VENEZIA – «Long months of silence and interrupted dialogue. The absence of a clear primary care reform plan for the Veneto, including resources. A few sporadic meetings, apparently more to buy time than to really address the critical issues. Time and patience which, however, have now run out. For this, with great bitterness, the Fimmg regional Veneto is forced, for the second time in a few years, to proclaim the state of agitation and the eventual call to strike by the profession». Thus begins the release of the Federation of general practitioners who today called a press conference to make the reasons for the malaise public.
«Unfortunately, for too long, this relationship with the Region has cracked – say the leaders of the professional association/union of general practitioners – Family medicine no longer receives due attention despite the serious crisis that Primary Assistance is experiencing, due to the culpable lack of regional programming which has inevitable repercussions at the individual health care level. The risks that are looming on the horizon are concrete: more and more citizens could be left without a family doctor and two bulwarks of general medicine are already missing, the relationship of trust and proximity. Fimmg Veneto has not remained silent in this long period: it has continuously drawn the attention of the Region with proposals and projects to face the future, according to the new and growing needs for assistance of a population with complex needs and aging; documents and proposals presented at all levels, managers, officials, V commission of the Regional Council, Regional Council».
Criticalities
However, according to Fimmg, this effort «is matched only by delaying strategies, starting with the desire not to make a regional Supplementary Agreement consistent with the new National Collective Agreement, effective from 28 April 2022; fundamental starting point for the organizational evolution of Primary Care. Fugitive regional institutions but immediately ready to deliberate initiatives, on which the medical part was constantly kept on the sidelines, if not in the dark”.
“Privatisation of home care”
«There are many examples – explains the note from Fimmg – from the document that defines the authorization requirements for the exercise and institutional accreditation of home care to the very latest DGR n 2/CR of 10 January 2023 which rushes to the implementation in an untimely manner of Ministerial Decree 77, resolution that is causing perplexity and need for government-level review. A path that, by now it is clear, runs straight towards privatization of home care. And this is precisely, observes Fimmg, «the real reason for the lack of involvement of General Medicine in decisions with a regional action that aims to modify the legal role of family doctors also through the creation of differentiated autonomy. Making the general practitioner dependent, even on private subjects, is a fundamental step in achieving the privatization of home care as well. Furthermore, the Region seems to indulge in a dramatic situation diaspora from public service towards self-employed or affiliated activities, caused, also in this case, by a guilty lack of planning and the scarce valorisation of the medical profession”.
The open nodes
Furthermore, the Region seems to support a dramatic diaspora from the public service towards self-employed or affiliated activities, caused, also in this case, by a guilty failure to plan and by the scarce valorisation of the medical profession. The halting and problematic recovery of district and hospital care activity now weighs even more on family doctors with unsustainable workloads and bureaucratic activity that has become unacceptable. No real support measures for general practitioners have been implemented. He only pulled the wool over his eyes with measures that were not at all incisive, such as the ceiling increase to 1,800 choices compared to only 1 hour and a half more per week of secretarial staff. Instead, i RAO which are revealing themselves for what they are: for the citizen an obstacle to accessing services, for the doctor a further bureaucratic complication. Then the situation of the Continuity of Care (Guardia Medica) is dramatic, where offices are merged – if not when they are really closed – depriving entire territories of night, pre-holiday and holiday assistance and then using the funds that remain, not to strengthen what remains “, but to finance freelance contracts in emergency rooms. And attention also deserve computerization and the electronic health record stranded in the inefficiencies of Azienda Zero.
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in Il Gazzettino