TRENTO. “We need a social pact on health, and we need to be honest with the citizens, without hypocrisy.” This principle is the beacon of the president of the Medical Association Marco Ioppi. Which declines it in each of the open fronts of the Trentino healthcare system. Starting with the two hottest ones: the medical guards sector, “abandoned for decades” and the issue of suspension of unvaccinated health workers “it would be time, the law is in April”.
Doctor Ioppi, let’s talk about medical guards. It was a difficult week, did you understand something?
“There are few doctors for the continuity of care and these few should undertake the care of an increasingly extended territory. Faced with this, some motu proprio executives have imagined reducing the offices, without the involvement of those who are directly interested and have to shoulder the burden. The Order gives full solidarity to the trade union body. We need a structured project that makes a forecast for the future ».
The issue of the shortage of doctors is serious everywhere, even more so on medical guards.
“By force. We are seeing the consequences of a non-provident planning of past years. Continuity of care is a very important aspect of territorial medicine. Because it entrusts the health of the population every night and on weekends. The temporal space is greater than that of general practitioners. It is a very delicate health function, it should be entrusted to expert and protected doctors ».
Isn’t that so?
“We have guards practicing in unprotected facilities, without alarms. In small towns they are alone all night. They are also exposed to risks: we have had some unfortunate episodes. It is estimated that 60% of the guards are women. Many are accompanied by their father or husband, who in some cases waits outside to ensure safety. This problem was never taken into consideration. We are not talking about the connection with computer systems, which often do not connect efficiently, so that the patient’s profile cannot be accessed. And this does not help to have a clinical picture of the patient ».
In short, it is not surprising that there is no queue to take that seat.
«It is a difficult and unattractive job, one goes elsewhere as soon as possible. But this is due to the fact that they have never been protected. For years now, when we talk about reform, we have focused on hospitals, never on continuity of care. And now we are at this point, aggravated by a general shortage of doctors ».
Has politics abandoned the medical guards?
“The organization did it. We do not always give all the responsibility to politics, the health managers did not understand that this was the priority. Then of course, politics did not control ».
Now the offices are safe, but the problem remains unsolved: doctors are not enough. Out of 108 needed, 19 are missing. And there are reports of patients who wait for a home visit for several hours. We are all over again.
“It all depends on the fact that sometimes promises are made for electoral purposes, except for being unable to restore the service. Yet what is needed is programming that takes into account the difficult moment. And we need a social pact on health: we must be honest with the citizens, say that the situation is difficult, serious, there are no operators and health care costs a lot. A lot of prevention must be done to get as little sick as possible and ensure that those who get sick are adequately cared for. People need to understand that they need to go to the doctor when they need to, not out of fear. Our health is a heritage that should not be squandered. Institutions must have far-sighted policies, without vain promises but solving real problems. It is everyone’s responsibility. Even health workers ».
Speaking of this, one has to think about unvaccinated health workers and suspension. What opens seems to be the decisive week.
“It would be even now, with a law that came into force in April 2021 and with a vaccination obligation that for health professionals was declared an indispensable condition for the profession and was declared legitimate by a sentence of the Council of State 4 days ago”.
You will materially proceed with the suspension.
«When the company tells us who has not been vaccinated, excluding those for health reasons. So far we have suspended about 20. The hope is that all doctors understand the meaning of the law. But even before that, they should go and get vaccinated more than out of obligation, because they are faithful to a code of ethics that calls them to protect public health. We do sanctions with a sense of sadness ».
Were there also disciplinary actions?
«The suspension for lack of vaccine is not a disciplinary sanction. We open proceedings against colleagues who have given discordant, unreliable or unsafe communications on the Covid infection, on how to treat it, how to prevent it and on vaccinations. I’m talking about information that would confuse the population. “
How many proceedings have you concluded?
“Four, resolved with a warning or a complaint, as the case may be. And two files are open ».
There is the case of the video in Bolzano, which has become almost famous. But the others, how did you find out?
«From reports. Also of patients ».
Beyond the few disciplinary sanctions, the issue is suspensions. The health authority has proceeded with great caution.
“In my opinion, delaying the application of this law, which came into force in April, is a sign of weakness. It could give breath and strength to those who do not want to give up. And it could be a mockery to those people who got vaccinated before the law came into force, out of responsibility and ethical duty towards people ».
The prudence was perhaps dictated by the shortage of personnel, by the fear of putting some service at risk.
“I don’t know, we have no data. But I think we have to get out of hypocrisy. There are people out there who may be in urgent need of an efficient healthcare system for serious reasons. Personally I believe that if a colleague has the courage to go and undermine the system for an ideological choice on this vaccine, then he could also declare his ideas and officially say that he is not vaccinated, that it is because of him that there is not. service”.