Anesthesiologists: “We were waiting for this measure”


by Domenico Minniti

21 OCT

Dear Director,
the bill “Extraordinary provisions to ensure essential levels of assistance in the regional health system“Already filed with the Regional Council of Calabria last week, has finally been approved. A decision as logical as it is simple, the result of that concreteness in action that is being demonstrated and which must be the guiding star in the difficult process of reorganizing our healthcare offer.

It is evident that this is a solution, this too like the others proposed up to now, urgent and unavoidable given that, at least in some respects – and the dramatic shortage of doctors in the Emergency Departments is the main one – in Calabria it will be necessary, by the light of the nose, that they spend no less than six or seven years to bring the system back to normal.

Provided, of course, that the central government in turn finds simple solutions to those complex problems that weigh on social security, health planning and financing of the National Health Fund, as well as on the anachronistic spending ceiling for Public Employment personnel, lower than the 1.4% compared to 2004. Today, a real madness.

It is always assumed that we want to give back to citizens that model of the Health System which has always been, for quality and universality of care, indicated as an example.

In the meantime, the Italian Hospital Resuscitators Association – Emergency and Critical Area, a trade union organization that focuses its attention precisely on the Departments of Emergency Urgency, applauds what represents a mechanism with multiple feed back positive: patient satisfaction for the reduction in surgical waiting times, satisfaction of the Region for the reduction of healthcare migration and, last but not leastgratification of the Anesthetists Resuscitators and the Doctors of the Emergency Urgency who finally see a re-evaluation of their high professionalism recognized, indecorously firm to the CCNL 2002/2005.

High professionalism – flagship of our SSN – just as the recent pandemic has unfortunately given us the opportunity to demonstrate.

But there is more.

With this measure it is probable that a virtuous change of direction will be triggered with regard to the escape of the Emergency Doctors from the Public Health Service. A real haemorrhage that is devastating the other regions, particularly affecting those young professionals who are the present and the future of the System, and who fortunately, in our latitudes, is still, for the moment, limited to the dripping phase.

And again, aside of the positive effects listed so far and considering that, right or wrong, we live in the logic of the corporateization of the National Health System, it is all too easy to demonstrate how a six-hour surgical session, with an additional cost of six hundred euros and in which planned interventions, for example, for DRG with an average total value of about twenty thousand euros, financial resources are retained in the region that can (must) be reinvested in our healthcare, avoiding or at least containing those dispersions from the distribution of the Health Fund, which led to a return plan from neverending story.

For colleagues in the emergency room, the fallout is all on performance system with foreseeable reduction of the exhausting workloads to which they are subjected, to the benefit of the quality of the service and the reduction of waiting times triage, which translates into a better relationship with the citizen-user and a potential reduction in conflicts that often lead to episodes of violence. A maneuver that, here too, waiting for greater gratifications aimed at recognizing the value of their work, it is desirable to contain that escape from public structures for the benefit of cooperatives, even faster than that of the Anesthetists Resuscitators from operating theaters and reanimations.

Speaking of cooperatives, on whose uneconomic appeal, according to the Consolidated Law on Public Employment (Legislative Decree 165/2001 smi), I have many doubts of legitimacy, I have not read, in recent months, the same complaints raised, today , by some, in the Regional Council. For years, in various regions, subject to inter-company agreements and in the absence of even regional laws, higher remuneration than those, now anachronistic and not at all attractive contractually provided for, have been paid for additional services.

And are we scandalized now, in the face of such a state of necessity?

The political choice is therefore excellent and certainly acceptable to our Association.

It is desirable that the imminent start of the negotiation phase relating to the renewal of the CCNL will also see the next Minister of Health and above all that of the Economy and Finance oriented to follow the line drawn by the Regional Council of Calabria given that here, yes, the situation is dramatic, but in the rest of Italy, especially with clear reference to the Emergency / Urgency Departments, it is frankly only slightly less worse than ours.

And in this regard, it is necessary to propose a final consideration relating to this delicate sector of public health concerning the exodus of the pre-hospital Emergency Doctors, 118 to be clear, which is, alas, massive.

The mechanisms of economic gratification, contractual protection and professional growth, which are currently severely limited if not absent, need to be reviewed with the same extreme urgency.

Maybe, even through their placement in the public service.

Domenico MinnitiNational Vice President of the South Area – President of the Calabria Section – AAROI EMAC
(Italian Hospital Resuscitators Association – Emergency and Critical Area)

21 October 2022
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