Once upon a time there was healthcare, in Sardinia. What remains after the pandemic hurricane is very little compared to the good levels of performance achieved years ago. And now there are even those who regret the commissioner Mario Niedduoverwhelmed by the reshuffle in the regional council imposed by the president Christian Solinas. His successor, Charles Doria, is managing to impatient most of the trade unions and trade associations. In the meantime, the majority in the Regional Council came together and defended it compactly (34 votes to 17) from the no-confidence motion proposed by the centre-left and the M5s. However, the tactical alchemies in the courtroom are not able to lower the tones of the general protest that arises from all sectors of public health: among the charges, the interminable waiting lists that are only minimally been reduced.
Now we have to record the answer that theAres (Regional health company) today sent to the cooperative centers regarding the affair of the management contracts residential, semi-residential and home serviceswith particular reference to mental health centers at the end of Asl of Cagliari, Sanluri, Oristano and Lanusei. The medical director of Ares, Joseph Dessihe reminded Federsolidarietà-Confcooperative, Legacoop sociali e Agci Sardinia that it is up to the Health Trusts to “organize health and social health services and manage the related procurement contracts”, which in those specific territories have expired some time ago. The problem therefore rebounds towards the local health authorities. The regional health councilor has so far not intervened in the matter.
Meanwhile, the discontent that winds its way among the Sardinian social cooperatives is taking shape more and more. This time it’s theAsarp, the Sardinian association for the implementation of psychiatric reform, which has convened a press conference to denounce an emblematic situation that is now paradoxical. There “Franca Ongaro Basaglia” therapeutic communitymanaged by Asarp Uno social cooperativeis a high-intensity reality that was opened in October 2016, following a six-year tender from the ASL 8. It welcomes eight people between the ages of 18 and 55 (4 women and 4 men) who are carrying out the their individual rehabilitation project: some are planning their return home with a supported shared housing project, others have resumed university studies, still others are experimenting with work inclusion projects, a couple of them are supported in the delicate recovery of family relationships .
The contract is currently going ahead under an extension regime. The tariffs, therefore, have not been adjusted and with them neither the intervention strategies. In essence, the cooperative loses because since January 2023, the ASL has not paid for services and community workers have not received remuneration. The cooperative finds itself in extreme difficulty also because it has to face huge management costs (room rent, utilities, food, insurance policies, security costs, use of company cars, etc.). “To date there has been no response from the Region and the Local Health Authority, the only exception is the letter from Ares,” he explains. Rosario Angrisani, vice president of Federsolidarietà Sardegna, to which Asarp Uno is associated. «On this matter, the mental health department of the ASL has expressed a positive opinion, however, other administrative steps are needed. It is a question of respect for the patients but also for the workers of the social cooperative, who have families and have been hanging by a thread for too long”.
«Ares basically recalls that the Local Health Authorities have full autonomy in defining relationships with suppliers for community activities and everything that takes place in the area of competence. Ultimately, he gets out of it », she accuses Gisella Trincaspresident of Asarp and national president of theUnasam – National Union of Mental Health Associations. «It is truly disturbing that a public company of this caliber does not consider it necessary to express an assessment on the choices of the general directors of the Sardinian local health authorities. Even at a national level, the opening of places that allow people to be kept under custody is called for, while in Sardinia the territorial communities are closed to allocate the structures to anything other than mental health and the paths of recovery and people’s emancipation . There is a political-cultural vision that goes in a diametrically opposite direction to the real needs of patients and their families».
“The six-year contract expired in October 2022,” he says Stephanie Matt, president of the Asarp Uno social cooperative (whose members are not the operators, but the patients’ families) and manager of the therapeutic community Franca Ongaro Basaglia. «Before that deadline we sent a Pec to the management of the ASL and Ares Sardegna, asking to know the decisions taken regarding the expiry of the contract. In the meantime, the users continued to stay in the community for the continuation of the rehabilitation project. Another reminder email was sent on 12 December: again no response. On 3 January 2023 we sent a third email to the Ares Sardegna purchasing office, highlighting that we had not received any extension for the continuation of the existing service. Indeed, no user was discharged from local services. To this communication, Ares replied that the invoice could be issued for the payments for November and December 2022. On 4 January, the Mental Health Department placed another user in the community. But after repeated attempts on our part to get answers, a few days ago we received a communication from the director of Local Health Authority 8 who, in response to a letter from the Ares purchasing office, said verbatim: “We inform you that it is not the intention of this Management to proceed with the request for renewal of the services in question”. In short, beyond the damage, the insult. It is not known, at the moment, what will happen to the patients and, least of all, the community workers. Who continue to work but do not receive a salary.