Staff on the run, competitions for (fixed-term) contracts that go deserted, congested departments, tiring shifts. These days there are several episodes that highlight a general suffering of public health. The union of doctors dependent on the national health system, the order and the Italian federation of health and hospital companies provide numbers and possible ways out. “The issue of first aid cannot be reduced to a single cause. The problem of staff of the emergency-urgency departments it is certainly one of the reasons that weigh more in the current difficult situation. Certainly – says Carlo Palermo, national secretary Anaao Assomed, the union of doctors employed by the National Health Service at Adnkronos Salute – the situation of the Italian emergency rooms. is something that comes from afar, we are talking about a decade of spending review which had reduced the specialization grants for doctors to 5 thousand a year. Minister Speranza did well in committing himself on this front and in a few years we have passed the planned 18 thousand post-graduate training contracts. But we will see the new colleagues in 5 years, so today we have an intermediate situation to overcome: in fact, 4,500 doctors are missing in the emergency rooms. To this is added a vicious circle linked to grueling shifts of those who work on the front line today, often with all working weekends and difficulties even in taking holidays“.
“What to do? – asks Palermo – The first thing is to take on all the precariousness that developed in the sector during the pandemic and therefore go beyond the limits imposed on personnel spending. Of the 50-60 thousand operators hired on a fixed-term basis for the Covid emergency, 1,350 are doctors. Few, but they are needed. Also because – recalls the secretary of Anaao – there are about retirements and layoffs 7,000 annual releases from the system. But even more needs to be done: broaden the recruitments in the NHS to medical specialists starting from the third year. It is the only weapon we have ”.
According to Anaao, there is a “serious” problem of “improper access to emergency rooms”, warns Palermo who cites a data: “Over 80% of accesses are made up of white and green codes that should be addressed outside the emergency room “. But where? “In community houses – replies the trade unionist – provided for in the Pnrr”. The problem often highlighted over the years by Anaao is that of beds. “We have solved the training funnel and now we have the hospital onethere are no beds in Medicine and Surgery and patients remain in the emergency rooms, often on stretchers, because there is no bed in the ward “. Finally, Palermo also highlights the need to “make hospital and emergency room work attractive, I find it scandalous that it is not possible to implement contracts that are not appliedthose signed in 2019 were blocked by the pandemic, that of the two-year period 2019-21 has reached the table of Aran and that of 2022-2024 we should discuss it in these conditions “.
Even the Italian Federation of health and hospital companies (Fiaso) to try to get out, immediately, from the criticality caused by the shortage of specialists involved in first aid, the way is: higher wages for those who work in the emergency room and the possibility for hospitals to recruit even non-specialist doctors in emergency-urgency areas. “More and more competitions banned by health and hospital companies fail to be attractive and go deserted, as happened for the emergency room of the Cardarelli hospital in Napoli, and more and more professionals are leaving the public to work in the private sector – declares Giovanni Migliore, president of Fiaso -. Faced with this emergency situation, it is necessary emergency legislation, on the model of the one that allowed us to overcome the pandemic, which allows us to hire in the emergency room both specialists from other disciplines, as well as graduates in Medicine and Surgery and qualified for the medical profession even if without specialization. Due to the training funnel there are many young people, who have been effectively employed during the period of the Covid emergency, who have not been able to access specialization and who can, however, be of great help to the health system. Furthermore, as companies, we need flexible tools for recruiting personnel ”. Best then defines “an important signal but not yet sufficient to stop the bleeding of professionals” the ancillary allowance of 90 million euros allocated by the Ministry of Health to those who work in the emergency room. “All the professionals who work there have to be paid more”.
The Minister of Health, Roberto Speranza, also spoke on this point today. Crowding is an issue that concerns “the great question of personnel, we have to invest more and we have finally made very strong choices. In the last year we have placed 17,400 postgraduate scholarships, three times more than three years ago and double that of two years ago. It is clear that these investments will have an impact in the coming years. We will still have a few years not easy to manage, but today the lesson of Covid was very clear: we must reverse the cutting season as we are doing and we must open a new great season of investment in healthcare as a whole. And, in particular, on healthcare personnel. We have already started to do it and the numbers say so “