Waiting lists: government blitz on the eve of the polls, but lack of funds

A blitz just a few days before the European elections: on 29 May or even more likely on 3 June. The government, which has been announcing for weeks that it wants to intervene on the burning issue of waiting lists - 3 million have given up on treatment precisely because of excessively long queues for visits and examinations - would have decided to present its plan on the eve of the vote on 8 and 9 June. The premier Giorgia Meloni herself, who knows how much the issue interests Italians, is counting on it to convince more than a few undecided people to vote for the majority forces. But the plan that SalluteMinister Orazio Schillaci has been working on for weeks is running into a problem of no small importance: there is a lack of funds to finance the most important measures.

The decree on waiting lists was already expected by mid-May, but now the postponement could arrive at the beginning of June, the deadline for not passing the elections of 8 and 9 June on which the majority is counting to consolidate the Executive with the vote. But there is a knot that is calling into question several measures that the Health technicians have been working on, and that is that of the necessary economic coverage on which the Ministry of the Economy is said to have raised a wall, given the current 'narrowness' of the public accounts pointed out several times by the same minister Giancarlo Giorgetti. The remarks that sound almost like a rejection concern several points and could turn into a tug-of-war between the Mef and the Ministry of Health on which Meloni could be forced to intervene to prevent this long-awaited plan from turning into a dangerous boomerang before the vote. But time is running out.

Health Minister Schillaci is counting on this decree to try to make a sort of mini-reform by giving a breath of fresh air to the health service, which is still in great distress after the tsunami of the pandemic and past cuts. Among the points that have raised the most controversy are some measures that are not free of charge: for example, the decree, as doctors have long been calling for, would aim to defiscalise the extra work of healthcare personnel dedicated to reducing waiting lists. However, also in the crosshairs would be the intention to further increase the spending ceilings - which have already risen in the last manoeuvre - for the purchase of healthcare services from accredited private companies: from visits to examinations and admissions. Another point concerns the expenditure ceiling on the hiring of doctors and nurses (today it is not possible to spend more than what was spent in 2004 minus the 1.4%): it would be difficult to overcome this ceiling now - for which the next manoeuvre is being aimed at - but the idea is to expand the hiring spaces by loosening this hated ceiling. Some doubts also seem to have been raised about the possibility of using the new service pharmacy to allow citizens to have certain examinations at pharmacists, always easing waiting lists.

So far, the most critical measures, but the rest of the decree should not pose any problems. First of all, the focus is on the effective unification of public and private accredited booking agendas: in practice, the Cup will have to be able to sort citizens' requests for services where there is free space, while today these agendas still too often travel separately. There will also be a real monitoring of times hospital by hospital - currently absent - which will be entrusted to the Agenas, the Agency for Regional Health Services, so as not to finance the regions in a haphazard manner but where more resources are needed. Another important chapter concerns the stricter control on the too many prescriptions of family doctors: today it is estimated that 20% of the services prescribed are inappropriate (i.e. not really necessary), thus contributing to longer waiting lists. Also under consideration is the introduction of a 'voucher' for citizens who cannot find a place at the Cup, with which they would be able to obtain the examination or test they need directly from the private sector, paying only the co-pay fee.