The regional health agency of Tuscany (ARS) at risk of closure or absorption by the health department: CUI PRODEST (who benefits?). ARS workers express their concern.
Following the hypothesis of the closure of the regional health agency or its absorption by the health department, circulated in the press in recent days, the ARS workers feel the need to speak up, showing concern for the potential consequences of this decision, which could cause damage to the efficiency, effectiveness and independence of health assessments in Tuscany. With this press release we intend to list the critical issues resulting from a hypothetical reabsorption of our agency by the regional administration and highlight what we consider to be possible opportunities for a strengthening and definitive relaunch of our institution, accompanied by some numbers.
THE ROLE OF THE ARS IN THE REGIONAL PANORAMA
The ARS is a technical-operational and study tool for both the regional council and council and offers support to the Tuscan clinical governance body. By its institutional nature it has a third and autonomous role: the Agency carries out almost 300 activities annually to carry out assessments on the state of health of Tuscan citizens.
ON THE QUALITY OF HEALTH SERVICES AND THE OUTCOMES OF TREATMENT.
Its impartiality is a clear element of strength, as underlined in many recent interventions by professionals from the healthcare and research world, who spontaneously took a stand in support of the agency and whom we take this opportunity to thank.
The results of the agency’s activities – from the monitoring and evaluation of territorial and prevention activities to hospital ones, to the monitoring of antibiotic resistance, to studies on the environment and health, research on inequalities, equity and inclusion, pregnancy and childbirth, chronic diseases and infectious diseases, monitoring of healthy longevity and aging of the population, pharmacoepidemiology just to name a few – are made available to those involved in service planning, political decision makers and citizens according to the FAIR principles (findable, accessible, interoperable, reusable data), which characterize the European Open Science model.
Made public on the institutional website (www.ars.toscana.it), on the Agency’s social channels and through dedicated publications, the data produced and the results of the research are consulted on average every year by tens of thousands of users through communication tools built and self-managed by ARS staff: a virtuous model of transparency and use not only for the other Regions, but also at a national and international level.
WHY THE ARS SHOULD NOT BE CLOSED, BUT ITS RELAUNCH IS NECESSARY ALSO TO PROTECT THE HEALTH OF CITIZENS
In these years of activity, the ARS has best interpreted its role as a third party in the evaluation of critical situations in the regional territory. We recall just a few examples of the Agency’s intervention in the environment and health field: the study on the effects on the health of populations living near polluted sites in the Tuscan territory (Livorno, Collesalvetti, Massa, Orbetello); the assessments of the effects on the health of the population of the electromagnetic fields generated by new 5G plants, of the geothermal plants on the Amiata, of the presence of Thallium in the Pietrasanta aqueduct, of the Chimet plant in Arezzo, of the new runway at Florence Airport; consultancy to municipalities and local authorities for continuous emerging local critical issues (around 15 in 10 years).
WITHOUT THE WORK OF THE AGENCY IT WILL BE DIFFICULT TO OBTAIN INDEPENDENT ASSESSMENTS IN STUDIES ON THE POSSIBLE EFFECTS ON THE HEALTH OF CITIZENS.
In over 20 years of activity, the ARS has also built a scientific database that produces health, social-health and economic indicators of the highest level. Many data are freely accessible on our portal https://www.ars.toscana.it/banche-dati/ which contains historical data relating to various aspects of Tuscan healthcare, valuable information for both clinicians and political decision makers.
THE SPLITTING OF SUCH SKILLS WITHIN THE HEALTH DEPARTMENT OF THE TUSCANY REGION WOULD VOID THE MISSION THAT ARS HAS CARRIED OUT SINCE ITS FOUNDATION: TO PROVIDE INDEPENDENT, SCIENTIFICALLY SOLID AND ACCESSIBLE DATA TO EVERYONE.
In the last 10 years alone, the ARS has also provided its technical and methodological expertise in over 140 study and research projects at national and international level on key issues for regional health policies, for a total of almost 9 million euros of revenues (with 38 projects currently underway, with an economic value of approximately 3 million euros). By establishing a wide network of scientific collaborations and strengthening its presence in the research panorama, the ARS, thanks to its project activity, has been able to virtuously integrate its economic income, despite a progressive reduction in regional funding, and fully fulfill its mission.
Also thanks to the funds from the tenders won at international and national level, the ARS – in synergy with universities, university hospital companies and with the entire regional higher education system – contributes to completing the training of many young professionals. In the last 10 years, the Agency has provided: 85 freelance assignments, 85 training internships, 72 scholarships for young graduates and 27 fixed-term contracts.
The wide network of scientific collaborations established and the growing presence in the research panorama have also guaranteed the agency different economic revenues, different from regional funding, which have allowed it over the last 10 years to contribute to the reduction of public spending, returning to the budget regional approximately 445 thousand euros in total.
We were able to achieve these results also because the ARS, since its establishment, has been an autonomous and third-party agency, which has been able to fully express its potential also thanks to the streamlined synergy of its various components: the administrative function, which is characterized by the its agility and speed in carrying out procedures; the documentation center, which inspired and currently coordinates the regional library system in the health field; the technical structures, which acquire, engineer the data flows and “certify” their quality; the communication sector, which through the various on and off-line tools, entirely self-managed, contributes effectively and efficiently to the maximum dissemination of results; the training sector, which every year on behalf of the Agency (ECM provider) offers a wide range of free training events for professionals in the healthcare world. And obviously the research observatories, the fulcrum of the ARS, which finalize its mission.
A dismemberment of the ARS, for reabsorption within the department, would mean distorting its distinctive essence, which has always constituted an added value for the regional system. The question that workers are asking themselves in this moment of great uncertainty about the fate of the Agency is therefore this: WHICH PRODEST?
The workers of the Tuscany regional health agency
