working on a decree that will overcome the problem of unnecessary prescriptions. Every year in Italy, several hospital and family doctors prescribe tests and medicines not necessary, which involve both an expense for the National Health System and an increase in the already long waiting lists. The reason this happens is the practice of defensive medicine.
Doctors, threatened by civil lawsuits and appeals from patients and their relatives, prefer to prescribe tests or treatments that are not medically necessary, but which prevent possible complaints. This way they avoid being accused of not doing enough for a patient in the event of adverse outcomes of a condition. The Court of Auditors has already clarified that sanctions cannot be applied to over-prescribing doctorstherefore the Government must find a solution other than the introduction of crimes or sanctions.
The ministry, to save the 10 billion a year that unnecessary prescriptions cause the doctor to spend National health system, is thinking of a system that involves widespread collection of data on the reasons for prescriptions and rigid standards in the guidelines for doctors who prescribe tests and therapies. In this way the regions will be able to easily detect problems relating to individual doctors who prescribe more than average.
Exceeding the spending limit
The reduction in unnecessary prescriptions could have a beneficial effect on waiting lists, one of the main problems of the Italian national health system. Despite this, however, the main cause of the prolonged times for administering a test remains the lack of staff from which most Italian hospitals suffer. One of the reasons for this staff shortage is the low salaries of doctors and nurses, blocked by spending cap.
The Government is trying to overcome this situation through various measures. The first, already approved, is the reform of the hiring of specialists, but the new decree should act directly on the hiring of professional doctors. The decree should move in this direction by gradually modifying the spending ceiling, even if the precise measure that will act in this context has not yet been anticipated.
More is known about another method for reducing waiting lists. The hospitals will be able to purchase services by self-employed doctors in the event of critical issues for certain tests or visits in which the waiting lists had become excessively long.
