by Francesco Medici
Let’s not be surprised if doctors leave the national health system: by dint of failure to adjust to inflation, failure to reform, excessive taxation, inapplicability of the contract, ungoverned coroner litigation…. in my opinion the “NHS glass of addiction” in public health no longer exists or at least it is broken and no one intends to remedy it.
08 MAG –
I believe that the glass is always “half full”. It is not just an attitude given by character, but a choice. Work, especially in medicine, should always be approached with cautious optimism. Showing oneself depressed or discouraged sends the patient a non-verbal message of fear in a moment (the disease) of fragility. In summary, work difficulties must never, ever fall on the patients.
Today, however, I find it increasingly difficult to smile, to appear optimistic, because the problem is not whether the glass is half full or half empty (where the water is certainly made up of personnel from the national health system). Today the problem is that I find it hard to see the glass intact (ie the National Health System).
Without a glass, or in the absence of a container, the water is lost on the table. And that is exactly what is happening in healthcare today! Doctors in particular flee from hospital dependency, preferring private or general medicine, seeing in those work environments more welcoming and performing “glasses” or simply better paid. We don’t need to make macro-economic calculations, but with inflation running at 11%, having increased the expenditure of the national health service by 2 billion euros (whose total expenditure amounts to 124 billion euros) means having increased it by less than 2%, Ministerial source: “The new level of national health needs, which represents the overall funding of public and accredited health in Italy, was most recently set by the 2022 Budget Law (Law No. 234/2021) at 124,061 million euros for 2022 , 126,061 million for 2023 and 128,061 million for the year 2024.”
In summary, in recent years and for the years to come, every year the national health system has to make cuts for 8 – 10 billion euros to guarantee identical services!
“Istat has announced that in October 2022 the national consumer price index for the entire community (gross of tobacco) recorded an increase of 11.8% on an annual basis (from +8.9 % of previous month)”
But are we sure that inflation in healthcare is ONLY 11%? An example?
Do we want to analyze the costs of robotic surgery, do we want to see the costs of prostheses? Do we want to analyze the costs of biological oncological drugs?
Believe me, the increase in spending far exceeds the increase in zucchini at the market. Inflation in medicine travels on 15%. That’s why they don’t raise salaries.
The definancing is bringing all healthcare companies to their knees but especially second-level DEAs who are forced to buy the most expensive principals. In Lazio, for example, as always, the AOs are champions of deficit (even the private or university ones).
But it’s not just a problem of the Lazio Region, so much so that all the Regions are going to a return plan. In my region, Lazio, we start again with the ballet of savings and cuts. Movie already seen! The governor of the Lazio region, I’m sorry to say a doctor, started very badly: by blocking hiring by revising companies’ hiring plans downwards, perhaps predicting who patients can do without doctors and nurses! Since all the companies in Lazio are in deficit (remember inflation?) not only does it block hiring but it also decides to block careers and, worse, career progression. Not being able to oust the general managers (appointed by the previous junta) in the short term, “he” wants to decide who can progress in their career and who cannot.
In short, what is the point of renewing a contract? What are we doing to make a “container of common rules” (the CCNL), if then a regional determination is enough to screw it up! How do we convince colleagues to remain in a system that no longer exists, in a system that cannot reward professionalism with career progression but only links it to political affiliation? Because this is what it is about: the region cannot know the professionals who work in a company, their skills, their dedication to work. So much so that the CCNL assigns this task to companies. If the Lazio Region wants to decide the names that can be promoted or rejected, it means that the only way to obtain positions will be to “sell yourself into politics”. Clientism in deliberation!
The ministry of health is also governed by a doctor. At least he has good intentions! But does he govern the minister or does the minister of the economy who does not provide funds? No recovery of inflation, Not a euro for the renewal of the contract which should recover inflation in workers’ payrolls (retirees have had it). Not a detaxation of additional services which have instead been detaxed in the private sector. In recent days we have discovered that we are also governed by the Ministry of Justice Hon. Nordio, who, putting the lie to Minister Schillaci, has already said that it will not be possible to decriminalize the medical act (as happens in all civilized countries of the world).
As a sop, he appoints a commission made up of well-known jurists (obviously it becomes difficult for these themselves to go against the category of lawyers who earn money from litigation) but also made up of very great university professors, illustrious professionals in the medical area, colleagues who will certainly represent their high professionalism, but I don’t know to what extent they have precise knowledge of medical negligence, or that they have arguments to oppose to the members of the lawyers and magistrates. As usual there is no representative of the union organizations but not even of Fnomceo who probably would have something more to say!
This is also a “container” that is missing! A container (a law) that would make doctors work better.
So let’s not complain or worse, let’s be surprised if doctors leave the national health system: by dint of failure to adjust to inflation, lack of reforms, excessive taxation, inapplicability of the contract, ungoverned legal medical litigation…. in my opinion the “NHS glass of addiction” in public health no longer exists or at least it is broken and no one intends to remedy it.
Francis MediciNational Councilor Anaao Assomed
08 maggio 2023
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