The hospital is a workplace with ever fewer prospects: it is not governed by doctors or merit, but by managers and politics. Healthcare reforms have failed because, far from co-opting doctors into management, they have spawned "monocratic" CEOs. These are the two "stones" thrown by the interviewees in the SWG survey for Anaao Assomed "the work of hospital doctors - critical issues and prospects", presented yesterday in Rome. Not that the NHS was the wrong choice: the 83% of the interviewees wants it. But the model doesn't work: 68% of respondents feel tired, 58% economically dissatisfied, 48% emotionally exhausted, one out of two finds the quality of services worsened. And if two-thirds of the overall quality provided "is good", one out of three believes that the NHS is now functioning worse than in other countries. The doctor is unhappy (77%) with his career not progressing and his paycheck not growing (75%) with contracts blocked for four years. Three quarters of the interviewees (unionized at 78%) would like to review the juridical role of the doctor in the Public Administration. There is no shortage of suggestions such as curbing overloads in the emergency room and cuts in assistance with outpatient visits also paid for by supplementary funds. "We expected similar data, and also the return of the flame of the wage issue," says the secretary Anaao Costantino Troise. «Some of the interviewees were exhausted by the loads 
they would agree to work more to bring home the money denied by the lack of contractual increases in intramoenia; after all, once upon a time there were incentives. Today the doctor, however forced to do more, says: at least pay me». But doesn't the search for a different legal role from the rest of the PA employees seem like a request to take refuge in a "golden" citadel? “On the contrary, we want to be interested in system management. In the cauldron in which he sits, the doctor is but an item managed by others, often seen as a cost to be cut. Its management skills are diminished and consequently its ability, albeit objective, to contain the costs of the system. But that's not going anywhere." But what can a union of employed doctors do if public health is skipped throughout Europe? In Italy there are cuts in departments, but in Spain there are cuts in hospitals and private structures outnumber the public ones (they are now the 55%). «Italy is not Spain. Here we already have a mixed system, but there are professional bodies that care about public health and the right to health is in the Constitution. We have fundamental “balances”. But we are seeing cuts in benefits and early dehospitalisations. In the South, cuts are made in the name of a balanced budget with criteria which, valid elsewhere, become unsustainable in the absence of infrastructure, alternatives for patients, technological adjustments. It's hard to say how long it will last, but if we get out of the economistic drift it will be thanks to those corporate forces that will have convinced politics to dialogue with the people". Mauro Miserendino Wednesday, September 24, 2014 – Doctor33
Troise, no idea from the government about the future
"Beyond the commercials and effective announcements, a real idea is missing" for the health of the future. This is what the national secretary of Anaao Assomed says, Constantine Troise on the sidelines of the conference to present the survey promoted by the Union together with Swg which traces an identikit of the hospital doctor today. «The Government – continues Troise – has excluded the health system from the wave of acceleration that is sweeping the whole country. The Minister has taken care to guarantee stable funding, but beyond the commercials and effective announcements, there is no real idea »for the healthcare of the future. «Our investigation – he concluded – shows a realistic picture of a situation that they already described a few years ago and which we denounced as a loose cannon in the system: sustainability is not only economic. Attention to accounts is a meritorious work but it is not enough. The way out is to restart from work and professionals and bring healthcare back to the center of the political agenda. These are goals that are within our reach. It is not a category interest but of the whole system ». Wednesday, September 24, 2014 – Doctor33
