Hospital doctors will work overtime to fill the community care homes

To staff the more than one thousand community centres set to open by the end of the month, the Minister of Health Orazio Schillaci is also turning to hospital doctors. On a voluntary basis, they will be able to work overtime in these large-scale local clinics, funded with 2 billion from the NRRP: “We are considering removing certain restrictions on holding multiple posts which, I believe, should no longer apply today, because if a specialist in neurology or geriatrics working in a public hospital wishes, outside their working hours and on a voluntary basis, to work and see patients, thereby contributing their professional expertise to local healthcare, I believe this should be permitted.”

The minister’s move comes after the government’s sensational U-turn on the reform of general practitioners, which had also provided for the possibility of employing them as staff in the community care homes that are at risk of opening in various parts of Italia as ‘empty shells’ without staff or services. And the idea of drawing on hospital doctors to work in community care homes is already being trialled in Veneto, not without controversy, partly because the issue of staff shortages affects the entire public health service. Hospital doctors have, however, said they are open to ‘working in community homes’, but in ‘a proper role and not just as stopgaps’, explains Pierino Di Silverio, secretary of Anaao Assomed: ‘The important thing is that we are not seen as a last resort’. This fear could well become a reality if, as is likely, an agreement with GPs cannot be reached in the near future.

The Ministry of Health is pushing for a new, fast-track National Collective Agreement (ACN) that would provide for a 6-hour weekly duty rota in community care homes, but an agreement with the sector does not yet appear to be in sight. Although GPs confirm their willingness to agree to the terms, this is only within the framework of trade union negotiations: “The recognition of the role of the GP is not achieved through regulatory imposition, but within the framework provided by the Constitution and the law for regulating the relationship between the State, the Regions and the profession, namely the National Collective Agreement,” stated the Italian Federation of GPs (FIMMG). The Health Minister remains confident: “I have faith in the sense of responsibility of all doctors. I do not believe that general practitioners will fail to fulfil their commitment within community care homes,” he said, adding that he will be meeting with doctors and regional authorities in the coming days

Meanwhile, following the rejection of the reform proposal put forward by Minister Schillaci, the Veneto region has announced that it has reached an agreement with the trade union representatives for the sector. GPs will ensure they are on duty between 8 am and 8 pm, through dedicated shifts. Night-time and weekend cover will be provided by doctors working on a fixed-hour rota. The agreement is expected to be signed by the end of this week, with the scheme due to come into effect in September. “Cooperation with the trade unions has been vital, and it is precisely thanks to this cooperation that we have today managed to finalise this agreement, which will enable our 99 Community Centres to operate,” said the President of the Veneto Region Alberto Stefani. Lazio is also moving in this direction. The President of the Region Francesco Rocca has announced that the agreement with the doctors is almost finalised: “We are finally signing the supplementary agreement. It has taken us more than six months to finalise an agreement that had been missing for twenty years in the Lazio Region and which could be of historic significance,” he said.