Health professions: reorganisation process started, more resources and clear roles

Article 2 lays down the general principles and guiding criteria for the delegation of powers, providing that the delegated legislative decrees shall contain a reconnaissance of the incompatible provisions, with the consequent express repeal, as well as a coordination of the new provisions with those that have not been repealed, in compliance with the division of competences outlined at constitutional level. Finally, provision is made for the revision and adjustment of the existing administrative and disciplinary sanctions apparatus.

Article 3 sets forth principles and guiding criteria for the adoption of measures in favour of the healthcare workforce. In exercising this delegation of power, the Government shall observe the following principles and guiding criteria in order to strengthen the attractiveness of the National Health Service:

(a) 'Reorganisation and rationalisation' of flexible working for trainees, drawing on already existing rules.

b) Introduction of 'minimum permanence constraints' for staff recruited in remote areas and smaller islands.

c) Measures for 'retention in service' through professional recognition, favourable career advancement and enhancement of work in disadvantaged areas.

d) Rationalisation of administrative tasks (e.g. medical records, reports) to free up 'clinical time'.

(e) 'Strengthening' of operator safety protection, including through administrative sanctions.

f) Performance-related reward mechanisms, including for the reduction of waiting lists, to be implemented "within the existing expenditure ceiling".

g) Development of a common methodology for planning the number of postgraduate students, in synergy with the Ministry of Universities.

Article 4 aims to bridge the gap between the traditional skills of professionals and the new requirements dictated by technological and scientific developments. In exercising this delegation of power, the Government shall observe the following principles and guiding criteria for the enhancement of the professional skills of healthcare personnel:

(a) and (b) Agenas will use its ordinary resources to update professional competences and promote a National Certification System.

c) Defines a 'mere policy forecast' for the governance of Artificial Intelligence in healthcare.

d) Upgrading of managerial training for NHS personnel, with 'cost neutrality' compared to the current Ecm system.

Article 5 aims to reshape training courses, in particular for:

a) Redefining the path of general practice.

b) Enhancement of specialisation schools for the professions of chemist (to ensure generational turnover), dentist (to support forensic work) and biologist (for public environmental hygiene).

Article 6 delegates the Government to review the discipline of Orders (L. 3/2018), in particular to:

(a) adopt the necessary corrective measures concerning the competences and expiry of the mandates of the bodies;

b) introduce measures to enhance the role of professional associations as subsidiary bodies of the State.

Chapter II lays down provisions on the professional liability of healthcare professionals, while Chapter III provides for financial provisions.

The Commission's initial approach was produced by the president of the Fnopi, Barbara Mangiacavalli, according to whom the draft delegated law 'represents a strategic step for the country's entire health system. The change that is affecting the national health context calls for a reform of the health professions that will allow their institutional role to be fully valorised'.

For the Fnopi, the reform has the task of redefining roles and responsibilities according to people's health needs, also in light of the growing impact of technological innovation and artificial intelligence, fully enhancing the contribution that each profession can offer. Finally, for the Fnopi it remains essential, within the framework of the reform, to give space to a real economic valorisation of the health professions in order to bring Italian salaries in line with the standards of European countries.

For the Fimmg (Carlo Curatola), it is a good thing to have identified a pathway for the evolution to specialisation in general medicine, with the explicit exclusion of any hypothesis of equivalence with other disciplines, tying the redefinition of the training pathway of general medicine to European laws. For general practitioners it appears necessary and no longer postponable to provide, also, an alignment of the economic treatment of doctors attending the two separate training courses"...

The Anaao reiterated that a courageous reform is needed for the retraining of healthcare professionals' The Fofi believes, finally, that more subsidiarity is needed for the Orders and changes to the Ecm system.

For Diego Catania, president of the FNO TSRM and PSTRP, it is necessary to value and treat in a balanced manner all the professions that operate within the National Health System, in order to guarantee equal recognition both socially and economically. 'We want to avoid,' adds Catania, 'inequalities between the professions in the sector, so we are asking for equal dignity, so that our professionals can also be recognised and incentivised in their daily activities'.