Work activity of health professionals within the proximity structures to be regulated according to the national contract of general medicine; lack of funding for health personnel to be included in them; shortage of general practitioners to counter: these are the major criticalities of Mission 6 Health of the Pnrr in guaranteeing the operation of the planned structures, as emerged in the conference organized by the CISL Doctors of Catania on the subject. “The objective of Measure 6 Health of the NRP in response to the pandemic crisis – underlined Massimo De Natale, secretary general of CISL Medici Catania – is to strengthen prevention and health services in the area, modernize and digitize the health system and guarantee equity of access to treatment “. The Plan invests in local community assistance, the so-called community houses (Cdc) and community hospitals (Odc). In the province of Catania there will be 29 Cdc and 10 Odc. Community Houses are made up of multi-professional teams of general practitioners, specialist doctors, community nurses, other health professionals and even social workers. In the forecasts, the house will be an ongoing point of reference for the population.
Community houses and collective bargaining agreement
But in fact, something does not convince the union of medical leaders of the CISL. “The Measure provides that within the Houses of the Community – explains De Natale – the work activity of health professionals should be organized by management. Each healthcare professional, regardless of his or her employment contract, should follow the organizational model defined within the structure. Instead – specifies the union leader – we say that it will have to be regulated by the national contract of general medicine. Furthermore, the NRP does not foresee resources for staff financing. Those that will have to finance the hiring of 16,531 people from 2027 are very uncertain and should be found with the savings produced by the reorganization of health care ”.
Increase access to general practice
“In the intentions of the Measure, the CoC should become the tool for coordinating all the services offered, in particular to the chronically ill, a sort of Single Access Point (PUA) to healthcare services. However, it is explicitly understood as health Pua, in contrast with the regulations in force which, on the other hand, mean it as health and social “. And the medical staff? According to De Natale, “it is time for access to general medicine to increase. In fact, there are no general practitioners and the dropout rate, between 10 and 20 percent each year, among those enrolled in training courses is not taken into account. On the basis of the data collected by Sisac – Interregional healthcare facility with agreements – in Italy in 2027, about seven thousand doctors will be missing ”.
Community hospital: increase the staff
“As far as the Community Hospital is concerned, these are health structures of the territorial network ‘with short-term hospitalization’ and intended for patients who require health interventions with low clinical intensity. They will be intermediate structures between the territorial network and the hospital, usually with 20 beds (max 40), mainly managed by nursing. It would be appropriate to call them ‘territorial health care’ and they will have to provide greater appropriateness of care, to reduce improper access to health services such as, for example, those to the emergency room or other hospitalization facilities or the use of other specialized services. For all the structures – warns De Natale – the relative operations, in terms of personnel, must be guaranteed within the framework of the new resources. A structural increase in staffing will have to be envisaged, but today there is a lack of economic resources and medical and nursing staff ”.
