A few years ago amulti-pillar healthcare financing modelhighlighting onegrowing hybridization of the NHS. Unfortunately, this development has not been governed, while it appears necessary to regulate the process on the regulatory and organizational levels, ensuring adequate monitoring and supervision. First of all, there is a need for greater transparency and the working group requests the permanent national observatory of supplementary health funds, established in 2022, to publish the data from the ongoing trial, before the model becomes effective in 2025. Among others proposals, it is requested to expand the financing and reimbursement function of services towards the subjects of the collective supplementary system, protecting the interests of the patients in a logic of continuity of care. Finally, it is necessaryimplement a model that improves the collection of information on public and private healthcare services through the electronic health record.
Create a National Health Research Agency
Onresearch and clinical trialsone of the proposals is to support the development of a national health research strategy and clinical trial governance with thecreation of a National Health Research Agency. By 2027, in fact, a strong growth in the number of new trials is expected, unfortunately due to constraints imposed by Italian legislation, especially regarding privacy, and a lack of national coordination, our countryrisks losing ground internationally. To Italy, according to the analysis of “Agenda Salute”, “we need careful political, organizational and economic choices”Why“without interventions, growth would be 5%, while with “soft” regulatory actions it could reach 15% and rise to 30% with structural interventions”.
Health data and privacy
To promote preventive medicine, it is necessary to access the information collected in clinical assistance activities and that held by the NHS and SSR, but today there are serious delays due to the rigidity of the application of the GDPR. It is important, then,support the Bill, presented to the Senate in 2024, which regulates the management of health datawith an innovative modality (sandbox), borrowed from the financial sector, which allows the limits placed on the use of health data by DPOs to be addressed in a protected and secure environment.
Health professions of the future
I am currently in Italy30 healthcare professions recognisedand the volume ofprofessionals involvedwhich operate in both public and private facilities, is approximately1,500,000 units.For the future, for example, it is expected that among the most requested professions – not yet recognized – there will be the deep learning expert (algorithm trainer), the lifestyle strategist, the telesurgeon, the bioprinting expert (synthetic organs), the virtual reality therapist (mental health), healthcare data analyst (big data). Among those already recognised, however, the professional nurse, medical technologist and home health assistant are expected to be in greater demand.
In order to adopt adequately reliable predictive logics and support coherent development of the professional figures that will be most in demand, it is necessary to provide areform of specialist training and qualifying three-year degrees and the establishment of an inter-ministerial tablewhich deals with monitoring and identifies training trends useful in the short, medium and long term and explains them in university training offers and ECM courses.
Health strategies and energy transition
The impact of climate change on human health is now well established and the healthcare sector is responsible for an average of 4.4% of global CO2 emissions. The EU is the third largest producer after the United States and China, and Italy is among those countries whose healthcare sector produces emissions slightly above average, with 4% of total national emissions.
It is necessary, therefore,rethink the organizational and cultural aspect of hospital structures,for example,by including hospitals in the lists of energy-intensive and gas-intensive companiesAndestablishing a permanent tablewith the relevant ministries (Environment, Health, Simplification), the regional representatives and hospital associations, to simplify the existing legislation, providing for the establishment of acorporate green teamand the adoption of aannual plan of environmental policiesthat promotes the use of renewable energy.
“The priority is to guarantee quality healthcare and bridge the territorial disparities present in our country. This means intervening on the accessibility of healthcare services, enhancing local and community medicine and home care”.The President of The Bridge Foundation said it,Rosaria Iardino (pictured)who reiterated the urgency of “reform the National Health Service, with adequate services to address critical issues such as the fragmentation of access to services, the weakness of socio-health integration, waiting lists. In this perspective, we have developed a document centered on five specific themes with various proposals for health policies to be implemented, a Health Agenda that we ask you to sign in order to involve the institutions in a broad, shared and participatory way.“.
SecondAlessandro VenturiProfessor of Administrative Law and Regional and Local Government Law at the Department of Political and Social Sciences of the University of Pavia, Alma Ticinensis:“The themes present in the Health Agenda are revolutionary and fundamental for the future of the NHS. Supplementary healthcare is among the most important points. We have been reading for some time that private spending on healthcare in Italy has increased, but this is not true. On the contrary, of the 42 billion that are often cited, given that they are estimates and no one really knows how much private healthcare spending amounts to, in reality only 17 are real healthcare spending, that is, that which is not replaced by the NHS. A physiological expense billion, then, we have 4 which are already intermediated by mutual or insurance funds, so they are reduced to 13 billion. So, with the first point of the Health Agenda, that is, to speak openly about integrative healthcare outside of any ideology. imagine a system that reduces spending from one’s portfolio as much as possible, pure out-of-pocket spending, while spending intermediated by insurance and mutual funds should increase. In a context, however, where the NHS with its 136 billion in spending still covers it the prevailing needs of all Italian citizens”.
ForAldo Bruno GianniFull Professor of Maxillofacial Surgery and President of the Management Committee of the Faculty of Medicine and Surgery, University of Milan:“The University of Milan has decided to be among the promoters of this initiative, which concerns the proposal for a fair, sustainable and participatory healthcare reform, because we think that the concept of the modern Academy is no longer that of the past, separated from the territory, but it is an Academy that must be an active part of important changes. We have provided our proposals in the training field and on the skills of the healthcare professions of the future, also in consideration of the great changes taking place in the population, think of aging and chronic conditions. , but also to all the technology that changes the way of approaching these problems. The Academy, therefore, and in particular our University, actively participates in the healthcare transformation processes that can change the way we deal with health.“.
