The eve of the Council of Ministers which will have to discuss the measures to reduce the waiting lists was full of meetings with an intense dialogue between the Ministry of Health and the Regions which will have to apply the measures announced by the Government.
The idea that is taking shape is that the announced decree law mostly contains organizational measures, light on the economic impact front, and that it is accompanied by a bill with provisions that require more substantial investments.
The Minister of Health, Orazio Schillaci, guest 5 minutes away from Bruno Vespa, confirms: “Some measures will be immediately operational after tomorrow’s Council of Ministers, I am thinking of the increase in the spending ceiling for hiring staff which will go from 10 to 15%”. The others will be active “I hope with the start of the new year, from January 1st 2025”. “We would like to abolish the spending cap on staff hiring – underlined the minister – which would represent an epochal result”. Schillaci spoke of “feverful contacts” to try to make the measure operational as soon as possible. “We are working – he said – to have services within 72 hours, where indicated, a CT scan, for example”.
From now on, Schillaci confirmed, “there will finally be a single booking agenda, which will bring together all the services available in the public and private sectors. This is not yet the case in most regions.” “It will be reiterated that it is not possible for a doctor or a healthcare facility – continues the minister – to carry out a greater number of services intramurally than those carried out in the public, because this affects waiting lists. And it’s not possible.” And again, “we will immediately implement a monitoring system, a platform to know region by region which performances are lacking in order to be able to intervene promptly”.
The meeting between the minister and the Regions was “polite in tone, but with some mutual embarrassment”, because the Regions complained that they had only seen the drafts of the Legislative Decree in the newspapers.
“We would like to contribute to the genesis of the rules, not just make observations when they are approved,” explained Raffaele Donini, health councilor of Emilia-Romagna and coordinator of the health commission of the Conference of Regions. “From a differentiated autonomy we move directly to an autonomy in the undifferentiated – he added -. We were told in brief the contents. We understand that there could be a bill and a decree, but we have no information on the details or even on the coverage. We understood that Agenas’ inspection powers towards individual healthcare companies should be strengthened, which is absolutely unacceptable for us”.
The ministry spoke of a “privatization issue but we don’t know how it would unfold”. Among the guidelines mentioned to the Regions also “a single national Cup”. But “details are missing – underlined Donini -. We Regions have reiterated our willingness to collaborate and meet even seven days a week, 24 hours a day, to address the issue of waiting lists, one of the main problems we have, obviously sharing a vision”.
In the decree, therefore, there would be the performance monitoring platform that will be managed by Agenas, to understand the weight of supply and demand for services; the interoperability of regional systems and then an inspection structure created ‘ad hoc’; the implementation of regional Cups with accredited private individuals and the purchase of intramural performance packages. Furthermore, within the decree, access to telemedicine should also be guaranteed to family doctors and paediatricians.
The bill, however, which will have longer costs and times for approval, should include the increase in the spending ceiling for private individuals and additional resources for staff. The contribution of “service pharmacies”, present in the draft decree, currently seems “more nuanced”.
