In Sicily, health care is at great risk

The regional health blanket is too short. And to make ends meet you have to pull it one way or the other, the balance of numbers or levels of assistance. The document bequeathed by the former general manager of the regional health department, Mario La Rocca, in mid-February, is disruptive from this point of view. And it was anticipated, a month ago, by a series of letters sent to the various health agencies of the island, which had to make the best of a bad situation. The risk, however, is that the cuts don’t stop there. A risk that also emerged during yesterday’s session of the Ars Health Commission, which was attended by the regional councilor Giovanna Volo. «The faults and defaults of the regional government must not fall on assistance to citizens – says the group leader of the M5S to Ars, Antonio De Luca -. Indeed, today we learned of the need for the councilor for health to negotiate cuts of 120 million euros with the Asp and Sicilian hospitals. The risk that this translates into new cuts to services and assistance to citizens, who are already heavily in deficit in Sicilybut it is as intolerable as possible.” During the session, the document was finally produced in which La Rocca, before leaving his office, described the financial condition of the regional health system. According to De Luca «it is unlikely that the engineer La Rocca himself was not summoned to the meeting. And it is absurd to have learned that the hole produced during the years of the pandemic, also due to a wicked management of the Healthcare accounts, is partially covered by a mere stroke of luck, i.e. thanks to the repayment of the sums previously destined for the payment of mortgages , reimbursement imposed by the Court of Auditors with the rejection of the 2020 report”. The contents of the La Rocca document are emblematic of how the accounts of the regional health service are set up. “A deficit of 248 million – wrote the former executive – due to the extraordinary Covid costs, which amount to 439 million euros for 2022”. Deficit covered, in fact, with mortgage shares. “It was clear – added La Rocca – the danger that the dragging of Covid costs on the 2023 budget could lead to a structural increase in the costs of the system which, if not adequately governed, would bring the budget itself into disequilibrium”. And to avoid this risk, “the 2023 consolidated financial statements were “designed” by imparting the appropriate indications to each company in good time”. Those indications started on February 1st and the various companies had to take them into account when preparing their financial statements. The Policlinico di Messina, for example, as we read in the report to the budget of the extraordinary commissioner Giampiero Bonaccorsi, had to review some aspects, especially regarding personnel expenses. Complaining that in the Palermo directives “there is no reference to the memorandum of understanding between the Region and the University of Messina” linked both to the values ​​of the DRGs and to the activity of training and research, a specific characteristic of the university hospital. The point is that despite a personnel requirement quantified at almost 102 million euros, that account “has been considerably reduced – explains Bonaccorsi – for the purpose of respecting the spending ceiling assigned to this company, equal to 86.7 million, for the raising of which discussions have been initiated with the competent Department of Health ». A downsizing that will have a direct consequence: “The impact in both welfare and social terms of the reduction of at least 70 personnel, related to the fact that, following the conclusion of the pandemic, the cost of personnel hired to deal with the Covid emergency it can no longer be deducted from the expenditure ceiling”. The commissioner of the Polyclinic still specifies that “a large part of the health personnel hired for the Covid emergency is in possession of the requisites for stabilization and the staffing endowment has vacancies such as to guarantee their recruitment, against a spending ceiling that does not permits permanent recruitment. In short, there are personnel with the requirements, there are vacant posts, but «the coverage of vacant posts, necessary to guarantee the implementation of the hospital network and the essential levels of assistance, cannot be implemented because it would exceed the current ceiling expense”. An “impassable limit” which, says Bonaccorsi, “does not allow us to accept the new requests for equalization of teachers and researchers, contravening the provisions of the memorandum of understanding” between the Region and the University. Read the complete article in the paper edition of Gazzetta del Sud – Messina