In Lombardy, 60% of chronic patients are managed by co-ops: this is why it is necessary to 'work together' with the region

Today, are we sure that the health service reaches everyone? Excessively long waiting lists, difficulties in finding family doctors, increasingly complex management of chronic illnesses: these are the three knots on which the resilience of the Lombardy health system is measured. Without a thorough reorganisation, the risk is a fragmented and unequal response, where those who can pay and those who cannot wait or give up.

Territorial healthcare must be enhanced, investing in the innovative models that already exist, and this is where the strategic role of healthcare cooperation comes in: through investments in telemedicine and territorial diagnostics, we aim to guarantee quicker responses to citizens, relieving the pressure on hospitals. Integrating pharmacies, family doctors, and social and health services means building a widespread, accessible territorial presidium capable of intercepting needs before they become emergencies. If we look at Lombardy, waiting lists remain one of the main obstacles, territorial medicine is struggling to withstand the impact of demand, and the shortage of general practitioners is intertwined with an increasingly elderly population suffering from chronic diseases. Let us think of the family doctor, alone it is clear that today he is no longer in a position to manage the growing complexity of needs. Cooperatives allow what the system lacks today: structured care. Where doctors work together in a cooperative, the taking charge works and the services are managed more efficiently. For a chronic patient, for example, this means having a stable reference who schedules visits, examinations and controls, for him, up to the follow-up. We do this and it already works.

Of the 5,000 general practitioners, 1,350 professionals now work within the cooperatives that are members of Confcooperative, and these 27% deal with 60% of chronic illnesses. It means having created an organised channel of access to care on which we have already opened a dialogue with the Region. The same applies to patients who today do not have a reference doctor. Thousands of people still do not know where to turn even for a prescription. It is a gap that must be filled with structured and replicable models. The Lombardy Region has already opened up the possibility of organised care. One example is the project of the Insubria Doctors' Cooperative, which will manage on behalf of the Asst Lariana about 800 patients between the province of Como and some valleys above the lake, who have been without a family doctor for months. But a few experiments are not enough; initiatives of this kind must become a system.

In addition, cooperation between doctors is already developing telemedicine and first-level diagnostic services in the area: electrocardiograms, spirometry, retinograms, Holter scans, ultrasound scans. Services that, if widespread, can reduce the impact on the public. In this design, the service pharmacy is a decisive node. In Lombardy there is a network of cooperatives that are members of Confcooperative, with significant numbers in terms of presence and logistical capacity. The Brescian cooperative CEF - Cooperativa Esercenti Farmacia, through Q-Farma, today represents a central reality: a structure wholly owned by independent pharmacists that covers 92 per cent of regional drug distribution. In the network pharmacies, classic services are being joined by telemedicine and services such as deblistering, the personalised preparation of medicines in daily or weekly doses, useful for helping the elderly and chronically ill to follow their therapies. The question, then, is not whether the solutions exist. They already exist. The cooperation has proposed a model to the Lombardy Region that networks skills, professionals and infrastructures. But a collective step forward is needed. Because continuing to postpone means accepting, de facto, that the right to health is no longer really for everyone.

* Coordinator Health Committee Confcooperative Lombardia