Healthcare, waiting lists: the maxi time-cutting plan arrives

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The Government, with the Minister of Health Orazio Schillaci in the front row, is ready to launch an extraordinary plan worth up to 600 million a year to be replicated until the end of the legislature to defeat the number one enemy of Italian healthcare: the lists of wait. The funds will be used to pay for the extra work of doctors and nurses but also to purchase services from private structures if public hospitals cannot manage on their own: but compared to the past, the resources will not be distributed indiscriminately to the Regions which neither faced with the great demand for post-pandemic care, they were able to spend it all, this time the money will be assigned by the Ministry of Health directly to the individual local health authority where the queue for an X-ray, a CT scan or hospitalization is longer as will be shown by careful monitoring which is being set up.

Objective of unification of agendas

To cut the long waits to which patients are condemned, work will also be done on the unification of the booking diaries of public and affiliated private hospitals, so the CUPs will be able to sort citizens’ requests where there is room (today this unification it is still not fully operational in many parts of Italy). Finally there is the most complex part of the plan which in the medium to long term can bring very significant results: that of the so-called “prescriptive appropriateness”.

Today, doctors also prefer to prescribe an exam or an additional visit to protect themselves, to defend themselves from possible lawsuits – a front on which the Government is working with the medical negligence reform – but in many cases this service is not really necessary for the patient . The problem is that this over-prescription contributes to clogging the system and therefore lengthening the waiting lists even further. Hence the idea of ​​entrusting the Higher Institute of Health with the task, on which it is already working, of developing guidelines on treatment paths which will indicate the appropriate services to prescribe which doctors will have to adapt to in order to limit useless waste.

Law decree coming soon

The plan on waiting lists will take shape with a law decree that should see the light in the next few weeks, but certainly before the European elections in June: healthcare is a very sensitive issue for Italians and for this reason Prime Minister Giorgia Meloni is focusing on it quite a lot, as he anticipated in recent days: «We are working on a provision on waiting lists, with particular attention to regions that have high passive mobility. That is, when “to get treatment a person” has to move and his region pays the other one. The longest waiting lists are in fact concentrated above all in some areas of the country and in particular in the South and so patients pack their bags especially from Campania, Calabria and Sicily in search of treatment in the hospitals of Lombardy, Emilia and Veneto, moving a flow of money – especially from South to North – which in 2022 for hospitalizations alone was around 2.7 billion. Now the basic idea of ​​the plan is no longer to distribute the funds pro-quota to the Regions – we are talking regarding 600 million a year – as happened in the past, when immediately following the hardest months of the pandemic in 2022 they were 500 million were allocated to recover the waiting lists, but following two years there were still 160 million to be spent.

Towards the “autonomy” of hospitals

This time, on the basis of detailed surgical monitoring at the level of the individual hospital which will be entrusted to Agenas – the National Agency for regional health services – it will be known precisely where a health facility has the most difficulty in ensuring hospitalization, a CT scan or a plate (today there are no official data). So, for example, if the Matera Local Health Authority is in trouble, the ministry’s funds will arrive to try to shorten the waiting lists: with that money the structure will pay the staff more to work overtime or will resort to the network of private structures credited to purchase that service for which the queue was created. Minister Schillaci also confirmed this direction in recent days: «The reduction of waiting lists is a priority of the Government in order to address a long-standing problem in our healthcare. The private sector with an agreement is certainly an integral part of our healthcare system. The direction is to guarantee an adequate offer to citizens. To this end, we need the contribution of all the actors involved, the collaboration of the various stakeholders and the Regions to overcome the many inequalities that often force healthcare migration.”