the CF
The Center Right won the elections and the Brothers of Italy established itself as the first national party whose leader the Head of State should soon entrust the task of forming the new government. The coalition’s health program, as is known, is very concise and therefore to better understand what could change for the NHS we went to re-read the broader Meloni program. And, alongside proposals in line with health policies in recent years, there are however some clear signs of a turning point and a great deal of attention to psychological well-being
26 SET –
The Center Right won the elections. And among the three main components of the grid to prevail clearly is the Brothers of Italy, led by Giorgia Meloni now a candidate to become the first woman premier in Italy as well as the first leader of a decidedly right-wing party to govern the country since the war.
For this reason, in order to try to understand if and how something will change in national health policies, I think it is correct to go and re-read not only the very stringent unitary program of the coalition but above all the broader one of Fratelli d’Italia, the first Italian party and expression of the next. Prime Minister.
However, let’s start from the seven points of the unitary program:
• Development of local health care and territorial medicine, strengthening of predictive medicine and increase in the workforce of doctors and health professionals.
• Update of pandemic and emergency plans and revision of the National Health Plan.
• Beyond the pandemic: restoration of ordinary services and screening procedures, reduction of waiting list times.
• Extension of ticket-free medical health services.
• Fight against the Covid-19 pandemic through the promotion of virtuous behavior and structural adjustments – such as controlled mechanical ventilation and the enhancement of transport – without restricting individual freedoms.
• Reorganization of specialization schools in the medical area.
• Review of the national cancer plan.
What to deduce from these seven points? First of all, a confirmation of the policies hitherto hoped for a little by all governments in recent years and that is the need to give a new structure to territorial medicine to which, let us not forget, the PNRR dedicates about half of the funds to health.
Then the explicit desire to turn the page on the pandemic both by restoring the ordinariness in the assistance modalities and recovering the waiting lists but also, this can be clearly understood, definitively abandoning any hypothesis of new limitations of personal freedoms which, moreover, no one has desired, not even on the other side.
Then there is a point that, strangely, does not seem to me to have ever been taken up in the electoral campaign despite its potential appeal, which is the expansion of ticket-free medical health services.
And finally some big announcements: revision of the national cancer plan and the pandemic plan and reorganization of the specialization schools in the medical area.
In short, if we want to stick to the words and not to the assumptions, from these seven points, we have very generic commitments and slogans for which we will have to wait for the first real moves of the government that will come to understand whether or not something will change for health.
Let’s move on to the party program of the future premier Giorgia Meloni.
The incipit chosen by Meloni to introduce the health part of his electoral program refers us to the WHO and its now ecumenical definition of health: “According to the WHO, health is“ a state of total physical, mental and social well-being ”and not simply“ the absence of disease or infirmity ”.
“It is time – reads the FdI program – for public health to return to taking care of the well-being of the citizen in its entirety, offering proximity solutions, in a reasonable time, and of quality”.
“We must overcome the pandemic emergency, having clear the importance of health for our nation, through a new vision of well-being that derives from prevention, an efficient territorial care system and attention to all diseases ”, concludes the brief introduction to the health section of FdI.
And that “Overcoming the deadlock of the pandemic” is one of the strong points of the program is confirmed by the fact that by reading the dedicated chapter, it figures in first place.
But how to overcome it? First of all by restoring “the ordinary performances and the procedures of screening”, then, strengthening “predictive medicine with a mechanism of rewarding access to the health system for those who follow a regular and agreed path of monitoring the state of health“.
And here we discover a first real novelty of the Meloni program with the idea of rewarding those who are more attentive to their health with faster access to treatment. A suggestive idea but obviously all to be declined both in the practical and in the ethical aspects on which already in the past there were heated debates about the so-called “ethical state”.
Still on the subject of recovery after the pandemic, FdI promises “the reduction of waiting list times” and, another novelty, the “creation of a Health Authority, independent at an administrative level, with inspection and reporting to the competent authorities, to which every citizen can turn for lack of quality or lack of access to services “.
If we understand well, it would therefore be a new Authority, such as those already operating on competition or privacy, which would be responsible for monitoring and verifying “medical malpractice”.
Moving forward with the program, we find the commitment to “Promote the synergy between general practitioners and the local hospital system also through a centralized and regional IT booking platform for diagnostics and hospitalization, with the possibility for general practitioners to make a number of urgent reservations in hospital and diagnostic centers ”.
Basically a sort of “super Cup” with an active role of general practitioners.
And then the “possibility for citizens to allow access to their electronic health record also to general practitioners, nurses and pharmacists” and the promise to “encourage the spread and development of telemedicine, home care and territorial aids in inland areas with low population density “.
FdI then puts on paper the commitment to “reduce the inequalities between the Regions in the provision of health services and essential levels of assistance (Lea)” but without explaining well how and without touching the issue of differentiated autonomy very dear to League.
Meloni then promises to “extend Lea to essential dental care” obviously to be defined and overcome “the system of access to the faculties with limited and closed numbers”, through “access for all to the first year and selection for the passage to the second year”, essentially the so-called “French model”.
Commitment also for the “strengthening of the figure of the school psychologist”, for “the increase and use of the Fund for the treatment of subjects with autism spectrum disorders” and “the updating of the national cancer plan”.
Then a suggestive slogan idea that of the creation of “cardioprotected city”, favoring “the supply, maintenance and recharging of defibrillators in Italian municipalities”.
And then the commitment “to the constant updating of pandemic plans and emergency plans”.
And we come to the Covid chapter. For FdI, the “fight against Covid-19 and new threats” must take place through “structural measures”, such as “controlled mechanical ventilation in schools and offices, and the enhancement of transport”.
But there must no longer be any “vaccination obligation against Covid-19”, which will be replaced with “information, promotion and recommendation to vaccination”, in particular for “age groups at risk and situations of fragility”.
Furthermore, it will be necessary to guarantee “full freedom of choice between the vaccines authorized by the EMA and AIFA and recalls”.
And still “no reintroduction of the green pass” while the “Possibility of screening in environments at risk, to protect fragile individuals “.
And then the commitment to the establishment of “a commission of inquiry on the medical and economic management of the Covid-19 pandemic as well as on adverse vaccine reactions”.
A separate paragraph is then dedicated to “psychological well-being” defined as the “Cinderella of the NHS”. “Attention to psychological well-being treatments – reads the program – is fundamental to guarantee people’s health but also to improve the quality of relationships, coexistence and life, affecting the paths of affirmation and achievement in the working context “.
For FdI it is therefore important “over 40 years after the law establishing the NHS”, “to innovate and strengthen mental health services, child neuropsychiatry and services for pathological addictions, as well as create a network for the prevention and promotion of psychological well-being , able to hinge on schools, primary care and welfare services “.
“The psychological bonus, which we supported in Parliament – reads the program again – is a first step to give attention to the unsatisfied need for mental wellbeing but, obviously, it is neither sufficient nor exhaustive. Our proposals include the introduction of the School Psychologist in the school staff, as well as the strengthening of primary care, through the coaching, of General Practitioners and Pediatricians of free choice, of the so-called Basic Psychologist, in addition to the proposal of the law on the acceptance of psychotherapy “.
“We want to build a state that guarantees social and health services to effectively help people overcome psychological difficulties and, in doing so, prevent even more serious psychiatric manifestations. The health of Italians is at stake, the possibility of feeling better about themselves and with others, to live a full and satisfying life, to make people feel fulfilled who, actively, will have to contribute to reviving Italy “, concludes the health program of the party that won the elections.
C.F.
September 26, 2022
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