The letter

Family doctors, paediatricians also against reform: 'Children are being penalised'

The decree is expected in the Cdm at the end of the month, but there is still the knot to unravel on the dependency of doctors with the SSN. The unions are on the warpath and even the Fimp is taking the field

by Letizia Giostra

 Adobe Stock

3' min read

Translated by AI
Versione italiana

3' min read

Translated by AI
Versione italiana

Paediatricians in agitation. The reasons are set out in black and white in an open letter from the Italian Federation of Paediatricians (Fimp). The problem is the reform wanted by the Health Minister Orazio Schillaci on territorial healthcare that - according to the union - risks raising a wall against families.

A new episode that follows that of the talk table between the government, the regions and the unions on 12 May. The white coats of the youngest are therefore lashing out against the dependency model presented in the draft decree, as it would not guarantee a care model based on the choices made by the doctor, making them dependent on the National Health Service (NHS).

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Black smoke on reform, now the turn of paediatricians

With the decree-law still in the pipeline awaiting the meeting of the Council of Ministers scheduled for the end of the month, this time expressing their views on the family doctor reform are the paediatricians, entrusting an open letter with their considerations on the case.

The Fimp rails against the tightening of the autonomy of the profession expressed in the draft: less choice and more doctors dependent on the SSN. For the union, it would be families and their children who would lose out because - as indicated in the federation's letter - the relationship of "trust, continuity and proximity" with parents would be cancelled. And it is precisely the concept of trust that paediatricians are most pressing on, rejecting a model that for them puts children at a disadvantage.

What the draft says

The draft decree - which Il Sole 24 Ore was able to read - also calls paediatricians into question. Article 2, in fact, establishes that 'the employment relationship constitutes a residual and complementary channel, selective and planned, which can be activated by the Regions and Autonomous Provinces to cover vacant appointments not assigned through the conventional channel, structured territorial functions and unmet care needs'. The model, according to the Fimp, would create Series A and Series B children.

Then there is the talk about the Community homes, which, according to the draft, will also benefit from a quota of at least six hours per week for forty-eight weeks per year for other non-employed doctors. This quota is based on the number of patients and meets regional needs. Here, too, paediatricians speak of a 'health call centre'.

But there is more, because among the latest innovations in the draft there is not only the downsizing of the doctor's autonomy, but also the redefinition of the age for registration as a paediatrician, which 'is included from the birth of the child until the completion of the sixteenth year of age'. An age threshold 'that can be raised to eighteen through autonomous regional organisational determinations'.

Fimp appeal: 'No to soulless paediatricians'

The union's concerns revolve around the design of the reform under discussion because, according to them, it would attack the autonomy of the doctor, transforming territorial paediatric care into an 'impersonal service', which bases the medical profession on 'shifts, counters and bureaucratic logic'.

Minister Schillaci's reform therefore continues to heat up tempers. Now that paediatricians have also taken the field, their appeal is not to approve a decree-law that does not protect the little ones. An outright no, therefore, to paediatricians 'without a face and without a soul'.

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