cooperatives of doctors and nurses, 165 irregular health workers discovered in hospitals and nursing homes

I Carabinieri of the NASin agreement with the Ministry of Health, since mid-November they have planned and conducted targeted control services throughout the national territory at public and private health and social-welfare facilities which, to make up for the lack of personnel and guarantee the minimum provision of care and assistance services, they increasingly resort to tender contracts to make use of healthcare professionals – doctors, nurses and healthcare operators – supplied by external companies, usually attributable to cooperatives.
In order to verify the correct application of this recruitment method, the adequacy of the qualifications and the observance of the service shifts and the use of absences, in compliance with the National Contracts of the Category, accesses were carried out at 1,934 health facilities, monitoring 637 companies/private cooperatives and verifying the suitability of over 11,600 figures including doctors (13%), nurses (25%) and other health professions (62%) (social welfare operators, laboratory technicians and similar figures), finding irregularities in 165 job positions.
I NAS reported a total of 205 people, including managers of cooperatives, owners of health facilities and health workers, of which 83 to the Judicial Authority and 122 to the Administrative Authority.
In particular, 8 owners of cooperatives were deferred for alleged crimes of fraud and non-fulfilment in public supplies, held responsible for having sent personnel for auxiliary assistance activities in public hospitals, in a lower number than that envisaged by the contractual conditions with the ‘Health agency, or simple auxiliary staff employee, without the prescribed qualification, rather than social-health professionals (oss), and, finally, non-specialised medical personnel for the position to be filled.
In this regard, the supply of doctors by cooperatives with an age higher than that established contractually – even over 70 – and the outsourced use of human resources not suitable for the needs of specific hospital departments, such as the supply to “obstetrics and gynecology” departments of healthcare personnel, including general practitioners, not trained to manage caesarean deliveries or, again, medical personnel to be employed in the emergency room not specialized in “emergency medicine”.
Numerous cases of abusive practice of the profession have emerged (43 operators) in particular concerning the performance of nursing activities in the absence of registration in the register and without the recognition of qualifications acquired abroad, frequently favored by the lack of preliminary verification by the managers of cooperatives.
In one case, a cooperative active in the province of Latina provided a doctor, already on duty at a public hospital on an exclusive basis, to a hospital in another province to cover shifts.
Numerous violations highlighted by NAS regarding the use of external health figures, placed in work activity without adequate training on the protection of safety in the workplace.
Violations were also ascertained and contested for authorisational, functional and structural deficiencies which led, in the most serious cases, to the closure of 5 social and health facilities.
Most significant interventions:
Nas Turin
The owner and director of an RSA in the province of Turin have been referred, together with the manager and 4 employees of the social cooperative that supplies the structure’s personnel. The investigations made it possible to ascertain that the 4 employees practiced the health profession of nurse, although without the recognition of the respective qualifications qualifying the profession.
A further check carried out at a hospital in the province of Vercelli led to the referral of the legal representative of the cooperative company managing the health services in favor of the structure, for having provided doctors older than that contractually established (under 70) as well as sent health personnel, including general practitioners, in the “obstetrics and gynecology” department not adequately trained in the needs of the sector as they are unable to perform caesarean sections.
Nas Milan
During the inspection activity carried out at an RSA in the province of Milan, the presence in service of a non-EU citizen nurse was ascertained, lacking the necessary qualifications enabling the health profession on the national territory. The woman was referred to the competent AG for abusive exercise of the profession, in competition with the manager of the cooperative supplying the health personnel to the structure and the two owners of the RSA.
Nas Alexandria
Following the check at a rest home in the province of Cuneo, the following were deferred in a state of freedom:
– a woman, a member of a cooperative in Cuneo, for having practiced the profession of nurse illegally because she lacks qualifications;
– the president of the board of directors of the same cooperative for having failed to verify the possession of the title by the woman, making her available to the accommodation facility for the elderly.
Two further checks carried out at RSA located in the provinces of Cuneo and Alessandria, led to the reporting to the competent Administrative Authorities of the legal representatives of the cooperative companies supplying personnel, for having sent respectively 2 and
5 social and health workers without the qualification.
Nas Florence
Following the inspection at an RSA in the province of Prato, a physiotherapist and the manager of a cooperative in Pistoia who had allowed the former to carry out her activity within the health residence, in the absence of the ‘registration to
relevant register of professions.
Latin Nas
A contracted surgeon was referred, with an exclusive relationship to the emergency room of a hospital in the province of Rome, for having carried out on-call shifts, on behalf of a health services cooperative, at another hospital in the province of Latina. The undue receipt of indemnities was quantified at 3,000 euros.
Nas Campobasso
The two owners of a cooperative company were referred for having provided health services other than those contracted out by the Regional Health Authority, in the pediatric wards of several Molise hospitals. In particular, the use of doctors on continuous shifts of more than 24 hours was ascertained, without the granting of any rest period, provided for after 12 hours of service also by the tender specifications. The more than 100 working shifts with considerably redundant hours were carried out both by doctors supplied by the aforementioned cooperative and by those belonging to the Public Health Authority, which is why the general manager of the local Company was also reported to the competent Administrative Authority Healthcare.
nas catania
Following a check carried out in the emergency room of a hospital in Catania, the president of the cooperative managing the internal auxiliary assistance activities was referred, held responsible for contractual fraud in public supplies. In fact, the presence, during the work shift, of ancillary personnel in a lower number than that envisaged by the contractual conditions established in the tender regulations was found.
In the same way, the presidents of two private health service cooperatives managing the supply of specialized personnel in two further hospitals in the province of Catania where it was detected, in one case at the complex surgery unit general, the use of normal auxiliary personnel without the prescribed qualification in place of social-health professionals (OSS), and, in the other, in the first aid department, the use of medical personnel without specialization in medicine and acceptance surgery
and urgency.
Nas Napoli
The president of the board of directors of a health cooperative in the province of Naples has been deferred in a state of freedom for having failed to carry out the required medical examinations and the training of its workers. In relation to the description of specific interventions carried out by NAS in this press release
press, the persons referred to the judicial authority are to be considered presumed innocent until a definitive finding of guilt in a subsequent trial.