Diagnostic and specialist visits are also possible on Saturdays and Sundays, with the extension of the time slot for the provision of these services. Single regional or intra-regional booking system, with accredited private hospital and outpatient facilities that must belong to the Single Booking Center (CUP), under penalty of nullity of the contractual agreements for accreditation with the NHS. A ‘Recall’ system, activated by the Cup, to remind the patient of the date of provision of the service, to request confirmation or cancellation of reservations: in case of no-show and visit not cancelled, the patient can be held to pay the same. These are some of the measures envisaged in the draft law decree of the Minister of Health Orazio Schillaci for the reduction of waiting lists, approximately 25 articles, expected in the Council of Ministers on 3 June.
This, in summary, is the architecture of the provision. “To implement the effectiveness of coordination at a national level for the reduction and overcoming of waiting lists, with particular regard to the resolution of regional inequalities and the phenomenon of active and passive mobility – is underlined in the draft decree seen by Adnkronos Salute – at the Ministry of Health the ‘National waiting list management system’ is established (Singla), “what set of structures, tools and skills” are necessary. It will be governed by one Control Roomalso established at the Ministry of Health and chaired by the minister himself, who “supervises the development of the national government plan for waiting lists and supervises the implementation of the measures” established by the Legislative Decree.
With the National Waiting List Government Plan, the Ministry of Health defines specific guidelines aimed at the regions and to the autonomous provinces of Trento and Bolzano, “aimed at aligning the demand for healthcare, defining national standards of an organisational, technological and infrastructural nature, also relevant for the review and updating of care standards relating to hospital care and territorial”. Agenas will carry out national monitoring on compliance with the maximum waiting times for priority classes of services booked under the institutional regime and under the intra-moenia freelance regime.
And the National Waiting List Platform has been established at Agenas “aimed at achieving interoperability with the platforms for the waiting lists relating to each region and autonomous province”. Finally, the register of reports for failure to respect citizens’ rights has been established on the institutional website of the Ministry of Health.
Certain times for services and citizens’ charter of rights
The draft decree also provides for a charter of citizens’ rights for the provision of services that fall within the essential levels of assistance without the large funnel of waiting lists, setting the maximum times to be respected.
“For the purposes of providing health services falling within the essential levels of assistance – we read in article 1 of the text, which Adnkronos Salute has viewed – citizens have the right to access the waiting lists for the provision of health services , without incurring the suspension of reservations; to the effective provision of healthcare services within accredited public and private facilities; to compliance with the maximum waiting times for access to healthcare services; to clear, transparent and updated communication on times expected maximum waiting times and on the type of protection paths for taking charge of requests for which the Health Service is not able at the time of booking to offer the service within the guaranteed times, together with the definition of the methods of provision of the aforementioned services “.
The regions and autonomous provinces of Trento and Bolzano guarantee their patients the respect of these rights, both through the instruments defined by the Legislative Decree, and by implementing “every useful initiative to ensure their patients the effective provision of healthcare services within the of accredited public and private structures, to guarantee compliance with waiting times, to monitor and supervise the results achieved, providing, if not, suitable measures to be adopted towards the general managers of healthcare companies”. In the case of ‘blocked lists’, with the suspension of service booking activities, the expected sanctions are increased.
Increased spending cap for personnel
To reduce waiting lists, the spending ceiling for staff of companies and bodies of the National Health Service is increased at regional level, for the year 2024. The increase is “equal to 25% of the increase in the regional health fund compared to the previous year – we read in article 11 of the draft seen by Adnkronos Salute – Starting from 2025, the expenditure for the personnel of companies and NHS bodies, within the level of financing of the standard health needs to which the State contributes, is determined on the basis of the methodology for determining the staffing needs of the NHS”.
New squeeze for token operators with new contracts
To “counteract the phenomenon of the so-called ‘token operators’ and to reinternalise the health services entrusted to cooperatives, until 31 December 2026, the regions, the autonomous provinces of Trento and Bolzano and the bodies of the National Health Service can recruit personnel from the sector and medical and healthcare management as well as healthcare professions through forms of autonomous work, including coordinated and continuous collaboration, by way of derogation”.
To increase the number of visits and tests that can be carried out, the spending limits for the purchase of healthcare services from accredited private entities are being adjusted. Compared to what is foreseen by the budget law, the spending percentages are increased, from +1% to +2% for 2024, from +3% to +4% for 2025, from +4% to +5% from 2026 The life-saving services provided by the emergency rooms of accredited private hospitals are not subject to any spending limits.
Schillaci: “No one left behind”
“I believe that the government must ensure, and we will do so, with the provision on waiting lists, which citizens will finally be able to have the tests and treatments they need on time” and “that no one is left behind, especially in Naples, in the South”, stated the Minister of Health, Orazio Schillaci, on the sidelines of the Lilt event in Naples. When asked by reporters whether any particular measures were planned, he reported: “We are still working.”
