Health is not a bureaucratic issue: each of us, when we have a serious problem, rightly claims to be treated quickly and in the best possible way. For us to be possible Waiting lists must first be shortened who continue to hold hostage anyone who has to take an exam or a visit and cannot afford to pay out of his own pocket. then it must be there the right doctor in the right place and who has the necessary time to devote to us. All this does not happen today for one reason above all: Italian hospitals lack doctors. The Covid pandemic has shown us dramatically, and we touch it with our hands every time we have to book a medical service. And now we also have to deal with the phenomenon of token-operated doctors, paid in shifts and brought to the ward by cooperatives to plug the gaps in staff, but without guarantees of quality of care for patients: it is a question of recent graduateso specialized which may end up in departments other than their competence. In the absence of controls, the same token operator can also do it between day and night shifts 36/48 hours in a row jumping from one ER to another.
The mistakes of the past
We slipped into this sieve for two reasons. The first: the lanes have gradually emptied due to the block on turnover started in 2005 (art.1 paragraph 198) with the government Berlusconi 2 and continued with the Study Program 2, Berlusconi 3, Monti, Read, Renzi. As a nationwide media out of 100 retired doctors, 10 were not replaced. But in regions such as the Laziothe Sicily and the Campania the number rises to 31.
The second: bad programming. Over the years, the ministries in charge have not taken into account how many doctors left the national health system to retire, forming as many able to enter. Result: tBetween 2015 and 2022, the negative balance between retirees and new specialists was 15,585.
The Ministry of Health corrects the shot starting from 2019when the minister Giulia Grillo unlocks turnover (bringing possible hires to a plus 10%) and increases the number of places for graduate schools. As to form one specialist takes 4-5 yearsat least until 2024 we will discount the effects of wrong programming. For 2022 and 2023, the balance between retirees and new specialists is still negative: minus 1,189.
The question that arises now: between now and 2027 will we have a sufficient number of doctors to guarantee the necessary assistance? Let’s see what the data say Agenasthe National Agency for Regional Health Services which reports to the Ministry of Health, has developed exclusively for Computer room.
Forecasts for the future
Out of 103,092 doctors working in hospitals today, 29,331 will qualify for retirement in the next 5 years. Current staffing gaps are not quantifiable, but we know that il 10% has not been replaced due to the blocking of turnover, it means that at least others 13 thousand doctors they are missing. The total requirement by 2027 therefore of 42,331 hospitals. How many new specialists will be produced by the Specialty Schools by then? Since it takes them to form 4-5 yearswe must take the specialty contracts made available between 2017/18 and 2021/2022 (passed from 6,200 to 14,378 a year). In total there are 62,350. Considering that il 10% does not finish his studies and the 25% he does not stay to work in the NHS, it means that 42,086 specialists will be ready for public hospitals, again by 2027. The income and expenses are therefore in equilibrium. It should also be calculated that with the extraordinary interventions for the pandemic they were hired for an indefinite period 1.350 medici and other 9.409 fixed term until December 2022, and if they are confirmed they will give a shot in the arm to get to 2027. All right then. Not really: the accounts go back to paper, but in reality things go quite differently.
The problems to be solved
Places in schools have been banned, some specialties, among other things, precisely those that are most neededare not chosen: this year in Medicine emergency and urgency 57% of places not covered; 17% in anesthesia and resuscitation; 74% in radiotherapy. And the list goes on. Today the 71% of the first 1,000 in the ranking who passed the competition they choose 7 specialties are 51i.e. those with more appeal: cardiology, dermatology, pediatrics, neurology, ophthalmology, endocrinology e plastic surgery. To solve the problem, those who do programming (the Ministry of Health) and those who ban places in specialization schools (the Miur) must balance the offer by reducing the places in the most popular specialties. Only in this way is it possible to cover the real needs of the NHS that emerge dramatically from the infinity of public competitions to hire hospital doctors who go deserted.
In addition, economic awards must be added to make work in the hospital attractive where today there is a great escape: in 2021 alone 2,886 doctors decided to resign, exhausted by life in the ward.
The data of the European Federation of Medical Specialists of 2017 said that in Italy the hospitals earned just over 80 thousand euros, against 85 thousand of the French peers, 130 thousand of English colleagues and 150 thousand of Germans
Nurses and family doctors
The same goes for family doctors and nurses which are the cornerstones of the enhancement of care in the area provided for by Pnrr with community homes and hospitals. Here, too, from the data Agenas it appears that the training offer can cover the number of retirements for the same period. Of the beyond 264 thousand nurses today’s retirement requirements will accrue in 21 milawhile 13.200 they are missing to cover the gaps in staff. To the 2027 will complete the training in 61.760. By that date we should therefore be able to cover the demand necessary to run hospitals and community homes.
The same situation applies to general practitioners: of the 40.250 in service today, between 2022 and the 2027 they will retire 11.261and will be available, with constant legislation, 13,895 places for the formation. But again they are just paper bills. Just watch what happens in Lombardy: in February 2022 the training course to become family doctors are made available 626 placesto the test they show up in 502accept in 379and those attending today are 331, cio met it. D’altronde, finch the Scholarship of the recent graduates who enroll in the three-year training course of 11 thousand euros the year against i 26 mila of those who choose the specialization course, it is clear that the profession of family doctor considered as a series B.
This is the result of a short-sighted national policy which is destroying the best healthcare system in the world. The parties give him a hand, which from the ministries to the top of the health companies have too often infiltrated their most faithful managers, not the most capable, mortifying the health personnel.
The new government led by Giorgia Meloni and Minister Orazio Schillaci is expecting a signal of taking charge of the problem. For the moment only smoke and the risk of a gamble
Smoking the refill of the doctors no vax (mostly freelancers) because their return to service was already scheduled for December 31st. The risk of gambling the abolition of the obligation of the mask in hospitalswhen common sense would suggest keeping it given the fragile condition of those who crowd them.
31 October 2022 | 07:05
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