In 10 years 173 hospitals closed, staff reduced by 46 thousand units, poor progress on territorial assistance and more and more space for the private sector. Here is how the NHS arrived in front of Covid

by Luciano Fassari

Analysis of Health Newspaper of the Statistical Yearbooks of the NHS of the Ministry of Health relating to the years 2019 and 2010 which photograph the change of skin that in 10 years has seen our health less and less public, with fewer hospitals and personnel and which has not been followed by an adequate strengthening of the territory both in terms of workers and services. Here’s how the NHS presented itself in the face of the pandemic. YEARBOOK 2019 – YEARBOOK 2010

June 16 – In the last year of the pandemic, much has been said about divestment in our health care in the last decade. And now with the publication of the new statistical yearbook of the NHS of the Ministry of Health for 2019 (the year that preceded the pandemic) it is possible to evaluate how the face of the National Health Service has changed in a decade and in what conditions it has arrived. in front of Covid. And so comparing the same report for 2010 emerges with the clarity of the numbers the forced diet to which the various Governments that have followed one another in the last decade have subjected the NHS which in 10 years has found itself with 173 fewer hospitals, fewer staff (over 46 thousand employees and affiliated doctors) and a territorial assistance to the stake with only few and insufficient progress in integrated home assistance.

Let’s start with the hospitals. In 10 years 173 have been closed, as much as 15%. In 2010, between public and private, there were 1,165 while in 2019 they fell to 992, with a more marked cut for public ones.

The facilities for specialist outpatient care also declined: they were 9,635 in 2010 and dropped to 8,798 ten years later. The cut in Territorial Residential assistance is even more marked, which compared to the 9,635 structures present in 2010 has 7,683 in 2019. In contrast, however, the semi-residential territorial assistance that instead sees the structures grow: they were 2,644 in 2010 and 3,207 in 2019 The same can be said for the Rehabilitation, which has passed from 971 structures to 1,141. On the other hand, the numbers for other territorial assistance are stable.

But what is most striking is that the cuts concerned the public sector which in 2019 counts 41.3% of the total structures against 46.4% 10 years earlier.

Therefore, fewer hospitals but also fewer beds: in 10 years between public and private, 43,471 beds have been cut between ordinary hospitalizations, day hospital and day surgery. The number of Consultors is also down: 1 out of 10 have been closed (they were 2,550 in 2010 against 2,277 in 2019). Instead, Mental Health Centers have grown (they were 1,464 ten years ago and they became 1,671 in 2019).

But the bleeding of the public NHS is not only structural. Another sore point is the healthcare staff: in 10 years there are 42,380 fewer units (-6.5%). Specifically, 5,132 fewer doctors (they were 107,448 in 2010 and in 2019 they dropped to 102,316) and 7,374 fewer nurses (they were 263,803 in 2010 and in 2019 they dropped to 256,429).

Fewer public employees but also fewer affiliated doctors. The family doctors from the 45.878 that were in 2010 became 42.428 in 2019 (-3.450). Pediatricians are also down (-310 in 10 years for a total of 7,408 units in 2019). The doctors of continuity of assistance (former medical guard) are also slowing down, from 12,104 in 2010 to 11,512 in 2019 (-592).

As we have seen, the 10s of the new century have changed the face of our health service which is less and less public, has fewer hospitals and personnel, which has not been followed by an adequate strengthening of the territory both in terms of men and women and of services. . The only data partially in contrast is the Integrated Home Care (Adi): in 2019 1,047,223 patients were assisted against 597,151 even if the hours provided per patient went from 22 in 2010 to just 18 in 2019. And in any case the number of assisted persons is still much lower than that recorded in the main EU countries, which is why an ad hoc financing was arranged in the latest NRP for the strengthening of the ADI.

Luciano Fassari

June 16, 2021
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