Queues, drugs and community houses: the time bombs of the system

Waiting lists to be governed together with or against the regions, Community homes to be opened by June and filled with doctors and nurses, and apharmaceutical expenditure to be curbed. These are the three bombs ready to explode in the coming months in the healthcare minefield. The fire has been smouldering under the ashes for some time, but the temperature has risen again and the approaching end of the legislature will make the climate even more incandescent.

Let us begin with the number one emergency for citizens: the waiting lists that force more than 4 million Italians to forego treatment (they become 6 million if we add economic reasons): over a year and a half ago the government announced its plan to cut them down, but so far very few results have been seen. So much so that a few months ago the Minister of Health, Orazio Schillaci, decided to put on a brave face and has repeatedly reprimanded the Regions guilty of not applying the measures of that plan: from the openingon weekends for examinations and examinations, to the creation of unique contact points for bookings, to the useof the private sector or intramoenia - at the expense of the ASLs - to guarantee a place to citizens forced to wait too long. Certainly the original sin of the waiting list plan launched in August 2024 was that it was financed with few resources, but there is no doubt that the responsibility for its non-implementation also lies with the regions. The data - published in advance by Il Sole 24 Ore - show inexplicable gaps between the Asl (local health authorities), such as the 861 days needed to perform a programmable carotid echocolordoppler at the Teramo Asl, against the 32 days needed by the Veneto Region's Asl 7 Pedemontana.

It also makes one's wrists tremble to meet the deadlines of the NRP, which invests 15 billion in healthcare, about half of which in the new territorial healthcare. For the latter, there are mainly two knots: the new structures closest to the citizens (Community Homes and Hospitals) risk opening mainly in the Centre-North, confirming the historical fracture with the Southern Healthcare - so say the latest surveys -, but those that do open risk doing so as 'empty boxes', given that health personnel are lacking to guarantee all those services that are envisaged. The objective of these facilities would be to guarantee first aid and diagnostics to citizens - especially the many chronically ill elderly - avoiding clogging up hospital emergency rooms and also shortening waiting lists. But the risk of a hole in the water is real.

Finally, there is pharmaceutical expenditure: that borne by the health service is now running at around 25 billion a year, some 4 billion above the planned ceiling of available resources. Minister Schillaci has already written a letter to the top management of the drug agency (Aifa) to ask for an account of this. In this regard, there are several instruments under consideration: from the 'cut' on drug prices to the revision of the Pharmaceutical Protocollect. But the solutions at the moment still seem all to be tested.