In 10 years, in Lombardy alone, 111 hospitals and 13 emergency rooms have been closed, and there are 29,000 fewer doctors. Finding a general practitioner is very complicated in different areas of Italy, and the emergency rooms are collapsing. But why? And what happens in the rest of Europe?
The Italian healthcare not maybe never been so sick.
Covid has highlighted the serious deficit of territorial medicine in one of the regions that seemed better equipped, la Lombardy. In 10 years have been 111 hospitals and 13 emergency rooms closed. Compared to 2012 there are 29,000 fewer doctors. Early retirement (41,000 will go home in the next five years) and lack of turnover have given rise to that regrettable phenomenon which is token doctors
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Find a general practitioner now almost impossible in some areas of Italy e emergency rooms are collapsing.
The data confirm it: between the hospital and the territory, more than 20,000 doctors are missing, 4,500 in emergency rooms, 10,000 in hospital wards, 6,000 general practitioners. There is a lot of talk about it in the newspapers (in the Corriere Press Review, from which I also take this article and which subscribers can receive every day, we have published an eloquent piece by Margherita De Bac) and among the people, disoriented for the degradation of the system and for the lengthening of the times of interventions and visits.
Much less in politics, more concerned with thinking about the cash ceiling and other identity and ideological amenities rather than central issues like this.
Seven trade unions demonstrated in Rome, while Minister Orazio Schillaci promised salary increases. But programmatic health spending is standing reducing below 6.6% of GDPthat for the OECD, the limit below which the system risks collapse.
The fault of twenty years of indifference, for which various governments and parties, right and left, should mea culpa. But even the current government, for now, does not seem to have grasped the urgency of the situation.
And how is Europe?
An investigation by the Guardian allows you to look at the phenomenon in a broader dimension and to discover that healthcare is experiencing a difficult time throughout Europe. The causes, in addition to national policies, are known: the aging of the population, the increase in long-term illnesses, the recruitment crisis and personnel retention e the Covid and post-Covid effect. A combination of factors that call for an urgent reaction from governments and parliaments.
Some data to understand.
In France there are fewer doctors than in 2012. More than 6 million people, including 600,000 with chronic illnesses, lack a regular primary care physician and 30% of the population lacks adequate access to health services.
In Germania35,000 health care jobs remained vacant last year, 40 per cent more than a decade ago, while a report this summer claims that by 2035 more than a third of all health care jobs may not be covered.
In Spainthe Ministry of Health said in May that more than 700,000 people were waiting for surgery and 5,000 general practitioners and pediatricians in Madrid have been on strike for nearly a month to protest years of underfunding and overwork.
According to a report by the European section of WHO, in a third of the countries of the continent at least 40% of doctors are over 55 years old. Even as younger doctors continued to work despite the stress, long hours, and often low pay, their reluctance to work in remote areas or inner cities created medical deserts which prove almost impossible to fill. All these threats represent a time bomb which could lead to poor health outcomes, long waiting times, many preventable deaths and potentially even the collapse of the health system, warned Hans Kluge, WHO regional director for Europe.
The case of general practitioners
Let’s take general practitioners. There France has a particularly difficult situation. Already in 1971, he imposed a cap on the number of second-year medical students, through a closed number, with the aim of cutting health care costs and increasing earnings.
The result has been a drop in annual student numbers – from 8,600 in the early 1970s to 3,500 in 1993 – and although hiring has increased somewhat since then and the cap was lifted entirely two years ago, it will take years before the workforce recovers.
Last year, older doctors who left the profession outnumbered newcomers, who were still 6% less than a decade ago. There is a problem in the areagiven that away from the cities and in more rural France the difficulties increase. In fact, 87% of France could be called a medical desertHealth Minister Agns Firmin Le Bodo said last month.
The Germania the country that spends more on health care than any other country in the world.
Nevertheless in crisis.
The system imploded with the outbreak of respiratory virus of children, with patients traveling hundreds of miles to be treated. More than 23,000 vacancies remain in German hospitals after several years of low recruitment and recent mass dismissals, especially in intensive care and operating theatres, by staff complaining of extreme workloads.
In Spain it’s no better. In Madrid, at least 200,000 people took to the streets in mid-November to defend public health care against creeping privatization and to express concern over the regional government’s restructuring of the primary care system.
Il Guardian also quotes Italy: Italy’s public health service is also facing severe staff shortages, exacerbated by the pandemic, which has triggered an exodus of staff into early retirement or into private sector roles. Regional administrations have contracted freelance doctors to cover hospital shifts when needed, highlighting the low salaries of Italy’s public health sector.
There are holes that need to be filled everywhere, especially in emergency units, explains al Guardian Giovanni Leoni, vice president of a federation of Italian doctors. The problem that freelancers earn two to three times more, up to 1,200 euros for a 10-hour shift.