by Claudio Maria Maffei
16 NOV –
Dear Director,
I won’t comment on Undersecretary Gemmato’s latest statement. Yesterday many people did it authoritatively here on QS and there’s really no need for my comment on the matter. But Gemmato’s position on vaccines risks being involuntarily distracting because the issues on which the idea of protecting the health of the Brothers of Italy can do damage are quite different, the damage he is doing, for example, in the Marche. On the topic of vaccines, attention is so widespread and vigilant that every “slip” is immediately highlighted, resulting in the usual immediate and not very credible denials.
What I personally fear from the Marche is that other typical behaviors of the Meloni-driven center-right will escape, capable of doing even more damage because the spotlight of media attention does not illuminate them. Those behaviors that in the Marche region are demonstrating their completely negative effects (I meant to write nefarious, to tell the truth).
I would ascribe these behaviors to an autocratic government model in which the two categories of propaganda and the sovereign prevail (a term that the right likes) disinterest in the rules when they are not functional to one’s electoral program, which is seen as the main reference, certainly much more relevant to the rules.
Very significant in this regard is the experience that the Marches are having with the Health Reform desired by the centre-right, which was also discussed here on QS. This Reform provides that from 1 January 2023 there will no longer be the Single Regional Health Authority (ASUR) and that the current five Vaste Areas will be transformed into the 5 Territorial Health Authorities of Ancona, Ascoli Piceno, Fermo, Macerata and Pesaro Urbino all with legal. Furthermore, the Marche Nord company merges into the territorial company of Pesaro Urbino. It is an absolutely untimely reform in this critical phase of regional and national health care, intended only to demonstrate that the electoral program that provided for it is respected.
With Resolution 1385/2022 of a few weeks ago, the Giunta provided the addresses for the establishment of the Territorial Health Authorities. And here the autocratic approach to the government of health in the Marche region comes out in full force. In the Resolution it is said with regard to the Corporate Act that it will be done on the basis of “content guidelines” being defined which will be standardized, among other things, to:
- the Regional Social Health Plan in the process of being adopted;
- the regional planning deeds resulting from Ministerial Decree 70/2015;
- the regional planning deeds resulting from Ministerial Decree 77/2022.
It is interesting to note that while the new companies will be born on January 1, 2023 (i.e. in a few weeks):
- there is no Regional Social Health Plan being adopted, given that no document is circulating in this regard, even if only preliminary;
- the regional planning acts on hospital networks are not consequent to DM 70, but simply distort it by providing for 14 hospitals between first and second level when DM 70 would allow ten;
- there have been no regional planning acts on territorial services following DM 77 and those that have been in application of the PNRR are full of limits and errors as already described here on QS.
In summary, the new companies will be born in the Marches within a planning framework that is largely deficient and equally wrong. But they will be born because it was written in the electoral program.
I find a perfect correspondence between this approach of the Giunta delle Marche and the approach of Undersecretary Gemmato who, in addition to having reservations about vaccines, also has them about the PNRR, and therefore about Ministerial Decree 77, and Ministerial Decree 70 with respect to which the reopening of small hospitals, all positions inferable from your statements reported here on QS. Incidentally, Gemmato’s “lukewarm” position on vaccination not coincidentally has the same tenor as that of the Giunta delle Marche, a Region in which in fact the vaccination coverage rate is constantly among the lowest as evidenced by GIMBE elaborations.
I believe that instead of pursuing Gemmato’s statements (which, moreover, probably someone from his side will invite greater caution in public outings by reminding him that the rallies are over), it is better to deal with the vision of public health that this government has. For me it has none, as testified first by his electoral program and then by the declarations of Minister Schillaci who in fact speaks of dossiers to be studied, which is a normal attitude at the University, a little less normal in those who aspire to govern must have already studied .
Yesterday here on QS Cavicchi in a brilliant (as always) intervention on health close to the forfait wrote that: “After having built a public health committee, Schillaci should move to build a front with the unions, orders and scientific societies. Without the support of the “chosen people” I fear that Schillaci can do very little. It is about promoting a pact to save public health. Let him launch this idea.”
The proposal is certainly interesting, but I fear there is a big problem. Are we sure that the “chosen people” (identified in my opinion with the trade unions, orders and scientific societies) have a common vision of public health? It seems to me absolutely not, I am thinking of hospital networks, a theme that is familiar to me. And that’s a big deal, in my opinion.
Claudio Maria Maffei
November 16, 2022
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