You need a electrocardiogram? Come back in 400 days and, if it’s really urgent, wait 118 days. Which is four months. The problem of long waiting lists it’s all here, in a few numbers that highlight the seriousness of the phenomenon when a specialist visit or diagnostic test is needed, whether urgent or programmable. If it is programmable, it is discussed hundreds of days after the request is made.
Delays, territorial disparities and healthcare crisis
“Health cannot wait. National monitoring of waiting lists” is the dossier created by Federconsumatori and the Isscon Foundation, with the contribution of the Welfare and Rights Area of the CGIL. The dossier photographs the maximum waiting times recorded in the Regions and PAs of Trento and Bolzano, in the 41 local healthcare companies in metropolitan areas and peripheral to large cities and in 13 hospital companies.
The situation is dramatic, made up of delays, territorial disparities and lack of transparency.
“The cuts in healthcare and the shortage of staff, while the production costs of services increase, continue to produce delays and inefficiencies in the management of the demand for services”, explains Federconsumatori.
The analysis also takes into consideration the healthcare, social, economic and territorial context within which the waiting list phenomenon occurs and the many inequalities in access to healthcare services.
In this context, explains the association, “the cuts to the Health Fund, the differences in distribution between regions, the many commissioners, tears and blood for the citizens, weigh heavily, growing private spending on care reached 41 billion euros in 2021 and which varies in relation to the territories and the social conditions of the families. This proves that where the public declines, not all families are in a position to bear the costs of private care. This happens especially in the South where the quality and guarantee of Lea is lower, migration and life expectancy are higher”.
Waiting lists, come back after a year and a half or two
THE maximum waiting times recorded between Regions and healthcare facilities are impressive.
For them specialistic examinationswe arrive at maximum waiting times of 612 days of waiting in class B for an endocrinological visit; 426 days for an initial cardiological visit; 677 days for a first eye exam; 611 daysin class D, for gastroenterological examination; 176 days for an oncology visit; 342 days for a gynecological examination in class P.
In short, come back next year for specialist visits, while the higher expectations found for the diagnostic tests which also scale two years later. The monitoring of the waiting lists drawn up by Federconsumatori finds 735 days of waiting for a cardiac Doppler ultrasound; 118 days, in Emergency class and 403 days, in D class, for an electrocardiogram. We also have to wait 546 days for an MRI to the spine, 482 days for a bilateral mammogram, 545 days for an abdominal ultrasound in class B e 458 days for a gynecological ultrasound.
Defunding of healthcare and giving up treatment
“The exponential increase in waiting times for visits, tests and services is one of the main consequences of the progressive defunding of the NHS. Public health in the country is experiencing a condition of continuous stress and perpetual emergency, from which it appears impossible to escape without a concrete change of direction which, however, does not seem imminent”.
This is what we read in the dossier, which examines the critical issues of public health in Italy. The Covid crisis and the defunding of recent years will be followed by further reductions in healthcare spending, expected in 6.1% of GDP in 2026.
All this has dramatic repercussions on Right to health. To date, 7% of the Italian population (around 4 million people) has given up on healthcare services, due to economic problems or difficulties in accessing services due to waiting lists. Years of public health cuts have weakened the national health service and shifted demand towards private healthcareso much so that Italians’ private spending on health is estimated at 41 billion euros per year in 2021 (Istat data) and with a trend towards growth.
“Long waiting listsdifficulty in accessing services (often reduced to precarious conditions for those who work there, as well as for those who benefit from them) and tortuous paths in taking care of health needsare increasingly at the basis of the phenomenon of healthcare migration from the South to Northern Italy – explains the dossier – For the year 2018, the Gimbe Foundation photographed the flow of migration by Regions and the grandeur of the resources that move from the South towards the North, quantifying in approximately 14 billion euros the public health resources which, in the last 10 years, have found their way to the Northern regions and in many cases, towards private affiliated facilities”.
For many, endless waits mean giving up on health.
“From North to South, the main cause of giving up treatment is represented by waiting lists, while those who have their own resources access private paid care”.
Istat estimates for 2022, out of the total number of people with multimorbidity, 1.7 million will be forced to give up healthcare services, equal to 1 in 7 people (in 2019 the ratio was 1 in 9). The data processed by Federconsumatori on an Istat basis quantify, for 2021, the total direct expenditure incurred by families on health at 41 billion euros. Of these, 36.5 billion euros for care services, with an average annual increase of 1.7% in the period 2012/2021 and 2.1% on 2019; 4.5 billion euros for various forms of voluntary financing, of which 3.4 billion euros for voluntary health insurance, with an average annual growth of 2.9% since 2012.
Direct household spending on health, excluding voluntary financing, in 2022 amounted to 113.52 euros as a national monthly average. But the figure is lower in the South, in families with low educational qualifications, in families of foreigners only, of workers and for large families, in municipalities under 50 thousand inhabitants which often have fewer health services. And this means social inequalities. Healthcare that does not cure and leaves behind those who cannot pay.
