LAMEZIA TERME “Calabrian healthcare has the numbers to be treated, the keystone for the future is to support Calabrian doctors and managers with the right figures who come from outside and well-organized structures”. A historical figure in the sector expresses his point of view on Calabrian healthcare, who over the years has held important roles and positions (up to two weeks ago, for example, he was the regent general manager of the Region’s Health Protection Department) even in very difficult contexts . It is about Giacomino Brancati, guest of the second appointment of “Health and Health“, format de The other Corriere Tv, broadcast on Saturday at 9 pm on channel 16. Brancati is well aware of the problems of the sector, first and foremost it is the organizational deficits that paralyze the machine, leading to the denial or delay in the provision of services to citizens. “In Calabria we have a fundamental problem that does not end with the holding of competitions, but with the management of the entire functional system. Here the production of professionals itself is lacking ». It is not uncommon, in fact, that, following a diagnosis, Calabrian citizens have to look for a specialist outside their territory, and this happens for Brancati above all due to a lack of the “training market”. “That it is necessary to train more and more specialist figures – affirms the epidemiologist – it is clear also looking at the planning given to the NRP, government resources that focus a lot on training ». Healthcare, the Calabrian one, which rests on a system of deficiencies – outlined by some element of excellence – which has few resources, not only from an economic point of view (as the commissioner reminds us since 2009) but also and above all from the point of view professional, and which according to Brancati can only be healed with the right strategy: «Well-organized structures and specific training for high-level specialist figures».
“Not only the negative effects of Covid on health care”
To further complicate things in Calabria, Covid has arrived, with all its restrictions, additional services, and extra beds to be made available for those affected by the virus. But for Brancati there is a favorable factor caused by the pandemic: “The Region – he said – thanks to Covid has saved several million on health migration (in 2020 he spent 220 million against the 316 of the previous year). “By avoiding moving, the Calabrians were treated on site – he continued – and in fact the surgical services have greatly increased, as well as the cost of treatments outside the region has been reduced”.
“A ‘bad’ repayment plan because reducing expenses does not mean optimizing”
From the commissioner onwards, speaking of health has almost always been a discussion on the re-entry plan, or on that operation that should have oxygenated the whole system by changing point by point the inefficiencies present in health, at the time of the arrival of the first commissioner. According to Brancati, the repayment plan «has clouded the entire horizon of problems to be solved providing a single answer for each question: reduction of expenditure so simpler “. “Cutting costs without a selection – he commented – does not necessarily optimize services, the cuts must take place in a calibrated manner”. Among the things that have not yet been healed with the commissioner, but on the contrary have registered a worsening, are the Lea (essential levels of assistance). These represent one of the fundamental indicators for the good performance of a health system and “declined in the oncological field – says the doctor – the Lea determine the conditions of care and the life expectancy of the patient”. Here Brancati introduces the theme of early diagnosis, which “affects at least 50% on the eventual recovery from tumor pathology in a patient”, a form of check-up that could be defined as lifesaving, in short, but which in Calabria – according to the former regional manager – “is included in a dramatic situation “. “The good oncologist or the good surgeon – explains Brancati – are not the factor on which to center the organization of care, on the other hand, the oncology network system plays this role “. The latter includes a concatenation of examinations, diagnoses and therapies, and an important role, in this chain, is played by screening, a practice still little followed in the region. “If out of 10 people called to do a preventive check on breast cancer only two women show up – says Brancati – it is clear that screening loses its effectiveness”. The cultural reticence that characterizes the Calabrians in the prevention campaigns for the former executive “is also a result of the bad return plan. For 10 years we thought almost exclusively of the plan – he continues – and the cultural evolution of a society on health issues was blocked. The mayors – he gives an example – have continued to talk about services in their territory, instead of aiming for adequate and quality services, perhaps even in the neighboring area “.
“I too did chemo and follow-ups in Calabria”
What Brancati outlines is still a fragmented health system with branches that work alternating with others that are chronically “badly managed” or have never been activated. All this macrocosm generates mistrust among the Calabrians who, when necessary, or regardless of the need, choose to be treated elsewhere. Brancati himself is experiencing a particular phase of his life: «At the moment I am doing periodic follow-ups, due to a tumor pathology, and I am doing them in Calabria. After the diagnosis of an oncological disease it is right to move to the more specialized center. When I discovered I was sick – he said – I opened the national portal of Agenas to identify the structures that operated that pathology and I chose the center with the most performances ». Choosing the facility that has a large number of cases similar to your pathology is a good choice to make, but not the only one. «When care becomes standard and depends on international protocols – continued Brancati, one can rely on regional structures. I myself underwent the last cycle of chemotherapy at the Lamezia Terme hospital and I do my checks here “. In conclusion Brancati wanted to specify that «outside of oncology in some medical areas we are also a reference for other regions and there are patients who come specifically to our wards “. Therefore, there is also a flow of people who come from outside to take care of themselves in Calabria, a phenomenon that, however positive, does not yet have the right importance to counterbalance the atavistic distrust of the Calabrians in their health system.