It is interesting the linguistic analysis that makes up the list “We are Orvieto” of the resolution of the regional council (DGR) n. 1024 of last October 5 entitled “Plan for the Efficiency and Redevelopment of the Regional Health System 2022-2024″ and the interpretation can be shared as a “commissioner” aimed at reducing services.
I think the operation is even more worrying. Let’s get straight to the point. By examining no longer only the grandiloquent and substantially empty sentences, but the operational forecasts listed in the annex to the DGR, one draws the conclusion that if the times preceding the pandemic were problematic and those of the pandemic and post-pandemic worrying, those opened by the DGR of 5 October it is not difficult to imagine them more than worrying. Especially for Orvieto.
The reasons are soon stated:
1. More than an underestimation, a substantial absence of a strategic vision of the health system for the civil and economic development of Umbria and for its role as developer of quality services in central Italy and of connected inter-territorial attractiveness.
2. An even more evident absence of the interregional role of hospitals and territorial health services in the border areas, such as that of Orvieto. It should not be misleading that the Orvieto hospital is classified as a first level DEA together with those of Città di Castello, Gubbio-Gualdo and Foligno-Trevi coordinated with Spoleto-Norcia Cascia, because it was first level and of first level remains, but only on paper. In fact, this does not guarantee anything at all, given what has happened (indeed, what has not happened) in so many years to date, i.e. a progressive impoverishment of structures, technological equipment, quantity and functions of personnel, organization and consistency of services.
3. An interrelation / integration with the second level DEAs (Terni and Perugia) only formally established but completely indefinite, when instead it would have been much more logical and functional to provide in this part of Umbria a hospital network with differentiated and coordinated functions between Terni, Narni-Amelia and Orvieto, as I am not tired of saying for years even with timely initiatives in the City Council (see the last motion approved unanimously on May 31, which I will return to later).
4. The reduction of the Districts from 12 to 4 with the disappearance, I believe not by chance, of the Orvieto area. In replacement, the COT (Territorial Operational Centers, the take-over and sorting points for people in need of care) are provided, divided into 1 Hub and 8 Spoke (the centers responsible for guaranteeing the patient’s care path), in different areas (Perugia, Terni, Spoleto, Città di Castello) and nothing in Orvieto. That is, the loss of any presence in the role and in the managerial and administrative functions.
5. The network of community houses, insufficient from a quantitative point of view if they are to be the point at which local medicine is combined with the safety and well-being of the population, indeterminate in the times and methods of implementation, without indications on functionality of the locations (for the sake of my country I omit any consideration on the commitment of millions for the Orvieto location of the Casa della Salute, that of the former hospital in Piazza Duomo)
The logic followed is evident. The regional government does not start from the security and guarantee needs of the health service for citizens, which would entail a rationalization, but with attention to waste, to the overlapping of operational structures and functions, to network functions, to the enhancement of efficiency , to extra-regional attractiveness, etc. etc. Nor does it start from the fact that it has an unrepeatable historical opportunity, that of having the PNRR funds to make a serious, in-depth, detailed plan for the reorganization of the health system, with the central and decisive objective of significantly and structurally improving the complex. responses to requests for assistance from citizens in every part of the region.
No, it starts from the consolidated deficit of 150 million and the quota / year structural deficit, sets up a quantitative reorganization that it calls “rationalization”, stuffs it with foregone words of facade efficiency and entrusts peripheral structures and external parties with the task of planning the cuts . It is easy to imagine the results: quantitative and qualitative decrease of the public service and development of private healthcare, top-down power, sacrifice of autonomy and democratic control, problems for citizens, especially, as always, those of the weakest and most needy sections of the population.
This is the interpretation of the decisions of the regional council on the reorganization of health services, not prejudicial and non-partisan, certainly not vitiated by political prejudice, but is only concerned about the negative consequences that can derive from it for citizens, especially in the areas of ‘Umbria where inefficiencies and constraints on medical transhumance are more frequent. Orvieto is one of these, always subject to the commitment, availability and professionalism of the staff, who are often committed beyond pure duty.
I had presented a motion in the City Council on November 7, 2021, which addressed health issues as a whole and indicated a precise strategy for our territory with reference to both hospital and territorial services. The motion was unanimously approved on May 31st. The distance between what is written there and what the regional government has decided is evident. I wonder, and we must necessarily ask ourselves: what did the Mayor do to implement that unanimous act of the City Council?
And if he did what he had to do, now having to take note of the distance of the decisions contained in the DGR of 5 October from the will of the Council, what does he intend to do? Moreover, the question also concerns the Council itself, starting with its President. At the very least, it would be urgent that a unitary initiative be decided at an institutional level involving the other mayors of the territory, the political forces, the social forces, the public opinion, to define a common position to reverse a regional route that heavily penalizes us today and tomorrow. .
I will certainly submit an urgent question to the Council to find out if and what it intends to do. But at the same time I say Orvieto wake up!
Franco Raimondo Barbabella
(CiviciXOrvieto)