End of the use of generic terms that in some way legitimized exceptions to the contract; yes to timetables linked to the achievement of objectives proportionate to the size of the workforce; appealability of local health authority measures and hospitals that do not apply rules such as those on compulsory rest periods. The healthcare management contract signed early this year for the three-year period 2019-2021 seemed to have put an end to abuses on the workloads of hospital doctors, healthcare managers and managers of nursing professions. Today doctors can boast contractual regulations consistent with the provisions of the law. But this is not enough. Even today, many structures along the Peninsula continue to impose heavy hourly excesses compared to the limits set by the contract and deny remuneration and recovery of those hours. The discomfort continues to grow in the wards. The majority trade union Anaao Assomed has underlined in recent months how to regulate such difficult matters it is necessary to start from the daily activity of doctors in the contexts in which they operate, and draw a synthesis in the negotiations for regional agreements. On the topic of timetables at the Ospedale dell’Angelo in Mestre, the head of contractual policies of the acronym Giuseppe Montante and the General Director of Human Resources of the Veneto Region Claudio Costa, together with Professor Vito Sandro Leccese, labor law expert from the University of Bari, discussed. Luca Barutta, Secretary of Anaao Veneto, explains the background: «The 2019-2021 contract has brought about a paradigm shift in terms of working hours. No more unlimited attendance, space must be left for the worker’s daily life time, the time spent at home, with the family. With Covid-19 we had reached annual surpluses with single cases exceeding a thousand hours.”
In 2022, 18 million hours of unrecovered and unpaid overtime were totaled nationwide. In a recent survey, Anaao Assomed finds that 87% of doctors and healthcare managers are unable to have a satisfactory personal life, and 96.5% believe they are subjected to excessive loads. Result: 72% of those interviewed thought about leaving their current job in the National Health Service to move abroad, or about switching to General Medicine or going to work in the private sector. «The new contract helps us – explains Barutta because it imposes a ceiling on the hours to be allocated to achieving the objectives. The hours exceeding the agreed limit must be recovered. This change, however, creates application difficulties, often due to habits that are difficult to eradicate. We are still in a phase where the new benefits are not visible.” That annual hourly surplus of 150-250 hours reported by 40% of hospital doctors, those public holidays worked which are not recovered in one case out of two, weigh on the doctor’s daily life, even if in some regions they begin to weigh a little less . «Veneto, in agreement with the health management unions, is creating a synthesis to overcome the rigidities. The discussion with the unions has laid the foundations for resolving the problem. In agreement with the Region, we have created a handbook with guidelines for companies both on how to prepare the management of timetables in the departments and on how to manage work plans, preferably with an IT tool, a sine qua non for making the system work. Aimed at changing incorrect habits undertaken for years, in our opinion the document goes in the right direction. But now it must be applied. And not only in Veneto.” Among other things, there are problems to be resolved on the table of the regional administration. «For example, says Barutta, the change wanted by the Region which goes in the direction of the computerization of the hospital management system is currently creating difficulties. The data entry activity of us doctors also takes time and everyone’s schedules expand. It is necessary to collaborate so that the system is at the service of the operator (and the patient) and not vice versa.”
