The draft revision of Ministerial Decree 70, the “Regulation defining the qualitative, structural, technological and quantitative standards relating to hospital care” in force since 2015, which had aroused profound criticism among those in charge of hospital care, seems definitively set aside by the Minister of Health Roberto Speranza jobs. During the question time at the Hope Chamber he defined the text as a “non-existent fraud”, reiterating what emerged during the talks with the representatives of the scientific societies gathered in the ‘Permanent Forum on the National Health System in the post Covid’. So stop the de-hospitalization policies that reduce the essential characteristics of hospitals. “The policy of progressive weakening of hospitals must be abandoned”, he underlines Francesco Cognetti, coordinator of the scientific societies of the Forum: “We must give more to hospitals, certainly not less”.
Archived draft
According to scientific societies, the now outdated draft reform of the Ministerial Decree 70 risked causing serious damage to Italian public health and potential damage to millions of patients. No reference to qualitative standards, to the development of clinical aspects and to the increasing complexity of diagnostic and therapeutic processes, to organizational, clinical and scientific problems connected with hospital activities, but only aspects concerning some quantitative parameters of hospital care were mentioned. “Compared to pre-Covid, a decrease in the number of ordinary hospital beds had even been foreseen throughout the territory”, reports Cognetti.
Towards a new phase
A programmatic document emerged from the Forum with concrete proposals for the redefinition of healthcare in our country. A reform of hospitals – the scientific societies recognize – is necessary and urgent. The shortcomings in the hospital sector were among the main causes that caused and induced harmful effects during the pandemic, responsible for the very high excess mortality for Covid-19 as well as for other diseases, especially time-dependent.
As the Minister himself pointed out, the responsibilities are to be found in the weakening of hospital structures and services put into practice in recent decades. “A situation that must be addressed immediately, if only in terms of design, also because their practical application will be neither easy nor quick”, adds Cognetti. “It is necessary to speed up times. In fact, we will soon find ourselves confronted with an unprecedented and painful fact, such as the increase in excess deaths for various chronic diseases, especially oncological ones. Moreover, even in these days, the hospitals of various Regions, although subjected to a much lower stress test than those recorded during the first, second and third wave, are already suffering ”.
Experts hope to open a new phase of confrontation between all stakeholders, a phase in which the reference parameters are calculated in relation to a concept of a modern hospital that is adequate both for the complexities to be managed and for the sick, and that you face the problem of the relationship between the territory and the hospital, two entities that must work in synergy and collaboration. “The great complexities of the hospital cannot be managed in a single way but in a participatory way with a defined and relevant role for the clinical professionals who work there”, concluded Cognetti. In the interest of millions of Italian patients.