Waiting lists, emergency already forgotten: anti-queuing decree measures stalled

For one emergency, that of attacks on doctors and nurses, which the government is trying to plug with the decree law passed in recent days that introduces a clampdown (deferred arrest) there is another, perhaps the oldest one affecting the health sector, which once again postpones a possible solution. It is the odious emergency of waiting lists that condemns millions of Italians to postpone treatment or to give up on it: two months after the launch of the plan with which the government aims to cut waiting lists - the decree on waiting lists came into force on 1 August - all the expected implementing decrees are missing

The decree law passed last summer set a deadline of between 30 and 60 days from its publication in the Official Gazette for some of the most important measures to get underway. The plan, therefore, strongly desired by Health Minister Orazio Schillaci, which also started out with the handicap of scarce resources, is currently at the pole. In fact, there is still no implementing decree (expected within two months) with the guidelines outlining the identikit of the national platform on waiting lists, which will have the task of monitoring the timing of services hospital by hospital, interacting with the regional platforms. Also missing from the roll-call is the decree (to be adopted within 30 days) that must define the state's substitutive powers when the regions fail to ensure proper management of waiting lists. And there is no trace of the decree (also expected within 30 days) that must provide for the 'Classification and Stratification of the Population' in order to decide on the scheduling of care.

Then it still remains to be understood how to ground another fundamental measure of the waiting list decree: that 'queue-jumper' that provides that the Asl (local health authorities) in the event of excessively long waiting times for visits and examinations will guarantee the service to citizens by paying for it in intramoenia or by accredited private companies. Here, in addition to the fact that the Health-Mef-Regions protocol (expected within 60 days) is still lacking, which must decide how to use the resources not spent in the past on waiting lists (500 million euro had been allocated, but not all of it was spent), we are moving in random order. Some regions are giving operational instructions to the Cup, while others are still not, and so we are travelling in the dark: "This is one more tool for the companies, which are equipping themselves with internal regulations to apply it," assures Giovanni Migliore, president of Fiaso (hospital managers), who however calls for "also intervening on the appropriateness of the demand for care. Doing more services does not mean better protection of citizens' health'.

As of 30 September, the decree also included a requirement for all regions to set up the Central Unit for Health Care and Waiting List Management, a body needed to monitor the proper implementation of governance on waiting lists. At the moment, however, only a few regions have taken action. For Tonino Aceti, president of Salutequità, an extraordinary intervention is necessary at this point: "This delay in the plan is unacceptable, incomprehensible, and unsustainable for citizens who are confronted every day with the problem of excessively long waits for treatment. If the regions and the government delay any longer, we must think of an extraordinary commissioner for waiting lists'.