Waiting lists decree: definitive measures to reduce waiting times and guarantee health services

The decree on waiting lists is law. The Chamber of Deputies, with 171 votes in favour and 122 against, has definitively approved the bill for the conversion, with amendments, of decree no. 73 of 7 June 2024, containing urgent measures to reduce waiting lists for healthcare services. The text, approved at the beginning of June by the Council of Ministers, has been approved by Montecitorio in the same version as the Senate, which had made some changes, in particular the one that rewrites the measures on controls and sanctions against abuses and inefficiencies in the management of the lists, which return to the Regions, while the Ministry of Health will be able to intervene with substitutive powers in the event of delays and regional non-compliance. Here are the main measures provided for in the measure, which must be converted into law by Parliament by 6 August

If services are not provided on time according to the priority classes, health authorities guarantee the citizen the service in intramoenia or through the accredited private sector. The citizen will only pay the co-pay if already due. Visits and examinations may also be provided on Saturdays and Sundays, extending the time slot. In order to avoid abuse of intramoenia activity, the hours of free professional activity of doctors will not exceed those of ordinary activity. The general director of the Asl will verify compliance until intramoenia is suspended

The Agenas National Waiting List Platform is born. The aim is to have for the first time a real time monitoring of delivery times performance by performance in all regions. There will also be a ban on suspending or closing booking agendas (with increased penalties), while general managers will also be assessed on the basis of the performance of the ASLs on waiting times. There will also be a flat tax of 15 per cent on doctors' and nurses' overtime (today the tax authorities levy over 40 per cent).

The obligation to have a single regional or intra-regional Cup (the Reservation Centre) with all available public and private contracted services (today it is present in only a few regions). Hospitals are prohibited from suspending or closing booking activities (agendas). The Cup activates a citizen recall system to avoid the phenomenon of services booked and not carried out (this happens in 20% of cases). Citizens who do not carry out the booked examination or test without prior notice will still have to pay the co-pay fee.

An amendment approved in the Senate's Health Committee rewrites Article 2 on controls on the management of waiting lists by local health authorities. In fact, the Ministry of Health will no longer be able to intervene directly by punishing hospitals that make citizens wait too long to receive treatment. In fact, checks on the proper management of waiting lists will remain the responsibility of the regions - in particular, the 'Ruas', the new single regional health care managers - and only in the event of delays and serious non-compliance will Rome's substitutive powers be triggered. With the new Supervisory Body to be set up at the Ministry, which will no longer be able to perform administrative and judicial police functions.