Tramparulo (FP Cgil): “The agreement satisfies us in moderation, it is a starting point, with which the tariff is standardized at a regional level. But the solution to reducing waiting lists is to hire more staff”
June 3 2024 – “The regional agreement on the additional services of health professions satisfies us moderately”. Thus begins the interview with Lello Tramparulo, secretary of the FP Cgil Lombardia, on the minutes of discussion between the General Directorate for Regional Welfare and the trade union organizations of the public health sector signed on 22 May.
Why this moderation?
“To reduce waiting lists and speed up exams, visits and interventions, we are being asked to give even more, to work extra hours for workers who are already exhausted due to the chronic shortage of staff and who already have very intense work rhythms , missed rest periods, holidays that accumulate without being able to enjoy them. The problem cannot be solved this way but with hiring linked to the needs of each healthcare facility -, replies the trade unionist -. Since, on additional services, the national contract delegates the comparison of the guidelines at a regional level, we exploited this possibility to achieve one of our objectives: until 22 May these services were managed in an uneven manner across the territory, especially regarding the tariff system. Of course, this agreement is a first start and improvement elements will have to be added but we have given support at the national level, given that the regulation of these activities is also included in the document of direction for the contractual renewal with Aran”.
How many resources are reserved for this match?
“A clarification must be made – warns Tramparulo -. Overall, according to regional data, in Lombardy we have an allocation on additional services of around 40 million euros (including IRAP and social contributions) which is divided into three parts. The first is dedicated exclusively to waiting lists, for approximately 24 million and 900 thousand euros. The second concerns this agreement, with the approximately 13 million and 400 thousand euros allocated to our region by the 2024 budget law to deal with the staff shortage, the reduction of waiting lists and the internalization processes and already given, in December 2023, to the Asst. The third part is dedicated to reducing waiting lists in emergency rooms and is worth around 857 thousand euros”.
What are the general principles of the agreement?
“Meanwhile, the agreement is valid for 2024 and it is worth highlighting this. Additional services are exceptional services, provided on a voluntary basis, outside working hours and must comply with current legislation regarding rest periods”, replies the secretary.
Which staff are affected?
“Workers in the health professions of nursing, midwives, health technicians, rehabilitation and prevention. You must have passed the probationary period and have a full-time employment relationship. And then not having medically certified limitations due to the extra hours you have to work. Obviously the institutions foreseen by the national contract must be guaranteed first: any overtime work, ready availability, not having an hourly debt on the overall balance recorded in the previous month”.
Meaning what?
“If I perform an additional service in May, to evaluate my hourly debt/credit I will not look at what happened in the previous month but will add up all the months, from January to May”.
When can’t additional services be performed?
“For example during days of daily leave, holidays, recovery hours, strikes. Or in case of precautionary suspension.”
What are the organizational methods?
“Here I underline that so far the additional services have not been managed with the utmost transparency, while the agreement now establishes that in order to collect available staff, a call must be made, indicating the profiles, sectors and offices where they are necessary to do them and the workers decide voluntarily whether to join them or not. As FP Cgil we will monitor these calls – assures Tramparulo -. And we will be careful of the fact that companies will have to evaluate employee requirements also taking into account the rotation criterion: additional services must not always be carried out by the same ones”.
Compared to tariffs?
“This is another important goal. From 22 May 2024 there will no longer be differentiated tariffs. For the year 2024, each company raises the rate to 50 euros for each additional service (equal to a minimum of one hour of work while the overall duration is governed by legislation). We will monitor what happens at company level and demand to know how these economic resources will be allocated. If the conditions are right – continues Tramparulo – for 2025 we will ask to bring them to 60 euros, which is the maximum foreseen by the law (this is an intervention that the government is making for the three-year period 2024-2026). However, we will review the tariff year on year.”
Why do you want to know the distribution of funding?
“Because it doesn’t convince us. The Lombardy Region has reconstructed the history of each social health company and has distributed the resources on that basis and not with an analysis of the needs of that territory, from turnover and resignation rates to the status of competitions. So if some company has never asked for anything, perhaps it takes very few resources. This is why it is right that this agreement is annual and not three-yearly”.
Let’s get back to monitoring.
“It must be done, I repeat, at company level and within two months of signing this agreement. For the first time, as trade unions, we will be able to have a more active role in terms of additional services. Monitoring will also take place at a regional level, after the presentation of the quarterly income statement, with the reporting of the resources spent”.
Other?
“Yes, I would like to mention two other issues. The first. The law does not provide additional services for OSS, social and healthcare workers, nor for other professional figures other than healthcare professionals. We asked for the involvement of trade union organizations and RSUs to start a possible negotiation at company level for the valorisation of the OSS and other figures using resources from the fund – says Tramparulo -. The second. In Lombardy we have the ASP, the personal service companies, which apply the public health contract but are not recipients of the resources provided by the budget law (213/2023). We here have made a request, with a reference also to the Department of Family, Social Solidarity, Disability and Equal Opportunities, that ASP staff can also be involved in this agreement”.
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