The agreement provides for the commitment to collaborate in a rationalization of healthcare services and expenditure (therefore above all a reduction in medicines, an increase in services, etc.)
According to the agreement with the company, it is enough to reach the 40% of the objectives for it to be triggered in full. The ASL board of auditors disputes the mechanism and presents a complaint to the accounting judiciary.
by Luciano Menconi – 04 January 2016 – THE TYRRHENIAN VERSILIA
VIAREGGIO. Is it correct to establish the minimum threshold necessary to fully trigger a company bonus in the achievement of 40 percent of the set objectives? In a private company, that threshold would be very unlikely to be judged sufficient to assess the work carried out in a wholly positive way. Yes, in the Versilia healthcare company. At least as far as family doctors are concerned.
With them, the ASL has stipulated an agreement on the basis of which, in exchange for the commitment to collaborate in a rationalization of services and health expenditure (therefore above all a reduction in medicines, an increase in services, expansion of computerisation, etc.), the distribution of a performance bonus is envisaged, to be drawn from a specific annual fund for a maximum amount of 250 thousand euros. So far everything is normal, economical (thanks to the collaboration of family doctors, the ASL ends up saving money and therefore having more resources to reinvest in strengthening local medicine), indisputable.
However, what raises a doubt - not in a user association but in the board of statutory auditors and in the internal assessment body of the same ASL 12 - is the mechanism (the ceiling for which is not provided for by law) agreed between the parties for the recognition of the bonus: that is, the fact that family doctors are considered deserving of the entire award even if they do not even reach half of the set objectives.
On this point, the board of statutory auditors and the internal evaluation body requested clarifications from the administrative managers who, however, evidently were not considered satisfactory if it is true - as shown in the regional offices that mainly deal with health - that a exposed to the regional prosecutor's office of the Court of Auditors.
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On this matter, the board of statutory auditors and the internal evaluation body had also asked the former general manager and deputy commissioner of the ASL 12 for explanations Brunero Baldacchini who had responded by arguing, essentially, that the matter of the agreement with general practitioners is not comparable to those with the staff of the health company because family doctors are not employees of the ASL but external collaborators. Therefore, is his conclusion, "any institution relating to performance evaluation and even more to that of the minimum threshold cannot take place in sectors such as that of general practitioners except through negotiation and consequent agreement between the parties".
This is the opinion expressed by the top management of the ASL 12, which however did not convince the board of statutory auditors who decided to bring the matter to the attention of the accounting judiciary.
Ed.: it is truly incredible that even the author of the above article considers it "normal" to reward "virtuous" doctors, meaning by virtuous those who save on treatment for their patients! He is only amazed by the award of the prize upon reaching the 40% of the objective. We don't even see the aberration of a doctor who is rewarded for saving on treatments for his patients, that is, who in practice gives up his "mission".
On savings, we have probably reached the bottom of the barrel given that the expenditure of the Italian NHS is the lowest of the 5 largest countries in the European Union and the same is true of pharmaceutical expenditure with the lowest price of drugs. We don't know or don't really want to fight corruption and we simply prefer to make the greed and inefficiency of those driving these caravans weigh on the citizens' skin.
The ASL brings the names of these "virtuous" doctors to the attention of citizens so that they can consciously choose for themselves the "virtuous" doctor or the one who treats them according to science and conscience! Let's see what happens! The "Informed Consent" should also involve these aspects.
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