It resonates today the last call for the future of the emergency room in Veneto. In fact, the deadline for participation in the event expires at 18.00 competitionbanned by Azienda Zero, for thepermanent employment of 154 doctors for the Emergency-urgency discipline: “It’s time for you”, the regional councilor Manuela Lanzarin launches the appeal via social media, ideally addressing a white coat who feels the responsibility to help cover the shortage, still calculated three months ago in 229 holes in staff. The risk, however, is that specialists prefer thetoken engagementthus fueling a phenomenon that also appears increasingly out of control in other departments.
«I have been a doctor for 35 years and have gone from saint to dragon with flaming jaws»
Coin-operated doctors and nurses
Let me be clear: assignments to external companies are fully within the scope of the legislation. But as recently highlighted by the Anac, “the Far West of the contracts” is such as to require an intervention by the Ministries of Health and also of Finance, given the “great economic impact on public spending”. On this front, the Region has distinguished itself from the others by recommending that healthcare and hospital companies respect the limit of 100 euros per hour, when they are forced to look outside for the missing professionals. In effect, this has just happened in Adria, where the Ulss 5 Polesana awarded the group formed by the companies Mst Group and Bmc H24 Assistance the 118 medicalisation service and emergency medical assistance support for one year, renewable for another, at a cost of 1,200 euros for each 12-hour shift.
The negotiations
Sometimes, however, that roof turns into a boomerang. It always happened in Polesine, in this case for pediatric medical assistance in the hospitals of Rovigo and Adria. Since the end of 2021, the supply has been supplied by Pediacoop, at a price of 45 euros for services in birth centers and in hospital wards, while for outpatient services and consultancy in the emergency room, the price list fluctuates between 34.99 and 69 euros. depending on the low or high intensity. Since a “known very serious difficulty in finding” specialists persists, Ulss 5 has asked the cooperative to continue for another year “under the same conditions”, but the company has only made itself available for 100 euros an hour , since “the market requires a review of fees also for pediatric services”. Result: the healthcare company has only obtained a three-month technical extension to the old tariffs, after which it will start the new selection procedure with the highest auction base. Director Patrizia Simionato had to give an account of similar negotiations in her resolutions as well for other departments. For example, for an hour in the Anesthesia resuscitation of Adria, the Cmp company asked for 130 euros and Ulss 5 instead 100, until a compromise was reached for 115. Money which, it must be said, clearly does not end up entirely in the pocket of the individual doctor, since it is a gross amount in the freelance regime. But so be it.
Salaries
In the face of this scenario, the competition expiring this afternoon foreshadows the guarantee of a permanent job, but with a much lower pay, according to the provisions of the national employment contract.
For a basic professional assignment with an exclusive relationship, it is around 2,680 euros net per month
This was stated by Giovanni Leoni, Venetian secretary of the Cimo-Fesmed union. The comparison on the gross hourly amount is emblematic: 39 euros, instead of the 100 of token holders, although the latter do not have the recognition of holidays, sickness and social security contributions. Leoni’s reflection is bitter: «On these bases the free market will lay down the law. But here we are talking about the national health system, not a consumer product ».