ROME – The local health authorities must stop summoning doctors just because they have prescribed more than the month before. The prescriptive dynamics must disengage from the analysis of historical spending. And the national unions can impose their point of view in the training of local health officials and a common background for general practitioners, district doctors and pharmacists. As? With one hundred training courses in 88 Local Health Authorities intended for those who, in turn, in the Local Health Authorities save Ì Lea» manage the compulsory training. With the national secretary Giacomo Milillo, the drug policy manager Roberto Venesia, the economist Vincenzo Atella and the internist Enzo Manzato, Fimmg thus presents its strategy to stop the economistic drift of the NHS. «The idea came from a Metis-Fimmg working group (the union's scientific society, ed). Our need - says Milillo - is that the prescription be evaluated, not only in terms of how much we make the regions spend on drugs, but also how much expense we avoid in terms of hospitalizations ». The introduction of anti-ulcer drugs has almost eliminated gastro-section operations; and the most recent calculations by the University of Tor Vergata (and by Professor Atella) on the social costs avoided by a correct prescription of statins in diabetic patients are known. «We want scientific studies and the prescribing reality of the generalist who does not work on a selected population, as in clinical trials, but on complex patients, known to him, for whom he is often busy correcting therapies, to be taken into account from now on. We know how to manage this complexity and we would like to work with the ASL and other figures ». It is hoped that the local health authorities do not judge on the basis of historical expenditure alone. «We are aware that the problem cannot be solved with training alone, but common preparation is the prerequisite for modifying future decisions by the drug agency, governments and regions. We continue to see an attitude based on savings in the Local Health Authorities. Strategies that control today's pharmaceutical spending prove unhappy in containing tomorrow's healthcare spending. Does the union of 26,000 members spend itself on training also to guarantee unity of services in the federalism to come? "Yes. At this stage, a delicate game is underway. I register on the part of the government in Rome not so much a desire to govern the regions as to offer the Italians guarantees of uniformity, and I see the regions less fierce in defending certain autonomies and realizing that only self-sufficient realities should be supported. I believe that the crisis can speed up the processes». And the bill on federalism approved in the House? «I see it as a moment of regulation that can bring clarity and benefits to the center-periphery relationship. The fact that the equalization fund for poor regions is vertical and not horizontal (i.e. entrusted to the state-regions conference and not to automatic regulation mechanisms between regions, ed.) will be able to guarantee equity in services». The Ministry of Welfare takes the field on specific training, will you also be summoned? «At the Snamid congress, I anticipated an interest generally expressed by the Ministry of Welfare in coordinating specific training. In this regard, an article of the bill on clinical governance reports some important functions to the ministry». (mm)
Corriere Medico dated 20/04/2009, article of (mm) N.8 – 2 APRIL 2009 p. 3
