Do not condemn the other treatments intended for those who are not sick with Covid to a new lockdown, but rather try to recover the missed services – millions of hospitalizations, visits and screenings – in 20 months of emergency. Here is the absolute priority that is aimed at with the allocation of another 500 million in the budget law, after those of 2020 which, however, were often spent badly, little and late by the Regions. Among other things, the risk is that the counter will jump again since in the face of a rise in infections and hospitalizations some hospitals have already begun to steal beds from other departments. And there are those like the Province of Bolzano – one of the areas most affected by the fourth wave of Covid – has already decided to suspend all non-urgent hospitalizations. In short, the worrying signs are all there, and the specter of repeating what happened in 2020 returns to wander.
Many treatments and many missed admissions
In fact, last year, according to the monitoring of the Sant’Anna School of Pisa and of the Agenas, almost 50% of screenings for cancer were missed and there was also a sharp decline in scheduled hospitalizations (-24.15%), of those in day hospital (-29.66%), surgical interventions (-26.22%), but also those urgent for heart attack (-11.5%), stroke (-12.62%), angioplasty (-14 , 43%) and aortocoronary bypass (-24.5%). In short, a collapse against which the Minister of Health Roberto Speranza had already wanted, in the summer of a year ago, an initial allocation of 500 million in the decree of August 2020 to try to recover the skipped treatments. Funds that, however, were in several cases badly spent and very late: the regional plans that had to be ready by September 2020 arrived many months late and without effective monitoring of the amount spent. According to a photograph by the Court of Auditors dating back to last June, the Regions used only 67% of the funds (300 million out of 500 million) with some Southern Regions that would not have spent even a single euro.
Countermeasures to avoid waste
This is why countermeasures were included in the maneuver to avoid waste and delays. With the new funds, once again the Regions through the ASL will be able to pay extra services for doctors and nurses (overtime will be paid 80 euros gross per hour for the first and 50 euros, again gross, for nurses). The budget law also provides that up to 150 million will be spent on purchasing services from accredited private nursing homes. But the maneuver also includes some stakes: the ministry will in fact be able to verify on the basis of the reports sent by the Regions “number and type of services subject to recovery”. And only if there is no “need for the recovery of waiting lists” will he be able to leave the unspent funds to the Regions for “carrying out other health purposes”. Will these extra cautions be enough to avoid the half flop of 2020?
What went wrong in 2020
“This time Covid cannot block the treatment of other diseases – warns the president of Salutequità Tonino Aceti – it would be unacceptable”. Aceti underlines how the operational plans of the Regions on the 2020 funds “arrived too late and were too uneven in the performance objectives to be recovered with different firepowers because some regions have added their resources, others not”. «The other weak point – warns the president of Salutequità – was the control by the central part which was more formal than substantial. The new maneuvering plan will instead have to identify priorities on which to concentrate resources, the allocated money will have to be released in tranches based on the achievement of a certain number of recovered services “. “It will then be necessary – adds Aceti – to indicate by what percentage the Regions must increase productivity in order to have a minimum standard to be achieved on which to be evaluated”. Finally, «citizens must be intercepted and not expected with a true taking in charge of the patient from diagnosis to treatment. For all this it is necessary that national guidelines be approved to accompany the Regions and that an institutional information campaign be launched to convince Italians to take care of their health again ”, concludes Aceti.