We have received and published the note sent by CGIL, CISL and UIL on the tender for the assignment of management of welfare, therapeutic, rehabilitation and social rehabilitation services for psychiatric users in residential and semi-residential facilities in the Basilicata Region
A dangerous competition for the future of mental health care in Basilicata is that for the assignment of the management of welfare, therapeutic, rehabilitation and social rehabilitation services for psychiatric users in residential and semi-residential facilities in the Basilicata Region. Because restoring the centrality of mental health means guaranteeing the centrality of the public service, always starting from the uniqueness and complexity of the person with mental disorders and their citizenship rights.
We raise the alarm about a tender, currently underway, which is drawing an unacceptable reverse with respect to a path of advancement towards the discipline of accreditation of the structures operating in the sector.
A tender, worth approximately 100 million euros, on four lots, depending on the type of structures (residential or semi-residential) and the intensity of the assistance, which risks, in our opinion, throwing away the entire experience of social cooperation on mental distress, opening the way to the giants of maximum discount. The open procedure for the assignment of the management of psychiatric services effectively stops, with an improvident post-election timing, the implementation process of the Ministerial Decree of 19 December 22 towards an accreditation system for health and social-health facilities in our region, which also was bound, with a resolution of January 2024, to update the accreditation requirements in force in the regional regulation for health and social-health facilities, adapting them to the new provisions of Legislative Decree no. 502 of 1992 as well as the criteria for issuing new accreditations.
In the continuing absence of social and health planning, the Basilicata Region produces extemporaneous initiatives, forgetting that mental health escapes a performance and profit logic. The tender, in fact, requires abnormal economic requirements compared to the participation of a single medium or small sized company, such as those currently operating in the sector, given that a single operator should be awarded the entire single lot. Which, despite formally respecting the relevant regulations, could actually result in a substantial damage to the principles and rules protecting competition and the free market. Another peculiarity is the request that the owned structures, naturally compliant with the structural requirements established by regional regulations, are already equipped with the relevant authorizations; an impossible mission for a single operator to equip himself in such a short time with all the structures provided for in the individual lots, unless he already has them! Not to mention a gross error regarding the staff: in addition to the number of hours not being correctly indicated, the tender contains a generic reference to the workers’ contract to be applied, the CCNL for healthcare personnel. Which? The Aris Aiop healthcare contract? We remind you, among other things, that the CCNL currently applied is that of social cooperatives, recently renewed, while the average hourly cost indicated in the tender specifications does not absolutely comply with the tables of the recently signed CCNL.
A competition conceived in this way risks favoring some giants in an opaque market, very distant from the reality on which mental health in our region is based. This is demonstrated by the very identification of the structures being entrusted, which raises more than a few questions about its adequacy to the real mental health needs in our territory, where we register a general lack of structures compared to the national average (1.9 structures per 100 thousand inhabitants , below the national average which is 2.2 structures) mainly relating to semi-residential structures: 1.7 per 10,000 inhabitants compared to 2.8 nationally. Without local medicine, and even more so that linked to the mental distress supply chain, Basilicata risks losing the 40 years of experience gained with the services of law 180. The Region should withdraw the tender notice and resume the process of equipping also this territory of a discipline for the accreditation of structures to guarantee the continuity of work and assistance while maintaining quality standards of services that guarantee concrete responses in the territories and removing the regressive temptation of possible forms of neo-institutionalization.
The General Secretaries FP CGIL – CISL FP – UIL FPL, Scarano – Faraone – Guglielmi
