Waiting lists: substitutive powers against defaulting regions and local authorities are a blunt weapon

"What has happened to the 'Organismo di verifica e controllo sull'assistenza sanitaria e sulle liste d'attesa', set up by the 'Schillaci law', the plan approved in August 2024 and created to combat once and for all the absolute evil of Italian public healthcare that cuts 6 million citizens off from treatment? Theoretically, everything would be ready to make it operational: funds and composition of the 'control room' - one general managerial office and four non-general managerial offices, three of which are complex structures plus 20 staff units - that should make it work. And yet, 18 months after its establishment and with almost EUR 1.4 million for 2024 and over EUR 2.6 million from 2025 allocated by Law No. 107 of 2024, it seems that nothing substantial has moved.

Asking the question by indirectly forwarding it to the Ministry of Health is the president of Salutequità Tonino Aceti. A non-trivial question: the body has the task, by law, of strengthening the national system of verification and control over health care, of ensuring the timely and correct implementation by the regions of the rules laid down in the decree (then law) on waiting lists, and thus of 'promoting and ensuring the full and effective protection of citizens' interests,' Aceti points out. Not only that: he can access the booking agendas of healthcare facilities, for an audit and analysis of the dysfunctions taking place.

But above all it can exercise the power of substitution, in the face of repeated failures by the regions to implement the rules on waiting lists. This last aspect has kept the regions and the ministry engaged for months in a tug-of-war, which has contributed to the lengthening of the waiting lists, as reported in the investigation published last Sunday in the Sole-24Ore on the basis of the first data from the national platform on waiting lists, is far from being resolved.

'There seems to be no news of the Verification Body and its director general, not even by looking in the Organigram section of the Ministry of Health's website,' Aceti further stresses. "Yet," he warns, "the activation and full operativeness of the Verification Body is essential to change the state of affairs in practice and also not to waste the large amount of data produced by the National Information System on waiting lists, developed precisely with the creation of the National Platform. Relying only on the extraordinary work of the Nas may not be enough,' the president of Salutequità concludes.

From a reconnaissance carried out by its Observatory, it appears that the first tasks assigned to the body by the law have been fulfilled by all the Regions: the establishment of the Central Unit for the Management of Health Care and Waiting Lists and, very important, the appointment of the Single Regional Health Care Manager (Ruas). The regional administrations actually 'did their homework' even before the issuance of the Dpcm 'Modalities and procedures for the exercise of the substitutive powers granted to the Body for verification and control on healthcare', issued last August with a 10-month delay compared to the deadline set.