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‘Emilia Romagna will put an end to the use of coin-operated doctors for emergencies within this year’ This was announced a year ago by the regional health councilor, Raffaele Donini, responding to a question in the legislative assembly. Commitment reiterated by the same Councilor in the Modena session of the Territorial Social and Health Conference on the occasion of the presentation of the regional emergency reform.
Together with Councilor Donini, to criticize and question the effectiveness of the use of external private cooperatives to cover shifts in the Emergency Department (in the province of Modena, particularly used in the northern area for emergency emergencies and obstetrics of hospitals of Carpi and Mirandola), were the same managers of the healthcare companies.
The critical issues in the organization of external and internal doctors within the structures, in addition to the important costs (approximately 1300 euros per shift), were also included among the elements underlying the request, made by the regional technical health commission, not to extend beyond the 31 December 2022, the opening, by way of derogation, of the birth center in Mirandola.
Recommendations, commitments and promises include the rapid cessation of the use of private entities to cover costs
In the Bill Decree, the Minister of Health Orazio Schillaci intervened to discourage the use of token operators, inserting limits on outsourcing during the year and on the recruitment of professionals leaving the health service. “Outsourcing is a distortion of the system – declared Donini – in Emilia Romagna we have made moderate use of it, but it is our intention to stop this practice by 2023”.
The shortage of staff at the Mirandola hospital continues: new contract to external private cooperatives
The shortage of medical personnel serving in the obstetrics and emergency departments of the Mirandola and Carpi hospitals continues, albeit to a lesser extent but still significant, and the use of the services of external private cooperatives by the Modena Local Health Authority continues. , to make up for the lack of internal staff.
This despite the critical issues that emerged from the analyzes of the health and hospital managers themselves who have repeatedly highlighted how the use of private cooperatives, in addition to costing the public coffers much more than the use of internal staff, presents strong limitations in terms of organization and efficiency of work groups. External assignments, we remember, were among the critical issues with which in October 2022 the regional health commission justified the indication not to extend the opening of the birth center in Mirandola beyond 31 December 2022. Closed in December of the same year.
The use of external cooperatives to cover shifts in the emergency room and in obstetrics in the Mirandola and Carpi hospitals, at a cost of around 1300 euros per shift, widely used in the last two years, seemed to be coming to an end. The regional health councilor had also underlined the need to limit the use of this type of assignment to the point of exhaustion. It didn’t happen and it won’t go that way. The contracts stipulated with the two cooperatives for the supply of emergency operating units and gynecology and obstetrics departments in the aforementioned hospitals, already renewed until 31 January 2024, have been extended to 29 May 2024, using that 50% granted by law and enshrined in contracts. But not only. In view of the expiry of those contracts, rather than blocking the use of external cooperatives, the Modena Local Health Authority has decided to put the services out for a further 12 months for a total amount of 807,000 euros (excluding VAT) for the emergency department emergency in the northern area, and therefore for the hospitals of Carpi and Mirandola, and for 188,000 euros for the Obstetrics and Gynecology Operating Unit. But the expenditure does not stop here, because to give continuity to the service itself, pending the completion of the new tender procedures for the awarding of services to private individuals, from the deadline of 29 May, the Local Health Authority has allocated 554,000 euros excluding VAT for the emergency emergency and 334,000 for gynecology and obstetrics at the Carpi hospital to cover the service until October 2024.
an estimated total need of 52 shifts and 7 on-calls on base
4 week monthly,
.
Court of Auditors: The use of external cooperatives is a critical element in the budget of the Modena Local Health Authority
“The repeated use of shift doctors from cooperatives undermines the rational and systemic organization processes of the staff”
This is one of the aspects identified by the Court of Auditors when examining the 2022 budget of the Modena Local Health Authority. ‘In particular – writes the Court of Auditors according to what was reported by Ansa – a series of significant problems were highlighted, such as the significant deviation of the operating result compared to the budget estimate, and the partial coverage of Covid costs which were only partially compensated with state resources received for the health emergency. The ASL’s response was not long in coming.
“With regards to the use of shift doctors from cooperatives, the Company has already implemented important efforts aimed at progressively overcoming the use of this form of acquisition of services with a reduction, to date, of 60% compared to 2022” – explains the Local Health Authority. As regards the economic aspects, the extent of the deviation of the operating result compared to the estimated economic budget has been agreed with the regional level. Regarding exceeding the debt limit, the Court of Auditors itself confirms that at the time of taking out the loan the Company respected the limits set for debt”.
“The section of the Court therefore ordered that the company comply with the indications given and invited the Region to exercise its supervisory powers” - closes Ansa.
