Family doctors go on strike: 'Reform weakens relationship of trust'

National demonstrations and permanent assemblies, up to and including strikes: the family doctor unions, albeit to varying degrees, are mobilised to amend the current draft decree-law reorganising general medicine, aimed at guaranteeing the full operation of the Case di Comunità (Community Hospitals) and which also provides for the residual use of dependency, a novelty that the category sees as smoke in the eyes. For everyone, the current function of the family doctor must be defended, based on a relationship of trust and continuity that is fundamental for more efficient care, especially of the most fragile. Unanimous, therefore, is the 'no' to shifts and timetables that would see an alternation of doctors, with the consequent loss, for citizens, of a constant point of reference such as the general practitioner currently is. The reform decree is expected in the Council of Ministers by the end of the month.

The Italian Federation of General Practitioners (Fimmg), which is the main trade union in the category, judges the draft decree to be 'unacceptable' and announces 'an escalation phase of protests, which will start with initiatives shared by the provincial and regional levels and will only end with the signing of the national collective agreement', up to and including a strike. At stake, he notes, is the defence of the 'right to fairness of the SSN' against a 'deregulation' with different models of family medicine from region to region. "General medicine," says the Fimmg, "is and must remain a profession that has a contractual, fiduciary, territorial nature, integrated in the SSN, but not absorbed in a relationship of dependence. Moreover, the Fimmg 'categorically rejects any reference to complementary recourse to the dependent employment relationship, even if defined as 'residual', but which instead appears to be one of the unstated purposes of this decree'. According to the union of general practitioners, "general medicine is and must remain a contracted, fiduciary, territorial profession" but above all "not absorbed in a relationship of dependence" and indicates as possible dangers of the approach envisaged in the reform the "deconstruction of the fiduciary model".

Similar is the line taken by the Italian Medical Union, which has called for a national demonstration on 28 May in Rome, in front of the Ministry of Health. In the meantime, the union proposes some amendments to the draft decree law on reform. In particular, it reiterates the 'no' to the single role, to the hourly debt, and to remuneration linked to objectives, and the 'yes' to enhancing service medicine 'as a preferential channel for working in Community Homes', to 'university specialisation in general medicine'. Yes also 'to the relationship of dependency within the Community Homes but as primary care physicians'. The National Union of Autonomous Italian Doctors (SNAMI) calls his a 'cautious but constructive evaluation', saying 'yes' to the reform of general medicine and 'no' to hourly provision. "General medicine must be strengthened, modernised and fully integrated into the territorial network, but without distorting its fiduciary, clinical and ongoing function," says the union. As for the obligation to work in community homes, "it cannot be reduced to a mere hourly obligation".