by Ornella Mancin, Laura Viotto
21 FEB –
Dear director,
in the darkness into which public health is sinking more and more in our country there are flashes of light that warm the hearts of those like us who hope that the public, universalistic, sustainable national health service can continue to exist.
Last weekend we attended the second meeting in Bologna organized by the NOW OR NEVER 2018 Primary Health Care (PHC) campaign group for a paradigm shift of the current territorial care model. It is a heterogeneous group that welcomes all health and non-health professional figures interested in building a health model that takes into account the complexity of the factors that determine it (cultural, economic, social, environmental), which makes use of the knowledge of the territories and places of life, which supports the participation of the community and which benefits from the work of several professional figures who, as a team, can give an overall response to the health needs of citizens.
From a collective comparison between the various professional figures who want to contribute to this new model of health which is not interested in the disease alone but guarantees a global care of the patient with an approach that is also “holistic and above all territorial-community”, the experience of the Blue Book, a collective, participatory and permanent writing that aims to be a tool for “reflection and change for the renewal of primary care”.
The blue book is inspired by the experience of the reform of territorial primary care in Portugal which began in the late 1990s and which brought results that were much appreciated by both politicians and Portuguese citizens.
In the Blue Book, personal care goes beyond “the only biological dimension of the health-illness dichotomy” and involves the “psychological, existential, cultural, social, economic, political, environmental aspects” and the care team must take charge of all this .
In Bologna, the PHC group met to discuss concrete experiences that around Italy testify to the possibility of applying these principles.
During the first morning of work, the first models of community houses with multi-professional teams were presented (the community house of Querceta in the province of Lucca, La Rosa health house in the province of Pisa, and my experience of future medicine in the metropolitan area of Venice where I work) and a new model of nursing care in the territorial hospital in the Giuliana area of Trieste.
Numerous other experiences followed such as for example the NAT (territorial assistance unit) of Reggio Emilia born to give an answer to the many citizens left without a family doctor; o the micromanagement of a general medicine facility to “Build communities” in Ferrara or the laboratory for the creation of a community clinic according to the principles of the PHC in Ponticelli in Naples.
It was a riot of experiences scattered throughout Italy involving professionals who personally work together for a primary care model that promotes health.
Many young medical and non-medical professionals participated. Among the doctors, many are GPs and/or trainees or trainees/specialists in community medicine and primary care. All enthusiastically study, discuss, devote time and resources to the creation of a new model of territorial assistance, for a public health service that allows “being a healthy person within a healthy society”.
These experiences help us to hope. I hope that the PHC group can contaminate all public health stakeholders in the hope that this will help avoid the definitive destructuring of our NHS.
There is a beautiful song by Ivano Fossati which closes by saying: “They say there is a time to sow
And a longer time to wait. I say that there was a time dreamed that one had to dream”.
May the time of action be tainted by dreams.
Ornella Mancin
Mmg Cavarzere (VE)
Laura Viotto
Rome
February 21, 2023
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