Exams on the weekend and visits to private individuals with the ticket: what is in the decree on waiting lists (without money)

Seven articles for the decree law on waiting lists and 15 for the bill. But no money. And the doubt that the Meloni government’s move serves more than anything else for the European electoral campaign. Apart from the coverage for the reduction of doctors’ overtime taxation, which is worth 250 million. Together with the increase from 10 to 15% in the spending ceiling for personnel. But it was the measures for citizens that were most awaited. The most important is the one that allows you to access the accredited private sector, or even those without an agreement, when the waiting times are longer than the law. But “at the current national rate”, specifies the decree. Once checks and analyzes have been cleared on public holidays, there is also a punitive rule for citizens: anyone who doesn’t show up after having booked tests will still have to pay for them.

The decree and the bill

The Minister of Health Orazio Schillaci explained that the rule in article 3 of the decree will allow the waiting list times to be cut. Because it will allow citizens to turn to private individuals if the time expected for the service requested by the Local Health Authority exceeds the legal deadlines. But the rule is that the tariffs must be the national ones already in force. For example, he explains The print, for a CT scan the private individual will not be paid the 130 euros he usually asks for but the 70 foreseen by the State reimbursements to the national health system. The possibility of turning to a private individual has actually existed since 1998. But the citizen must first pay and then submit a request for reimbursement, perhaps through a lawyer. Now, however, the general directors of the local health authorities will have to ensure the right. A memorandum of understanding between the State and the Regions will establish how within 60 days.

No money for private exams

But there’s a problem. The decree does not provide for greater appropriations. So it is not clear how the Regions will then have to pay for private services. Schillaci said that the entities can take them from the 500 million allocated for the same reason between 2022 and 2023. But those funds were a share of the National Health Fund. According to some estimates, the new costs amount to 1.2 billion. Another innovation halfway through the decree are the checks and analyzes to be carried out in the evenings and on holidays. Article 4 of the decree provides for this. Which entrusts the general directors of local health authorities and hospitals with the task of organizing and supervising them. Managers who achieve long hours will receive a bonus on their paychecks. But work on holidays and evenings pays more. While the government claims that the implementation of the law must take place “without greater burdens on public finances”.

Intramoenia and booked visits

Republic then he explains that article 3 provides that the doctor cannot work more in private profession than in the public service. This is a provision already present in the law that established intramoenia. The same article highlights the importance of canceling reservations at least within two days of the appointment. And anyone who doesn’t show up, reiterated Giorgia Meloni, pays. But even in this case these are measures already indicated in the national guidelines of the 2009 Cup system.

The articles of the decree law on waiting lists

These are, in summary, the points touched upon by the law decree on waiting lists:

Article 1: Establishes at Agenas the national platform for waiting lists used by the Ministry of Health. The objective is to have, for the first time, timely and real monitoring of waiting times for the provision of healthcare services.
Article 2: To strengthen the monitoring and control activities of the National Health Care Verification and Control System (Siveas) established in 2005 (Law 266/2005), a Health Care Verification and Control Body is established which reports directly to the Ministry of Health and carries out the control functions already envisaged with Siveas.
Article 3: For the first time there is the obligation of a single regional or sub-regional CUP with all the services available from the public and private sector. To date, in the regional CUPs the affiliated private sector is either not present or is only present to a minimal extent. For this reason, the contract with the accredited private individual who does not include the services in the public CUPs is expressly declared null and void (it must be connected and interoperable); for those who are authorized but not yet accredited, the connection with the public Cups becomes a requirement for the issuing of institutional accreditation (rewards).
Article 4: Strengthening the provision of care. Visits and diagnostic tests also on Saturdays and Sundays, extending the time slot.
Article 5: Spending cap for hiring. Spending on personnel is increased by a total amount equal to 15% of the increase in the Health Fund compared to the previous year.
Article 6: Action plan for the strengthening of health and social-health services in the 7 southern regions recipients of the National Health Equity Program 2021-2027.
Article 7: Flat tax at 15% of the additional hourly services of healthcare professionals involved in reducing waiting lists.

The articles of the bill on waiting lists

These are the summary articles of the bill:

Article 1: Prescription and provision of outpatient specialist services.
Article 2: National waiting list governance system for greater effectiveness of national level coordination to reduce waiting lists and overcome regional inequalities.
Article 3: National register of reports active on the portal of the Ministry of Health where citizens can report inefficiencies in the provision of services.
Article 4: Measures to increase the remuneration of staff involved in reducing waiting lists.
Article 5: To recover waiting lists, companies can also make use of internal outpatient specialists. Also in this case the hourly amount of additional services up to 100 euros applies (budget law 2024).
Article 6: Possibility for trainees to have freelance professional positions in the health services of the national health service for up to 10 hours per week (and no longer 8 hours per week). The role of trainees is enhanced to contribute to the reduction of waiting lists.
Article 7: To curb the phenomenon of ‘token holders’, companies are allowed to hire staff even with self-employment contracts.
Article 8: The spending limits for the purchase of healthcare services from accredited private individuals are increased by 1 percentage point for the years 2025 and 2026 compared to the increases already foreseen by the 2024 budget law.
Article 9: University hospitals that cannot meet healthcare needs with university-type functional staff may enter into contracts with medical or healthcare personnel not only on a fixed-term basis, but also with permanent contracts .
Article 10: Again with the aim of reducing waiting lists, the possibility of carrying out some services also in pharmacies (with adequately trained staff) and affiliated laboratories is envisaged.
Article 11: The reorganization of the laboratory network is also envisaged to overcome the difficulties of offering territorial assistance in the most disadvantaged areas (for example mountain areas).
Article 12: Provides reward measures and sanctions for the Regions, regional directors of health and general, administrative and health directors of companies and bodies of the National Health Service, to encourage the reduction of waiting lists and compliance with maximum waiting times .
Article 13: Starting from 2026, 60 million euros, for a three-year period, for the strengthening of mental health departments.
Article 14: Establishment of the National School of Higher Health Administration for the top management of the National Health Service.
Article 15: Measures regarding the approval of the financial statements of professional associations.