* General Secretary of Cittadinanzattiva
The National Recovery and Resilience Plan (Pnrr) is not the solution to all the ills of our country and not even our last chance, approaches both present in the debate of these weeks and equally risky.
Having made this general premise, for those who, like Cittadinanzattiva, have a particular focus on health, one could have expected an unprecedented investment from the Plan, after years and years of embezzling public health funds and considering that the Plan is the answer to a health crisis above all. Without neglecting the observation that, starting from the year 2022, the expenditure forecasts of the National Health Fund, therefore the current health expenditure, decrease at an average annual rate of 0.7 per cent, while in the same period the GDP would grow on average by 4.2 percent.
Furthermore, in the face of an expected reduction in the impact of the Covid pandemic, another emergency will concern Italian health, that of missed treatments, that is, prevention, diagnosis, assistance, follow up, blocked or strongly slowed down since the beginning of the pandemic and which add to the problems, in particular access, that the National Health Service already presented.
In reality, in the National Recovery and Resilience Plan, health is the last mission per planned investment, 15.63 billion, which will be used fundamentally to enhance local healthcare and finance innovation, research and digitization of the National Health Service.
Covid: where and when we are most at risk of contagion
by Donatella Zorzetto
But let’s try to carry out a reallocation experiment: let’s move the figure of 1.71 billion euros for the digitization of the I and II level Goddess and the figure of 1.67 billion for the strengthening of the technological infrastructure and tools from the total forecast. for data collection, which could for good reason have been classified among the funds provided for innovation and digitization, therefore in mission 1 of the NRP. And we also move the 1.64 billion investment planned for “a safe and sustainable hospital”, money that could have been included in the redevelopment of public buildings, therefore in mission 2. Let’s go down, for everything else concerning the health, just over the 9 billion envisaged in the first hypothesis of allocating the funds of the Plan, against which even Cittadinanzattiva did not fail to raise the shields.
The future of medicine is in big data. This is what the Italian system needs
by Tiziana Moriconi
Perhaps this is a provocation, and the areas of innovation and digitization and the efficiency of the structures are certainly some critical points on which it was necessary to invest. But other critical points declared in the context analysis of the Plan do not receive adequate responses in terms of planned investments. There is a lack of structured interventions on prevention.
There is nothing that represents a first answer to the question of environmental, climate and health risks. There is little reckoning with the most significant problem shown by the pandemic, which is the investment in personnel, starting from its shortage, and its training and qualification. How to respond, for example, to the downsizing of general medicine, given that in 2027 general practitioners will be 16% fewer than the current ones?
Fragile patients, the infectious disease specialist guide for ‘tailor-made’ vaccinations arrives
by Irma D’Aria
Furthermore, the fear is that the Plan will accept an interpretation of the theme of territorial assistance, also requested and hoped for by all, and also of hospital assistance which privileges space to networks, which invests in structures rather than skills.
There are three other issues that, given the attention to the spaces that the Plan raises, must be monitored with great attention: the first is that the issue of home care, of the home as one of the privileged places for assistance, is a great acquisition but it must be related to the inclusion and empowerment of citizens treated at home, in order not to risk opening up to new forms of isolation. And here too it is necessary to guarantee that the reorganization will hold up beyond the NRP, with the provision of ordinary funds; otherwise, as was the case with hospitals at the time, there is a risk of disposing of what is there without guaranteeing what is not yet there. The second is to distribute the health areas equally throughout the national territory, strengthening the weak areas of the country and taking into account the nature of the territories and not just an arithmetic logic that looks, for example, at the number of inhabitants.
More funding and less bureaucracy. Thus independent clinical research is relaunched
by Irma D’Aria
This must also be valid for the IRCCS, the scientific hospitalization and care institutes, with respect to which the issue of their location should be addressed, as there are only nine public and private agreements in the whole of Southern Italy. The third is to avoid making investments in the construction of new structures, which is also foreseen for community houses, and to ensure that the funds are used only for qualification and safety, if anything using all those structures, including hospitals, available that in the time have been decommissioned.
Covid: getting vaccinated in the company, here’s how and when
by Donatella Zorzetto
In short, it is necessary to consider the spaces that the Plan favors not as the aim of the planned intervention and investments, but as access points for a continuous and integrated health offer and as nodes of social and health, physical and digital networks.
.