They are numerous the proposals that the regional councilor Sardinian Carlo Doria put on the table of the Ministry of Health. And he will more places available for students who want to enroll in the Faculties of Medicine of the Universities of Cagliari and Sassari at new rules for the identification of deficient offices of general medicine.
The advanced requests are mainly two: the authorization to increase by about a third, for at least three years, the places available for enrollment in the degree courses in Medicine and Surgery in the two Sardinian universities, and the start of national negotiations for the modification of the parameter currently in use to identify the lack of general practice and their ban, from one doctor every 1,000 inhabitants to one every 1,200 for urban areas with a population of over 20 thousand inhabitants, while maintaining the doctor/population ratio unchanged for areas with fewer inhabitants.
«The problem related to the shortage of general practitioners in many of the territories outside the large urban centers it is common to all of Italy and has distant origins – explains Doria -, starting from a failure to schedule turnover with a clear yesbalance between retirements and entry into the national health system. In this context, an anti-historical number programmed in the admissions to the degree course in Medicine and Surgery is included. This imbalance, made more evident by the numerous retirements of medical personnel in recent years compared to new entries, has shown – he adds – the extreme vulnerability especially on the territorial health side with large sections of the population, especially in peripheral areas, currently deprived of the presence of the general practitioner, but also, sometimes, of the pediatrician of free choice”.
The report of one doctor for every 1,000 inhabitantswhich defines the current distribution of offices lacking general medicine to be banned it is no longer adequate to give answers to the territoriesaccording to the exponent of the council Solinas: «In order to better understand what is not working and what we are intervening on, it is good to know the numbers at stake: today in Sardinia there are 979 doctors with offices (as of January 31, 2023). To these add up about 200 doctors who today have the qualifications to participate in the next call assignment of offices lacking general medicine, 418 throughout Sardinia. If each of the over 1,100 general practitioners were maximalist, i.e. had 1,500 patients in charge, the people assisted would be 1,650,000, more than the number of adults present in Sardinia».
«However – declares the councilor – the current distribution of general medicine offices, according to the parameter of one doctor for every thousand inhabitants, determines an imbalance with a concentration of doctors in the large urban centres, which are most in demand, while the strongest shortages are recorded in the peripheral offices. The modification of the parameter would lead to a slight decrease in the seats available in the metropolitan areas, which in any case would continue to be covered in a satisfactory manner, to the advantage of the more peripheral areas”.
Finally, on the doctor/inhabitant ratio currently in use: «In the past, when the number of general practitioners was greater, it could have been considered an adequate condition, but at present, having lost about a third of general practitioners in Sardinia compared to ten years ago, we find ourselves with a parameter that inevitably ends up favoring large urban centres, which are more coveted and assigned, without then having available resources capable of responding to the needs of peripheral territories. It’s as if we wanted to fight this new battle with yesterday’s rules of engagement when we had a larger army».
“Pending a national provision, the region – says Doria again – has started negotiations with the unions of general practitioners for the modification of the parameter for the identification of offices, proposing the solution of one doctor for every 1,200 inhabitants, to be applied only in areas with over 16 thousand inhabitants, but, today this solution has not met with the favor of all the trade unions and, despite an initial agreement, yesterday during the last meeting some representations did not sign the agreement».
«If we want to respond to current needs, everyone’s commitment is needed. With a view to reorganizing the territorial health system, we have foreseen the allocation of 3 million per year in the three-year period 2023-2025 for the activation of the Continuity of Care Units, which will participate in supporting the activities of general practitioners, and 50 million in the three-year period 2023-2025 to invest in the Single Role of General Medicine in a cycle of choices and an hourly cycle after rapid negotiation of the new regional supplementary agreement (AIR) which represents the tool with which to incentivize health personnel to redesign the new territorial health care including the current continuity of care which must represent a safe territorial filter for all those pathologies that can be classified in the green and white codes that today they invade our emergency rooms», concludes the commissioner.
(Unioneonline/s.s.)
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