Health Management at the crossroads: definitive disappearance or relaunch

by Gianfranco La Bella

04 OTT – Dear Director,

on behalf of the biologist trainees, I would like to submit an analysis and a complaint on the now exhausting situation of the health area trainees, sadly defined as “non-doctors”. Although the pandemic we are experiencing has shown (if it were needed) how the National Health Service is based on a complex and indispensable multidisciplinarity, politics continues to see health care in a myopic way only in the figure of the doctor.

Yet there is an articulated group of professionals belonging to the same category of doctors, the so-called health managers (biologists in primis), which is always forgotten by politics. The reference is clearly to the non-remuneration of specialization schools in the health area reserved for “non-doctors”. Already this wording, which has now become normal in the political and health dialectic, places a distance and a difference between figures who are actually different, so much so that the Interministerial Decree no. 716/2016 “Reorganization of specialization schools with access reserved for non-doctors” has formally standardized the training courses between the two figures.
Basically, the same duties but different rights.

Although the mistake in not finding funds for the training of these health professionals has been perpetuated, the mockery of recent years has now made these categories of simple extras and no longer the main actors (as they are) of the NHS.
Indeed, the increase in funds and consequently the number of grants for medical specialist training has weighed heavily on the training of other health professionals.

If for the academic year 2018/2019 (pre-pandemic) 244 grants were allocated for medical specialization courses in the clinical services area (Clinical pathology and clinical biochemistry, microbiology and virology, medical genetics, pharmacology and clinical toxicology, nutrition, health statistics and biometrics), for the academic year. subsequent 2019/2020 and 2020/2021 (post pandemic) were respectively 596 and 827 (see table below).

Detail of the number of places and grants allocated for the specialist training of doctors in the three-year period 2019-2021

Inevitably, this has created enormous damage in the specialized training of biologists, pharmacists and chemists and in their future presence in the NHS.

First consequence: the Universities have no longer published the admission calls for specialization schools in the health area reserved for “non-doctors” (there is no single national competition), or by reducing the number of places reserved for them, seeing themselves ” invaded ”by medical personnel in laboratories and departments.

Second consequence: in a few years there will be only medical personnel in laboratories and the total disappearance of the other categories.

Third consequence: funds earmarked for medical training lost. Many of the doctors who enter one of the aforementioned specialization schools after the first year change specialization, preferring a purely clinical one, effectively leaving the scholarships destined for them in a limbo whose end is unknown to most.

It is necessary and urgent to resolve this situation as soon as possible, which has been affecting the specialist training of biologists, pharmacists and chemists for years. Now the maximum limit has been reached, or action is taken or the definitive disappearance of these health professionals from the health management and the NHS will be decreed.

For this reason, the Minister of Health, the Minister of University and Research, the Presidents of the professional associations involved, the President of the Conference of Regions and Autonomous Provinces, all the Parliamentary bodies concerned and the health management trade unions are asked to intervene. to remedy this absurd situation that penalizes and discriminates against professionals in the healthcare management.

The actions to be taken to avoid this:
– Remuneration of “non-medical” healthcare specialists;
– Single national competition for access to specialization schools in the health area reserved for “non-doctors”;
– Number of places available equal to national needs;
– Study grants / training contracts for all the places available;
– Creation of a national observatory on specialist training in the health area.

Dr. Gianfranco La Bella

Representative of Biological Specializing Students, Puglia

04 October 2021
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