The managers of the health professions children of a lesser god

by Marcello Bozzi

Still without recognition of the allowance of exclusivity and specificity, confusion in the competition procedures for access between one Region and another. We need a definition of reference standards to be made operational in all companies and healthcare facilities, public, private, accredited and private, as well as in residential structures (the COVID experience should have taught us something!)

14 OTT –

The contents of the Guidance Act of the Regions-Health sector Committee for the contractual renewal of the Health Area Management once again highlight the unwillingness to consider the Management of the Health Professions on a par with the other Health Departments.

Interventions are essential to overcome the critical issues present and, in this regard, joint declarations no. 6 and n. 7, reported at the bottom of the current National Collective Labor Agreement 2016-2018, which reads “With reference to art. 20, paragraph 1, (Assignment and revocation of management positions of a complex structure – Criteria and procedures), the parties hope that there will be a legislative intervention to define the procedures and requirements for conferring management positions of a complex structure to the managers of the health professions referred to in art. 6 of law 251 of 10/8/2000 “and” With reference to art. 89 (Indemnity of exclusivity), the parties hope that the regulatory process to guarantee the possibility of an option between an exclusive or non-exclusive relationship for the management of the health professions referred to in Article 6 of Law 251 of 10/8 / will be concluded. 2000 “.

Five years have passed … and nothing has been done! It is the only health management that has remained excluded from the exclusivity indemnity and the lack of clarity continues as to the competitive procedures to be followed for the coverage of the positions of SC of the Health Professions Management.

Therefore it is required:

the recognition of the exclusivity indemnity also for the Management of the Health Professions;
the recognition of the specificity allowance for all professions related to health management (all health professions have their own specificity and it is difficult to understand how only one has economic recognition, in a system that is increasingly multi-professional and inter- professional, where the work of each is connected to the work of the others, taking into account the specificities and characterizations of each);
a precise address to the Regions and the Company Departments regarding the bankruptcy procedures to be followed for the coverage of the top positions of SC for the Management of the Health Professions (hopefully the same methods followed for the other health managers).

In addition to the contractual aspects, precise government guidelines are needed (urgently) for covering the management positions of the health professions, also taking into account the heavy reorganizations connected to the development of the PNRR (prevalence of the development of territorial services, with contextual hospital reorganizations).

The in-depth analysis of the Regional Laws for the reorganization of health systems and the guidelines for the definition of the Company Deeds show a little knowledge and a little awareness on the part of the writers of the documents referred to regarding the role and responsibility of the Management of the Health Professions.

The same shortcomings are also found at the level of many Company Departments that find it difficult to consider the organizational structure of the Management of the Health Professions (organizational and professional) on a par with the other Health Departments, as defined by the regulations in force (Law 251/2000 and l. 43/2006) and by the National Collective Labor Agreement.

Some corporate decisions and resolutions appear to be truly imaginative and even suggestive, so much so as to make evident the ignorance of many on the subject (in the noble sense of “not knowing”) and the distance from the real needs for the functioning of the structures and for the guarantee of adequacy and appropriateness of the response to people’s health needs.

Some data help to better understand the differences in the distribution of the Executives of the Health Professions, in relation to the population:

NORD 265 Executives (27,500,000 inhabitants)

CENTRO 142 Executives (11,700,000 inhabitants)

SOUTH 40 Executives (13,500,000 inhabitants)

ISLANDS 24 Executives (6,500,000 inhabitants)

The hope is that a clear and unequivocal direction can arrive from the Ministerial / Governmental level, to overcome past inefficiencies, for a definition of reference standards to be made operational in all companies and healthcare facilities, public, private, accredited and private. , as well as in residential facilities (the COVID experience should have taught us something!).

Table 1 shows the current distribution of Italian health facilities

Table 2 shows the distribution of management figures, by single area (MEF data)

Table 3 shows a minimal planning hypothesis regarding the distribution of managerial figures pertaining to the health professions (with possible modifications that can be connected to territorial and structural characterizations), in parallel with the organization of the hospital and district medical departments.