The very bumpy path of what was technically the Council’s bill for covering the deficit resulting from the fourth quarter, however, leaves doubts and suspicion on the table and the risk that the day of reckoning (tax cuts, real ones, or increases) will be postponed.
Thanks to the opposition at the opening of the session by the president of the Budget Commission, Vincenzo D’Incecco, it was not formal, because the contribution of the minorities was there, although combined with the final vote against. The negative opinion of the Board of Auditors (“counter-deduced” by the technical structure during the morning Commission) had in fact complicated the majority’s plans, falling on a procedure that every attempt was made to present it as technical, bureaucratic: nothing more than a boring but necessary step, a neutral round of budget items, as part of the dialogue with the Monitoring Table, and if there was urgency it was due to the times imposed by the technical body. Faced with the unfavorable opinion, the Prime Minister Lorenzo Sighs late on Wednesday afternoon he prepared the ground for the involvement of minorities in a note, placing responsibility on the managers of the local health authorities and meeting the requests of the Pact for Abruzzo. The amendment of the leader of the Democratic Party Silvio Paolucci has become a shared agenda: the possibility of the Council, after consulting the Budget and Health Commissions, to place local health authorities under commissionership. The green light is also given to an amendment that is also shared which gives the same commissions the task of expressing a binding and obligatory opinion on the rationalization plans of healthcare companies, although the regional government (therefore defeated in this case) has asked to make it consultative. “The Regional Council no longer intends to act as a simple paper-passer of processes that we have not had the opportunity to evaluate from the beginning,” Sospiri had said, precisely.
For the President of the Council Marcus Marsilio “Abruzzo’s healthcare system pays for the administration from which we have not yet emerged, it is no coincidence that the coverage measures that we attempted to negotiate were partly not usable and there are still obligations to be carried out. The health difficulties in our region arise from here, ten years of policies have accumulated that have produced poor infrastructure and technology and a lack of staff.” Marsilio wanted to reduce the scope of the “hole”: “Less than seventy million out of 13,500 managed by the Health Fund in recent years. It is a percentage less than 0.5 percent. I believe that having kept all the facilities open, having bought new and modern diagnostic equipment, having therefore guaranteed widespread healthcare throughout the region and hired thousands of people, covering many deficiencies that existed in the Abruzzo local health authorities, is worth having had a small price to pay pay, move the balance by half a point. It was more important than closing the facilities and keeping the precariat inside the hospitals.” Defense of the Meloni government: “It has increased resources”, anticipation of the strengthening of AreaCom in terms of resource optimization, invitation to the Health Commission to discuss the hypothesis of a single local health authority.
The Health Councilor spoke in the Chamber Nicoletta Verì he admitted, however, between the lines, the existence of non-episodic issues: “It is a particular moment, a new legislature is opening, we have the opportunity to carry out checks and build bases to create strengths. The deficit is not just a problem for Abruzzo, it is common to fifteen regions. In previous years we have always responded to this problem by allocating funds of different types. This time we had the possibility of covering it with tied economies, there were negotiations with the ministerial table which only met on May 6th. The deficit derives from Covid, some greater costs have become structural, such as personnel, new equipment, energy. The truth is that our problem was political, we chose not to close the small hospital facilities that create services for a heterogeneous territory. Monitoring is underway, we will have tools to verify efficiency, the reorganization and remodulation of the system is underway”.
The opposition can claim, as Paolucci said, that the Council – Commission – Chamber path has brought out, as never before, that Abruzzo’s healthcare system has fundamental problems, and they are structural: “In the near future we will be forced to make very demanding budget choices and many other challenging healthcare model choices.” Article 2 is exemplary for Paolucci, which imposes recovery plans on the four healthcare companies within thirty days: “When a regional government and a majority reach this point it means that the spotlight is turning on 2024, and that if there were further passive there would be no more resources to deal with them. It’s a significant wake-up call that could translate into tax cuts and increases.” The card of going fishing from the provisions has in fact already been played, and also for the years to come. “The cut on provisions is a decoy, subsequently there will be the cut on appropriations,” said the leader of the Democratic Party.
For the Budget Councilor Mario Quaglieri the choice was between “increasing taxes as much as possible or reducing expenses, we chose the latter path. We have focused our attention on budget items that do not require immediate commitment, i.e. the forms of provisions. Then we will make targeted cuts in the adjustment.”
Luciano D’Amico he underlined: “Until last March you told us about a very efficient healthcare system, with good prospects. The councilor instead explained to us that the deficit is structural but she proposes coverage that is largely non-renewable: it is taken from provisions and it is difficult to imagine that the procedure can be replicated. Since we have a structural problem we want to know programs and projects to identify the causes and remedy them. We would also like the costs to be linked to the results.” Final sting to Quaglieri: if the deficit was already known in December, why wasn’t the economic maneuver at the end of the year as prudent as needed? An example of imprudence is the resources allocated for initiatives and subjects located in Trasacco, home of the budget councilor.
In the Budget Commission, the CGIL presented a memorandum in which it asked not to penalize precarious workers, as part of the rationalization plans of the local health authorities.
After the Council meeting, a Council meeting is held which completes the process, also linked to the negative opinion of the auditors. Marsilio said: “The auditors expressed an opinion that our budget service strongly countered. They believe this opinion is wrong on the merits also because the objection that is advanced, regarding the lack of an act, does not highlight that this act must be approved by the council immediately after the approval of the law itself. The Council is to approve this budget change immediately after the conclusion of the Council”.
