by Gregorio Mammì
09 GEN – Dear Director,
the role of general practitioners and paediatricians of free choice has become increasingly essential for our health system, especially given the continuous loss of professionalism in this sector that we have had to record in recent years. And soon the matter will get even worse because hundreds of retirements have already been announced who will not find replacements quickly and perhaps not even in the long term: if we consider the time frame, which from 2018 reaches 2028, the General Practitioners even 4167 have been affected by retirement, in no way compensated by the new professionals (data from the Italian Federation of General Practitioners).
In my opinion, the opportunity for the reform of the regional health system was wasted with a legislative initiative that once again thought more about favoring those who made health care a business and not a service for citizens. And a survey I promoted on over 1,600 general practitioners in the metropolitan city of Milan reveals that there is still a lack of information from the Region on what role these professionals will play with regard to the new territorial network envisaged by the National Recovery Plan and Resilience. There are those who don’t even know if they are building a community house in the area they are responsible for, but the most disarming fact is the lack of information on who will manage these structures and how they intend to do so.
I fear that this is yet another demonstration of how the Lombard center-right has taken the opportunity to re-establish our health care only as an opportunity to add notches to their long list of administrative errors instead of correcting at least some. As far as I’m concerned, even from the opposition benches I still tried to make an effective contribution to simplifying the working conditions of GPs while guaranteeing the Lombards the right to have a referral doctor in their own territory without paying a subscription to the facilities private.
An example is when with motion 628 we committed the regional council to “take action so that, in accordance with current legislation, in the event of hospitalization, the certification of illness is issued directly by the structure or by the health professional concerned, relieving the General Practitioners from a duty which, in practice, they are burdened with”. Over and over again I have fought in the Regional Council to implement the possibility of facilitating the work of healthcare professionals with new technologies, such as for example the expansion of possible prescriptions using digital channels, in particular for class F drugs. also other practical solutions such as different forms of organization which with motion 458 approved in 2021 the junta agreed to “promote and favor forms of aggregation of general practitioners, not necessarily in the configuration of single-professional groups, but above all favoring multi-groups – specialists”.
I have often hit the rubber wall erected by the centre-right, but even in the context of the debate on the centre-right’s non-reform I have managed to get the principle of bringing specialization schools for general practitioners to the territory: in this way we could partially cover those gaps in personnel created by the policies of recent years and immediately encourage the creation of that relationship between the doctor and the territory which is the basis of proximity healthcare. And with decisive actions I also brought to the Council and had initiatives approved to recognize “forms of incentives, including economic ones, for GPs” in areas in need who would have agreed to raise the number of patients.
I have also tried to fight to obtain a more person-friendly administrative management by making the Regional Administration commit to “guarantee that, in the event of the retirement of General Practitioners, the competent Health Protection Agency takes an active part towards the elderly and frail patients, managing the assignment of the new doctor according to the criterion of proximity, without prejudice to the principle of free choice”.
And I could go on and on, because the organizational shortcomings of the territorial care system are innumerable. As a representative of the opposition I tried to put some patches, but the result of the survey I promoted confirms to me that the Fontana-Gallera junta remains more committed to obtaining media visibility rather than thinking about the administration of the regional machine. A trend that continues to undermine the right to health of all Lombards.
Gregorio Mammi
M5S Councilor of the Lombardy Region
09 January 2023
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