by Claudio Maria Maffei
02 NOV –
Dear Director,
in her speech to the Senate, Prime Minister Giorgia Meloni finally spoke of public health, demonstrating a worrying lack of awareness of the dramatic crisis that the National Health Service is facing. This segment of her speech had the structure of a meeting with a recourse to climax, a procedure which by definition implies a crescendo of intensity at the end of which there is a peak, the most important piece of the listed elements.
The peak in our case was reached when the Prime Minister became inflamed (I swear it’s not a play on words) talking about the too restrictive measures adopted by the previous government for the control of the pandemic and in particular when he spoke of the 12-year-olds not vaccinated excluded from the possibility of physical activity in the absence of “certain” evidence in this regard, but purely for political choice. In closing, the message was that evidence-based choices will now take precedence over political choices.
In reality, the government’s “restrictive” position was supported by solid scientific references, given that, for example, the Mario Negri Institute wrote a year ago based on the data available in October 2021 that: if on the one hand vaccinating adolescents is not a priority, unless a variant capable of causing serious illnesses is spreading, on the other hand vaccinating them could allow them to return to normality with greater tranquility and continuity, in view of the resumption of school and sports and social activities.
In an update on the topic of January 2022, the same Institute stated that: Regulatory agencies strongly recommend the vaccine especially in those “fragile” children, that is, those who suffer from chronic diseases such as diabetes, who have cancer, who have cardiovascular disease or who suffer from uncontrolled asthma. These conditions, in fact, expose them to a greater risk of severe forms. However, it must be said that even “healthy” children, who do not have particular risk factors, risk serious illness and hospitalization.
If this speech by the Prime Minister was an example of the “scientific” approach of the new government, there are many reasons for concern. The first represented by the very probable failure of any future vaccination programs as demonstrated by the data of the Marche Region which is the recognized laboratory of this government.
Concern grows when one listens to the full attention of the approximately two minutes dedicated to the remaining health issues by the Prime Minister before talking about the pandemic and scientific evidence. In this part, the President spoke in a flat tone, scrolling through the notes without ever even mentioning funding, PNRR, staff shortages, local services, social and health integration, prevention, training and research.
And therefore obviously not even mental health, counseling, palliative care, professionals, the elderly, chronicity and disability. The President spoke of the hospital only with reference to greater digitization. On the other hand, he referred to an unspecified proximity, to health tourism and to the role of pharmacies, general practitioners and telemedicine and with little conviction he evoked unspecified battles for the protection of inland areas. If I were to rely on the experience of the Marches, the protection of inland areas will result in the wrong defense of small hospitals as a result of the electoral promises that led the center-right to win the regional elections two years ago.
Between this intervention in the Senate and the previous one in the Chamber, it is clear that neither the Prime Minister nor his closest collaborators still have an idea of what is happening in Italian healthcare, a topic that is consequently treated with the tones and arguments of an election campaign. But that is over, moreover with success.
An important role could be played in reorienting this attitude by that ruling class whose interventions are hosted here on QS. A ruling class that is the expression of trade unions, professional associations, the academic world, citizens and all other stakeholders.
Unfortunately, conflicting messages often come from this ruling class, for example in terms of professional roles (think of the dispute over the autonomy / responsibility of nurses with respect to doctors), organizational models (think of the dispute over the organization of general medicine) and planning structures (yes think about the dispute over DM 70).
I fear that in this context, in which a shared model of public health does not emerge clearly, there is space for that populist management of health that is good for electoral campaigns, but bad for the health of citizens.
Claudio Maria Maffei
02 November 2022
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