Medici versus nurses. The former accuse the latter of wanting to appropriate health functions that do not belong to them. The latter think instead that the white coats want to prevent him from breaking through the glass roof, making sure that nurses can take on managerial roles within health facilities. The side effect of the clash is the risk that nurses and all the remaining health personnel, 600,000 people in all, will see the possibility of obtaining the increase envisaged by the new contract of 175 gross euros per month and the arrears that in some cases they are worth up to 4 thousand euros. But let’s go in order. The council of ministers gave the green light to the new health contract, which affects all employees in the sector except doctors who have a separate negotiation, last October 5. Now there is only the green light of the Court of Auditors and then the raises and arrears can be paid. And it is precisely to the accounting magistrates that the doctors have transmitted their grievances. Anaao-Assomed and Cimo-Fesmed, have sent a letter to the Court of Auditors claiming that “the staff of the health role cannot manage clinical-assistance and diagnostic processes, tasks that according to the law fall exclusively within the competences of medical graduates and Surgery ».
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In short, the contract would violate the law and could give rise to disputes. Article 28 of the agreement signed by the unions with Aran, the agency that negotiates renewals for the government, has been targeted. The article in question is the one that regulates the “assignments of organizational function”. Basically, the health and social health personnel can also be entrusted with management and administrative responsibilities.
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The nurses immediately took sides against the position of the doctors. For Andrea Bottega, general secretary of Nursind, “it is a real interference, a straight leg entry, among other things”, he explains, “when the hypothesis of a national collective agreement, signed before the summer, it has already been subjected to scrutiny by the government and the Regions ”. But there’s more, says Bottega. “With their observations”, he reasons, “the doctors demonstrate that they cannot read or do not know at all the hypothesis of a sector contract which, of course, cannot be placed either above or outside the law on the system of the assignments “.
Even the president of Aran, Antonio Naddeo, was surprised by the stance of the medical unions. “It is worth remembering”, he explains, “that in article 24 of the same hypothesis of agreement, the prerogatives of the managerial staff, represented by the two trade unions, are safeguarded, providing that the superordination within the company organization and the special skills and responsibilities of the manager for all types of office “. But above all, Naddeo asked himself, “given that according to the two acronyms this rule is so invasive of the doctors’ competence (and it is not), because they realize it now, given that the hypothesis was signed on June 15, 2022, so four months ago? ».
In reality, the new system of appointments serves to contractually regulate the growing managerial role that nurses are assuming in the territory. According to an analysis by Fnopi, the National Federation of Nursing Orders and Professions, there are more and more nurses appointed as health district directors. If in 2018 there were only four directors recruited from the ranks of nurses, in 2022 they became as many as fifteen. There are also three general manager nurses of health companies, two public and one private agreement. Two nurses in Emilia Romagna – the first Region to have formalized the role with regional law – have been appointed care directors; seven nurses with the qualification of social and health director of companies, as well as of course all the nurses who are managers or managers of the services of the health professions at company level, present in practically every facility where these figures are foreseen.