Basic medicine has never been so in crisis

by PM Speranza

07 FEB –

Dear Director,
for years we have been witnessing the attempt to dismantle primary care with the creation of new cathedrals in the desert – which are reflected in the Health Homes and Community Hospitals – and with the burden of an excessive bureaucratization of our work, which has now reached unbearable levels . This has taken precious time away from clinical practice, which is essential to really assisting our patients. An assistance practiced through careful medical examination and therapeutic measures that are effective for their health and constitute a filter to improper access to hospital emergency rooms.

On the other hand, we are witnessing – astounded with each passing day – the introduction of other tasks, the continuous adaptation of codes to be included in the compilation of dematerialized prescriptions in order to evaluate the prescriptive appropriateness (i.e. our therapeutic appropriateness), continuous updates of the notes for the compilation of therapeutic plans, the formulation of therapeutic plans that were previously delegated to other figures … Our working days have become endless, the workloads unbearable: from being in the studio, to constantly staying in front of a computer well after hours work, home visits, integrated home care visits, vaccinations, medical-legal practices, compilation of certifications of all kinds and more…

In addition to this, the establishment of Health Centers and Community Hospitals, in the intentions of the legislator, would constitute further work for the professional figures of basic health care, while it would be advisable to provide dedicated staffing resources. Our NHS has always been considered among the best in the world and, as far as general medicine is concerned, the fundamental connotation has always been the capillarity of medical studies, present in every territorial reality and efficient in integrating with the continuity of care principals, thus offering the territory an active service 24 hours a day, 7 days a week.

The New System risks leaving the suburbs behind and not giving everyone the same rights and the same levels of assistance. Even in the hospital sector, the political decision-maker, over the years abandoning the concept of staffing plan in favor of that of staffing, has in fact progressively impoverished human resources and departments and made the NHS incapable of responding to the health needs of users, thus realizing a disguised dismantling of public hospitals.

Without an adequate number of health workers provided for in a permanent organic plan, adequately remunerated, and a prudent distribution of hospital structures on the territory, the vaunted integration Hospital/Territory will never be achieved.

Pasquale Mario Speranza
National coordinator for general medicine Cisl doctors

07 February 2023
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