Limits on the engagement of token holders, doctors contracted out by companies as reinforcements in understaffed staff. Economic incentives for emergency room personnel who will be able to receive 100 euros for every overtime hour on duty, instead of the current 60. Gone is the exclusivity bond for public service nurses, established by a rule by former minister Bindi. Trainees will be allowed to work in emergency departments 8 hours a week. With these innovations, included in an omnibus decree on health being approved today by the Council of Ministersthe owner of the Health Orazio Schillaci proposes to address some of the most pressing problems that hinder the proper functioning of the health system.
The shortage of front-line workers and severe asphyxiation of emergency rooms are at the top of the league table. Rules are coming that provide for the possibility of stabilizing non-specialist doctors with experience in the emergency area. Open to EU and non-EU personnel: they will be able to serve in our hospitals with professional qualifications obtained abroad. A proposal concerns the contrast of increasingly widespread phenomena, violence against healthcare workersvictims of a long series of attacks especially in the shifts in which they are more exposed to the anger of dissatisfied patients and family members. There will be incentives for those who carry out their activities in critical departments, considered “weary”.
The entire provision is aimed above all at the front-line, at the forefront, the most exposed and suffering. With staff replenishment, incentives, defense of job security, even through the restoration of police facilities, we try to plug the most visible gaps of an organization that has to deal with the lack of specialist doctors and the problem of notices of competition without candidates. This is what Schillaci was thinking yesterday when, at the inauguration of the academic year of the San Raffaele University, he affirmed: «We need to ensure that those who graduate go to fill some roles that are a bit neglected today or not taken much into consideration by recent graduates. I am referring above all to the emergency-urgency, we are preparing a package of regulations. Those who work in these areas, since the years of specialization school, should have the right to a bonus linked to a job that is particularly strenuous”.
The decree today for the attention of Palazzo Chigi anticipates to 2023 for doctors and nurses the increase in the specific first aid allowance which will become fully operational in 2024 as indicated by the budget law. One of the main objectives is to contain the phenomenon of token holders who belong to cooperatives, used by companies to cover shifts. Their rates are up to 4-5 times higher than those of extensions, which creates significant disparities. The use of outsourcing is limited. A decree from the minister will establish the rules. Last November it was the Anac, the anti-corruption authority, to solicit the intervention of the Minister of Health and the Mef to “clarify” and give criteria for price adequacy”. Anac denounced «the high cost, the inadequacy of the service offered, the scarce reliability of the services (think of the lucidity of a doctor after 36 straight hours of work), the wild west of the contracts, of short duration with the avoidance of any principle planning and competition”. Cooperatives could disappear. The door opens to the alternative of flexible contracts managed by temporary agencies.