After almost 10 years of austerity policies, restrictions and defunding, the National Health Service he arrived exhausted at the unexpected appointment with the pandemic
Italy, traditionally accredited in the world for its public health service (in 2000 we were in second place in Europe after France), has paid a very high price of lives – both in the first and in the second wave – due to the general unpreparedness of the system for a pandemic event that hit us like a tsunami in the first months of 2020, with a violence that shocked the world. The reasons for this failure, which, moreover, did not concern only our country, there are many. An obsolete and outdated pandemic plan, few human and organizational resources, especially in the primary care and prevention services sectors, absence of guidelines and few means available and ongoing definancing.
A regionalized health system that has not contributed, in turn, to giving a valid and coordinated response to the emergency.
It could have been this shock the occasion to be seized to strengthen the national health system both in terms of human resources and with respect to building and technological structures; a hand in this sense has been extended to us by Europe with the funds of the Pnrr, a part of which it seems, according to the media, will be diverted for the purchase of arms.
Instead just take a look at the table on public health expenditure 2022-2025 to realize that the trend for the next few years will be that of a further, progressive definancing of the NHS and a strong penalization of the public service.
And we know that a GDP/health expenditure ratio equal to or close to 6%, the health supply is no longer sustainable.
The new Executive has inherited this situation, and not only does it not remedy it but pushes towards it differentiated autonomy, accelerating a process that began with the Gentiloni government. The Senate Budget Office gave its opinion on the differentiated autonomy of the Regions with a document entitled “The cost of differentiated autonomy” which examines the critical issues of the Calderoli bill, raising doubts about the possibility of being able to guarantee the LEP (Essential Levels assistance) across the country evenly and causes friction in government
It is clear that we are faced with an inclined plane destined to produce the further and complete dissolution of the NHS, as it was conceived and wanted at the time of its establishment, i.e. a universalistic, public, free welfare service. The worrying thing is the apparent resignation – contrary to what happens in other countries – of citizens, operators, political forces faced with this scenario, destined to exacerbate inequalities in our society waiting for someone to formally announce one day that the glorious history of the NHS is over.
Instead each of us should be able to stimulate consciences, to create around him a movement of opinion to clamor for a counter-reform, which abolishes the mention of the balanced budget introduced in Constitution in 2011, a change that was approved in just six months, where important laws are stationed in classrooms for up to twenty years. Six months in which the four parliamentary readings foreseen in record time were made and approved by a large majority, even with the vote of the opposition.
The balanced budget goes to compress incompressible rights, according to the Constitutional Court: the right to health, the right to education, the right to safe and paid work.
Not to mention the Title V reform which, by giving the regions legislative autonomy and the possibility of dictating primary-rank rules, has helped to create 21 different health systems that travel at different speeds and the differentiated autonomy, currently under discussion, will widen the gap even more. It is no longer time for indifference.