Healthcare is at the heart of almost all party electoral programs. But, in practice, the relaunch of the public and universal national health service is present only in the proposals of the Democratic and Progressive Democratic Democratic Party-Italy, the Greens-Left and the Popular Union.
The waiting lists must be cut down, the health of citizens must be protected, but the proposals indicated by the various political forces that present themselves in the elections are different. The centrality of the NHS and the increase in resources speak, with different emphases, of the Democratic and Progressive Pd-Italy, the Greens-Left and the Popular Union. While the center-right forces pay attention to the relationship with the private sector. Forza Italia indicates an “improvement in the level of efficiency of the system by focusing on modern processes of corporatization of the public entity and on greater integration of the public and private components. Investments in health research “. The League, among other things, proposes to “identify measures aimed at guaranteeing compliance with the volumes of the free profession with respect to the activity provided by the NHS” and considers the private healthcare agreement “important in regional health planning”. Also for the Third Pole it is important to improve the synergy between public and private health. But let’s see the programs in more detail.
The Democratic and Progressive Pd-Italy defines health as “a fundamental public good”. In order to protect and extend it, it undertakes to: “overcome the planning model of healthcare expenditure built by closed sectors and expenditure ceilings. We will invest in Community Houses as a model capable of coming close to the needs of the entire population, with a view to proximity and multidisciplinarity. We will finance an extraordinary plan for NHS personnel, definitively overcoming the spending ceilings in force for more than 10 years, reducing the use of unstructured personnel (temporary workers, external collaborations and outsourcing), strengthening and encouraging the presence of doctors on the territory of general medicine and community nurses, ensuring the timely renewal of employment contracts. A Plan financed through an adequate increase in the National Health Fund, so that no one finds himself alone when he needs assistance. We will launch an extraordinary plan for mental health ”. While with regard to waiting lists: “We are committed to halving the maximum times by 2027 by reforming the current National Waiting Lists Government Plan with the introduction of a system of incentives-sanctions and mobility between health facilities”. Finally: “We want to guarantee the full protection of the free exercise of women’s sexual and reproductive rights and the full application throughout the country of Law 194/1978”.
The health chapter in the program is long and detailed Verdi – Left. Everything revolves around the centrality of the public service on which to invest in order to relaunch it. Among the proposals presented, there are: “The inclusion of the ‘health’ objective in all policies, strengthening of prevention and environmental protection services. A plan for the structural strengthening of employees, with the hiring of a total of 40,000 operators in three years. The revision of the outsourced services, first of all ensuring the working conditions and the just remuneration of the staff and proceeding to a gradual return to direct management, starting from the strategic sectors. The overcoming of the national conventions of family doctors, of free choice pediatricians, of outpatient specialists, of service medicine with the inclusion of these professional figures in the Single Contract of dependence on the National Health Service “.
The coalition’s program is truly generic, ranging from improving local health to updating pandemic plans; from the reorganization of the medical specialization schools to the revision of the national cancer plan.
Also Brothers of Italy lists a series of good intentions without specifying who, how and when to provide the services. “Overcoming the deadlock in the pandemic: restoration of ordinary services and screening procedures, strengthening of predictive medicine with a mechanism of rewarding access to the health system for those who follow a regular and agreed path of health status monitoring. Reduction of waiting list times. Creation of a Guarantor of Health ”. And again: “Encourage the spread and development of telemedicine, home care and territorial aids in inland areas with low population density. Reduce inequalities between regions in the provision of health services and essential levels of assistance (Lea) ”. What is evident is that the public health system is never mentioned or funding is mentioned.
The program of the League. It is requested that the NHS funding be maintained “mainly” by taxation. The question that arises spontaneously is whether the differentiated autonomy was approved from which taxation the SS would be financed in Calabria and from which in Lombardy. Apart from that, the League wants “freedom of therapeutic choice” with no more vaccination obligations. The detailed proposals include: “Identification of measures aimed at ensuring compliance with the volumes of the freelance profession compared to the volumes of the activity performed in the NHS. Identification of measures aimed at greater coordination between the actors and rethinking of organizational models “. And it is emphasized: “The role of private health care agreement, in this historical moment, can prove to be important in regional health planning, always maintaining the private health agreement complementary to the public”. Private agreement, it should be remembered, means paid with public money.
Also for Come on Italy they range from the elimination of waiting lists, to the revision of Lea through the strengthening of territorial medicine and to the revision of Mission 6 of the NRP. And all this can be done through the “improvement of the efficiency level of the system by focusing on modern processes of corporatization of the public entity and on greater integration of the public and private components”.
5 Star Movement
The chapter on the health of the Movement is very concise and detailed: “Enough political interference in the appointment of health managers. Reform of Title V of the Constitution to restore health to the direct management of the state and avoid the current dysfunctions of the 20 regional systems, all the more so that emerged with the pandemic. Enhancement and accessibility to innovative and advanced therapies. Incentives for First Aid. Increase in wages for health personnel ”.
The alignment led by Calenda calls for the reform of governance between the State and the Regions with a sort of “redefinition” of Title V. The aim is to redefine the relationship between primary care hospital medicine, territorial medicine and social services. We ask to increase investments in prevention services. We also need an extraordinary plan for waiting lists. To do all this: “it is necessary to establish more transparent ways of differentiating public and private services so that they can collaborate in synergy and integrate with each other, with the primary objective of putting the needs of the patient and his care choices at the center in an integrated public / private system “.
Ten proposals for the relaunch of the public health service whose funding “never falls below the European average (7.3 per cent of GDP)”. And then: “Increase the number of beds per 1000 inhabitants (in Italy 3.2 in 2017, compared to a European average of over 5) and medical and health personnel, also to eliminate intra moenia services and rebuild the network of general practitioners, immediately doubling the number of annual trainings “. Again: “Provide free assistance to non self-sufficient elderly people and an adequate regulatory framework for the protection and assistance of all forms of disability. Increase in disability pensions, more funds for the elimination of architectural barriers, more resources for home assistance and expansion of Lea (essential levels of assistance) for habilitation and rehabilitation therapies. Massively investing in territorial medicine not only in the structures, but also in the recruitment of personnel for a relaunch of prevention at the territorial level. Re-internalization of outsourced services and return to the public of contracted services with re-absorption of the personnel involved “.