Seminar on performance recovery in the National Healthcare System
Eurispes – Enpam | Observatory on Health, Legality and Social Security
Seminar on performance recovery in the NHS
A seminar was held this morning in Rome at the Ninfeo Museum Hall, entitled “The National Healthcare System faces the issue of performance recovery”, promoted by the Eurispes-Enpam Observatory on Health, Legality and Social Security. The event was also an opportunity to introduce the Observatory’s new President, Gen. Carlo Ricozzi.
The end of the pandemic has in fact left room for another emergency: the one generated by the lack of health services for every other pathology, with particular reference to the most serious ones.
On the sidelines of the meeting, the President of Eurispes, Gian Maria Fara, explained that: «The Observatory is working with a study group composed of leading representatives of the clinical world, with the aim of helping to identify and develop concrete proposals to address the issue of performance recovery for non-Covid pathologies. The initiative is characterised by the presence, at the same table, of representatives from the hospital and community medicine worlds. Thanks to today’s seminar, the Observatory intends to focus attention on the impact of this phenomenon on the National Healthcare System and, above all, on the lost right to healthcare of citizens, which risks growing even more acute».
«When it broke out, the Covid issue overshadowed all other healthcare-related activities, – said Alberto Oliveti, President of Enpam –. This shocking worldwide experience must serve as a useful lesson, because zoonoses are certainly not over. In our country, the flaws in planning and underfunding remain, and are now amplified by the need to return as soon as possible to “ordinary” assistance, which in the meantime has unfortunately fallen heavily behind. It takes money and human resources, which are in short supply. An attempt to remedy these shortcomings can only be made if the State and the Regions adopt a unified strategy. It is necessary to incentivise and structuralise the working integration of healthcare professionals, trying to adopt the best technologies available today to make them communicate with each other efficiently. Furthermore, care and screening priorities must be identified – Oliveti concluded – which can be guaranteed with the greatest possible uniformity throughout the country».
Recovering lost services and restoring the normal flow of NHS activity is certainly one of the most important challenges the new government faces. The proposals put forward by the Eurispes-Enpam Observatory on Health, Legality and Social Security can be summarised as follows: stimulate greater responsiveness on the part of the healthcare agencies in bed management to free up space, equipment and operating theatres, with specific guidelines from the Ministry and with a concrete control action by the Regional Departments, while respecting corporate autonomy; recover, for ordinary activities, the availability of nurses and healthcare assistants and establish an extraordinary plan set up centrally and managed at the regional level with the structural involvement of affiliated and accredited healthcare in a coordinated recovery effort for screening and diagnostics. The extraordinary mobilisation of general medicine for the drafting of lists and lists of diagnostic priorities of their patients is fundamental, as is the provision of technological equipment for the offices of general practitioners in accordance with the 2020 Stability Law, to make them more efficient. In addition, it is suggested that an institutional communication campaign be launched by the Ministry (taken up in the local media by the Regions) that signals the need/opportunity to return to regular medical check-ups.
«Waiting lists – stressed Nino Cartabellotta, President of the GIMBE Foundation, in his speech – are getting longer for various reasons. First of all, many requests for specialist visits and diagnostic examinations are inappropriate, both in terms of patient demand and of induction by specialists. Secondly, the supply of services, in addition to being non-transparent, often relies on public-private methods of interaction that end up increasingly favouring private supply and weakening the public one. Lastly, today there is a real shortage of healthcare personnel: in fact, despite the resources allocated by the State (almost €1 billion), no Region has yet managed to make up for the 2020 services, to the extent that the possibility of using the funds has been extended to December 31st, 2023. In essence, there is no “magic recipe” to solve the problem, but a multifactorial strategy is needed involving interventions aimed at both reducing inappropriate care and increasing the supply of adequate services».
Francesco Cognetti, President of the Confederation of Oncologists, Cardiologists, Haematologists (FOCE), emphasised that «many of the services not provided are now irrecoverable and have unfortunately already claimed many victims during the most acute phase of Covid, in terms of excess mortality for time-dependent cardiovascular diseases. For the oncological ones, the missed or delayed surgeries and the loss of millions of screening examinations have already realised the observation of more advanced tumours at the time of diagnosis and in months or years time will unfortunately realise an excess mortality for these pathologies, the dimensions of which cannot be calculated at present. The data published by AGENAS for 2021, with reference to the surgeries performed for the top five oncological pathologies by incidence, reveal that only 10 Italian Regions have their own hospital institutions included among the top ten positions by volume of cases operated on. This shows, therefore, an uneven distribution of hospitals with greater expertise in oncological pathologies, and this will be a major obstacle to achieving homogeneous standards throughout the country».
Lastly, Filippo La Torre, Professor of General Surgery at Sapienza University of Rome, pointed out that: «We find ourselves today chasing the myth of waiting lists: these were already long before the Pandemic, then they came to a halt and slowly resumed in the period after the closure at an insufficient pace, now becoming the “real” problem of the current NHS.
Possible solutions to address the problem include: a large-scale recruitment plan and, above all, a renewal of the contracts of all public health personnel and an investment plan to renovate the currently obsolete and dilapidated facilities. In addition to these two aspects, the following must be considered: the involvement of private contracted companies to cover the time and manner of renewing the NHS; a restructuring of the Urgency/Emergency system; the presence of family doctors and territorial outpatient clinics managed in such a way as to reduce incongruous hospital admissions».
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