There is a shortage of at least 840 paediatricians in Italy, and each of those currently in service must follow at least 100 more children over the maximum threshold established by law of 800 children to be assisted for each doctor, with peaks of over 1,000 assisted in Piedmont, Tuscany and the Province of Bozen. This was reported by the Gimbe Foundation which speaks of families increasingly in difficulty with large regional differences.
In absolute terms, the national average is 896 patients per doctor and at the regional level only Umbria (784), Sardinia (788), Sicily (792) and Molise (798) remain below the ceiling without exceptions; 17 Regions instead exceed the average of 800 patients, of which Piedmont (1,092), the Autonomous Province of Bolzano (1,060) and Tuscany (1,057) exceed the average of 1,000 patients.
From the pediatrician up to 18 years to protect the health of adolescents
by Tina Simoniello
Pediatricians decreased by 5.5% in three years
Between 2019 and 2021, the professionals affiliated with the national health service decreased by 5.5%. “The alarm on the shortage of paediatricians of free choice, today is raised by parents in all regions, from north to south – he says Nino Cartabellotta, president of the Gimbe Foundation -. They complain about bureaucratic issues, lack of responses from the local health authorities, paediatricians with exorbitant numbers of patients, up to the impossibility of exercising the right to enroll their children with the family paediatrician with potential health risks, especially for the youngest and of the most fragile”.
“Compromise” rules
To better understand the causes and dimensions of the phenomenon, the Gimbe Foundation has analyzed the critical aspects of the rules governing the inclusion of free-choice paediatricians in the national health service and estimated the extent of the shortage in the various Italian regions.
“It is good to specify three fundamental aspects – continues Cartabellotta -. The rules on the age groups of exclusive assistance of minors, those to define the ceiling of the assisted and those to identify the areas lacking in paediatricians are the result of compromises with general practitioners , as well as the trade union policies of the paediatricians themselves. Secondly, on shortages and needs it is only possible to make estimates at the regional level, because the real need for paediatricians is estimated by the individual Local Health Authorities”.
The exceptions that lead to 1,000 assisted
Up to the age of six, children must by law be assisted by a pediatrician of their own choice, while between the ages of 6 and 14 parents can choose between a pediatrician of their own choice and a general practitioner. At the age of 14, the revocation of the doctor is automatic, except for patients with documented chronic pathologies or disabilities for whom an extension can be requested up to the age of 16. According to the provisions of the Ministry of Health, the maximum number of patients assisted by a pediatrician is set at 800, but there are various national, regional and local exceptions which often lead to exceeding 1,000 members.
Letter from paediatricians to the Minister of Health: “Care guaranteed for all children, but without waiting lists”
by Annamaria Staiano
Underestimated need
“It is quite clear that the calculation method underestimates the need – underlines the president of the Gimbe Foundation -. Paradoxically, referring to the rules in force, paediatricians would even be made redundant because their need is estimated only for the little ones up to the completion of 6 years”.
“The shortage derives from errors in planning needs, but remains strongly conditioned both by short-sighted trade union policies and by local variables that are not always predictable which make it difficult to calculate. Raising the retirement age to 72 and increasing the ceiling to 1,000 serve only to sweep the dust under the carpet and not solve the serious shortage problem”.