Waiting lists decree, doctors on the alert: 'The government does not touch the NHS funds'

In order to cut waiting lists, extra investments are needed without committing the increasingly counted resources of the National Health Fund already allocated to other items. Doctors and nurses are asking for this without mincing their words. They are worried that the new decree on waiting lists, which will be presented to the Council of Ministers on 3 June, will turn into a real mockery for the world of healthcare, which is struggling with funding that is never enough. The first draft of the decree does not leave the health workers calm: the coverage has not yet been clarified with the Ministry of the Economy, even though many measures are already foreseen to veil the Health Fund. Precisely what doctors and nurses do not want.

The one on waiting lists is, after all, a very sensitive measure - today about 3 million Italians give up treatment because of waiting lists - that the government, led by the premier Giorgia Meloni, will try to play in the last days of the election campaign. However, the draft decree is not yet complete: what is missing is Article 25, the one concerning financial coverage. A not insignificant detail on which the interlocution with the Ministry of the Economy has been going on for days. Among the measures for which coverage will have to be found, there is, for example, the one on the 15% defiscalisation of overtime, which translates into lower tax revenues. However, it is already clear that several measures will be financed from the National Health Fund and therefore within the perimeter of resources already allocated to the health service: in practice, there is the risk of launching the plan on waiting lists without too much fresh money. This is the case, for example, of the new increase (after the one already envisaged in the last manoeuvre) of the expenditure ceilings for resorting to the private sector, which increases again by a value that should be around 450 million. This is a crucial point in the decree because - precisely to prevent queues from getting longer - the Asl (local health authorities) will have to provide at least 90% of examinations and examinations on time, and to do this they will be able to resort more 'to accredited private providers' to which patients will be sent through the Cups.

For the Anaao Assomed hospital doctors' union 'the main problem' is precisely that in the draft 'no financial coverage is indicated. We hope and ask that the funds will not be taken from the National Health Fund," hopes the secretary Pierino Di Silverio, "because the 'cauldron' is always the same and without further investments we will do nothing but use sums already provided for and destined for something else". We therefore need 'extra investments from the health fund that are specifically earmarked for waiting lists'. Also critical is the president of the nurses' union Nursing Up, Antonio De Palma, for whom the financial coverage to implement the reduction of waiting lists is currently lacking. Minister Schillaci's commitment, "is undeniable," stresses De Palma, but "we would not like it to be a political strategy, the umpteenth, a few days before the vote in Europe". According to De Palma, in order to cut waiting lists, it is necessary "to hire new professionals and above all to guarantee salary increases and incentives for staff to increase workloads and get to streamline the time of an examination or surgery". In addition, 'it would be necessary to cancel the spending cap on the recruitment of doctors and nurses'.

For the Anaao secretary, there are 'positive' aspects in the draft decree, but also 'dark sides'. "Positive" are the defiscalisation to 15 per cent of doctors' additional services and the overcoming of their ceiling, as well as the lowering of the expenditure ceiling on staff recruitment. Finally, 'the point is that we continue to act on the effects and not on the cause: to eliminate waiting lists, it is not enough to make doctors work harder or to open up to the private sector, but we must change the system structurally, starting from a real promotion of the medical profession and making it more attractive,' he adds. For Rita Longobardi, Uil-Fpl general secretary, the decree 'makes the National Health System the first customer of the accredited private market. We do not need spot solutions, in the run-up to the European elections,' she says, 'but rather structural interventions through the recruitment of new professionals and the renewal of expired collective labour agreements with adequate resources for the enhancement of staff'.