The criticisms with which the medical world has accepted the amendments to the Balduzzi decree finalized on Saturday by the health councilors of the Regions and today being examined by the Conference of Governors sound like a slam. From the executives to the affiliated it is a chorus in which the criticisms of the individual proposals alternate with concern for what the unions bluntly call "institutional conflict". Not surprisingly, the formula rebounds decided by the press releases of the two most representative acronyms of addiction and family medicine, Anaao-Assomed and Fimmg. "The regional councilors" accuses Costantino Troise, national secretary of the Anaao "continue to deny the State, today the Government yesterday in Parliament, the possibility of legislating on rules that, at home, many of them have already approved". "The amendments" echoes Giacomo Milillo, leader of the Fimmg "appear to all intents and purposes a provocation in the eternal struggle of competences between the Regions and the Government in health matters".
For the two acronyms, this is the only way to explain the corrections made by the Health Committee of the Regions to the two most important articles of the Balduzzi decree, the first (reorganization of territorial assistance) and the fourth (fundamental principles of medical management and clinical governance). . Two articles that have been the subject of as many negotiation tables between the Ministry and the unions in recent months, concluded with agreements that the decree should always incorporate. And that the councilors would instead like to rewrite extensively. With regard to primary care, for example, not only is it asked to put aside the compulsory obligation; aggregations (to be considered only «priority» say the Regions), but remuneration mechanisms are also proposed which the Fimmg rejects without appeal: «The doctor» observes Milillo «would be imposed individual expenditure ceilings, so that once the resources are exhausted the patients will have to say "I'm out of money, come back next year". Or we'll have to skimp on the expense of each client to scrape together a reserve». And as if that weren't enough from the Regions also comes the request to be able to classify the doctors with agreements in the management and, in the other sense, to allow the doctors of the NHS to access the role of Mmg and Pls. «The figure of the family doctor would be progressively eliminated» continues Milillo «we are faced with indecent and inconsistent counter-proposals, a collage of the "desiderata" of each Region». «The document» adds Giuseppe Mele, president of the Fimp «attempts to assemble a babel of different interests, all particular, all with little perspective and without organic strength, if not that one! to further demolish the NHS".
Same tones from the Anaao regarding the corrections proposed by the health councilors on article 4. «The vivisection to which he is subjected» says Troise «overturns what was approved in Parliament in the bill on clinical governance and represents an attempt to safeguard and expand the intrusiveness pervasive of health care policy. Professional merits and logic are trampled on, introducing forced mobility and arbitrary flexibility; a system such as that of the appointment of directors of a complex structure is preserved, built under the banner of a relationship of trust that has proved to be bankruptcy. Which among other things is claimed for hospital doctors, but not for the yes
