New hospital, the city ask for lost money

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– The health situation in La Spezia is increasingly dramatic. Just scroll through the articles published in “City of La Spezia” in recent days: a real war bulletin.
The condition of cancer patients is intolerable: the day hospital service of San Bartolomeo di Sarzana has been transferred to Sant’Andrea, in inadequate spaces, causing long queues outside the pavilion to wait for treatment. First outdoors, then in a Civil Protection tent. When is an adequate structural situation?
It is not just the “fault” of the pandemic. On Saturday an experienced patient wrote it clearly: “the pandemic has only further aggravated and brought to light an already dying situation”. Which has been described as follows:
“A dilapidated and dirty hospital, with rats that I personally met in the gardens; the chronic shortage of staff: doctors, nurses but also other health workers, those who are not seen in the ward but who are essential for the care of patients, such as hospital pharmacists; the diagnostic therapeutic assistance paths never actually implemented, with patients and caregivers who are sometimes denied even the minimum levels of assistance; the strong and clear protests raised by health personnel for the impossibility of providing adequate services “.
Last Wednesday, doctors and nurses turned their backs on Sant’Andrea with mourning in their arm to express their dissent for a “killed” healthcare system: “permanent hires immediately” they clamored, raising signs with eloquent slogans such as ” Without doctors and nurses, only miracles remain “,” Thanks are not enough, resources are needed “,” Spezia and Sarzana united for a new public hospital … Public! “,” At the hospital in Sarzana 1 doctor on call for 135 patients ” .
What needs to be done has been clear for some time, and has been proposed by many: more staff and more resources for ASL 5, marginalized and mistreated by the Region since 2008 (the numbers, repeatedly reported in this column, speak unfortunately alone).
And then a new hospital, soon. Last Sunday I focused on the financial model chosen by the Region to implement it:
“The structure will be built by private individuals, according to a formula, that of“ leasing in construction ”, which is the most popular in the“ ideal health ”of the current Ligurian council, that of Lombardy. In exchange, private individuals will have the management of the hospital in terms of hotel services, not health care, for at least thirty years. Therefore: the private individual, exclusively with their own capital, will build the hospital and then rent it to the ASL 5, which in turn will pay a very expensive rent to repay the private investment in the following thirty years. The healthcare company will pay the builders-managers two annual fees: one linked to the construction of the work and one connected with hotel services ”.
The risks are obvious, I summarize them in a single question: will ASL 5 be able to support this financial burden or will it be forced to sell the hospital’s health management to the private sector?
These are risks that can be avoided by resorting to public resources. Also on Sunday, I quoted the sentence pronounced by President Toti in Spezia: “instead of investing 175 million in building capital, it is better to use that money for other interventions that we have spread over the region”.
And I asked: but why spend the resources that have been earmarked for some time in Spezia on others? Or is this money gone?
In the absence of answers, I read the resolution of the regional council of February 24, 2020. Despite the bureaucratic language, the truth emerges clear: the money was largely lost.
To be exact, there are no longer the 120 million assigned by the CIPE (Interministerial Committee for Economic Planning) between 2008 and 2009. About 14.2 million were spent to pay the Pessina company for the work done (demolition of the old hospital of Felettino, concrete trench, earthmoving and leveling, debris disposal, etc.), to pay IRE (which followed the process of building the new hospital on behalf of the Region), for legal and consultancy costs, etc. The other 105.8 million were lost because they were revoked as “deemed ineligible for the loan within thirty-six months of the signing of the Agreement itself, with the consequent revocation of the corresponding spending commitments.” The thirty-six month limit is set by the law of budget n. 266/2005, amended with law 205/2017. The Program Agreement referred to in the resolution of the Regional Council was signed on 11 May 2017: the new call for tenders should therefore have been launched by 11 May 2020.
Another destiny was 23.75 million, the second and subsequent commitment of the State’s expenditure, again granted for the construction of the Felettino Hospital. These resources were also about to be lost, but were saved by the Region in extremis with the proposal of a new and different Program Agreement, thanks to the resolution of 24 February last. These 23.75 million are destined for other works “spread over the regional territory”, as Toti revealed.
What happened is, in essence, clear. Let’s leave aside (the judiciary is dealing with it) the way in which the relationship with the Pessina company was interrupted. The company presented a variant, after the recommendation of the Province, for a new foundation technique. Variant that was approved by the Province and the Municipality but not by the Region, which instead told the company that it had to start working at the hospital again on the basis of the old project, the one envisaged by the original contract, whose foundations technique had worried the Province ! But when, in September 2019, the Region made this choice, it knew well of the deadline of May 2020 for the new call, on pain of losing most of the funding. May passed, in December the proposal for a hospital built by private individuals was made known.
However, the city must not resign itself. That money has not yet been allocated to other works. They can return to Spezia if the whole city, starting with its Mayor and its Municipal Council, asks for them in the name of the health of the La Spezia people. A new agreement with the state for a public hospital is possible. But now it depends above all on us.
I refer, in this section, to the articles: