by Saverio Andreula
03 NOV – Dear Director,
the Italian proposal of the PNRR, better known as (National Recovery and Resilience Plan) of the European post-pandemic Recovery Plan is to implement the “Next Generation EU” program implemented by the European Union to counter the economic and social consequences induced by the pandemic in place since Covid-19. The key points that the PNRR places in the theoretical application line can be summarized as follows: Digitization; innovation and ecological transition.
Evidently all 6 areas of development envisaged directly and indirectly involve the nursing profession which, through its professional representation bodies, and not only, must consider the PNRR an opportunity to concretely affirm its role and professional value. It is therefore necessary to implement an activity plan consistent with the objectives and areas of intervention of the PNRR.
The health mission of the PNRR is evidently the most relevant and appropriate for the development interests of the Plan for all stakeholders (nurses in primis) of the health system and brings with it an economic endowment equal to 15.63 billion euros and is mainly focused on two objectives:
– The strengthening of prevention and the enhancement of assistance in the area with the integration of health and social services today clearly separated from each other.
– The modernization of the technological equipment supplied to the National Health System.
Very interesting is the last key point of mission 6 which concerns the development of the technical, digital and managerial skills of the personnel involved in the Health System declined in the promotion of scientific research in the biomedical and health sectors.
Mission 6 (health) also develops aspects of programmatic definition for the use of available resources, committed to the extent of 7.00 billion euro for “the proximity networks, structures and telemedicine for territorial health care”; Innovation, research and digitalization of the National Health Service.
In truth, the topics referred to in “mission 6” of the PNRR, in large part, could easily run and achieve the objectives set with the motivated and incentive direct and indirect involvement of the Nurses, frontline actors of the structural and functional context in which articulates the same. It should also be noted that the topics covered by the mission have already been baptized in numerous previous institutional tables before being declined within the PNRR. In short, a “déjà-vu” today enriched, it is appropriate to say, by the economic resources available to the mission on old projects and old programs without economic coverage. What must be avoided is the selfish affirmation (linked to interests and purely economic reasons) of the corporate projects that certainly some health classes will present for collection, especially related to local medicine which is a key topic in the PNRR.
In this regard, the first signs began, in my opinion, minimized by the “parent company”. In fact, the ability of the medical profession, for example, to influence and induce the political class (with which it has always found synergies) to reform previous regulations that allowed nurses, as well as the healthcare professions of management, the possibility of management is already perceptible. , with the assumption of overall managerial / organizational responsibility for community hospitals or in any case for health facilities that provide home health services. In fact, with the State-Region agreement of 4 August 2021, in fact, the nursing profession is “expelled” from the class of health professions which, as a result of the agreement and for the purposes of the same, remains the exclusive prerogative of the figure of the Doctor who are given the responsibility of managing the structures or organizations dedicated to the “domiciliary” of health care.
A decision therefore that “humiliates” the nursing class that is not effectively opposed by the “parent company” of professional representation. It happens that the strengthening of the so-called “local medicine” understood as the ability of the hospital and in particular within the immense sphere of action of the nurse, to go to the citizen’s home to respond to his or her health needs, risks causing a further loss of confidence in the nursing profession, whose performance areas will always be chained to the will / power of the medical profession, even in the most profound acts that the professional system declines.
Here, then, is the starting point of the “nursing question” today more than ever, no longer eludable or postponable indefinitely. There can never be a real turning point in the legitimate wishes of the nursing profession if it does not become aware of its own defeats that are increasingly retreating it in all its social, political, professional and contractual dimensions.
The “identifying” dimension of professionals on the front line (heroes) during the pandemic period is now strongly under discussion and risks being further depleted by the “alms” that the renewal of the CCNL provides in economic terms without underestimating the arrogance of the Political class which denies nurses the possibility of having the same privileges as the “noble” medical profession which is recognized the right, even in the CCNL for public employment, to exercise freelance activities in the forms they like best. The overcoming of the exclusivity constraint, therefore, remains strongly conditioned by the political will to curb the nursing profession, today with an identification profile rich in academic knowledge that declines professional skills capable of satisfying the health needs that citizens express. In short, words of praise (heroes) but many slaps and many tackles with “straitjackets” to prevent their professional growth. In short, in the “waltz” of the PNRR, at the moment we only have seats in the last row.
Having said that, I wonder: where is the strength and pride of the 50,000 nurses who took to the streets in Rome in the year 94?
Saverio Andreula
President Opi Bari
03 November 2021
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