Listen to the audio version of the article
Almost a year after the Government’s tightening and only a few weeks after the Lombardy stoppage, the war against coin collectors in the wards is becoming more complicated: the phenomenon of doctors and nurses “rented” to hospitals to cover staff gaps which in the case of white coats are expensive even over a thousand euros for a single shift. The TAR has in fact suspended the resolution with which the Lombardy Region had prohibited the use of outsourcing contracts: the reason is precisely in the bill decree where the Government and the Minister of Health Orazio Schillaci inserted the restriction last May.
The TAR’s rejection of the Lombardy resolution
The TAR suspended the resolution of 13 December with which the Lombardy Region decided to stop token operators, i.e. those doctors and nurses who provide their work through cooperatives contracted by public health facilities and are remunerated in proportion to individual attendance for the coverage of health services. The judges suspended the resolution as a precaution, in particular the parts in which it is stated that “new contracts for the outsourcing of core health services” such as assistance in emergency rooms where token operators are frequent are not “further authorized”. What justifies the suspension of the resolution, according to the administrative judges, is precisely the violation of Article 10 of Legislative Decree 34/2023 (the bill decree) which, on the one hand, introduced a crackdown on the use of token operators (an extension of a period of year to their use in case of necessity and urgency) on the other hand it did not immediately ban their use. However, the TAR has set the hearing on the merits of the appeal for October 24th
The reasons for the stop in Minister Schillaci’s decree
«The Lombardy TAR suspends the regional resolution in the part in which it does not authorize new outsourcing contracts – Mariangela Di Giandomenico, partner of Orrick and legal representative of Gapmed, points out to beraking latest news Salute – This in application of article 10 of the Schillaci decree which does not exclude outsourcing in cases of necessity and urgency, therefore obviously with certain limits”. And therefore this ban introduced by the regional resolution would be in conflict with the national regulation desired by Minister Schillaci. The company that appealed «is not a cooperative – specifies the lawyer – it is a company between medical professionals. It is not against the Region and has always guaranteed medical and nursing services with high quality standards.” The impact of the ordinance, he continues, «is also significant because it allows individual facilities in Lombardy to resort to new outsourcing contracts in case of necessity and urgency. It is an ordinance that “cautions and suspends” a passage of the regional resolution, underlines Di Giandomenico.
Bertolaso: «We will go ahead and appeal»
According to the regional councilor for Welfare Guido Bertolaso, the order pronounced by the TAR «does not shift our action against token operators one iota. It simply suspends the ban on stipulating new outsourcing contracts but this does not mean that we will be obliged to stipulate them”. “The provision – adds the councilor – suspends, as a precaution, only the parts of the resolution which provide that new contracts for the outsourcing of health services are not further authorised”. The general structure of the provision, according to the councilor, therefore remains absolutely valid, also with regard to the methods of staff recruitment identified: the Region has activated a list of suitable doctors to whom freelance professional positions can be assigned. «I highlight that the company that appealed – continues Bertolaso - declared that it ‘lost’ revenue of around 30 million in Lombardy, half of its annual turnover, a decidedly important figure which also gives us the measure of how unfair this system is. We keep the point and continue on our path with all the tools we have at our disposal, also by appealing to the Council of State.” The opposition is critical: «The rate of amateurism in the Fontana-Bertolaso-led Region is worrying. It is essential to close the issue of the token holders, but we must be able to do it in an impeccable way”, warns the group leader of the Democratic Party in the Lombardy Region Pierfrancesco Majorino.