According to a ministerial recalculation of NHS revenue, there would have been a surplus of 518 million euros in 2012 and 811 million in 2013
NHS spending historically grew by an average of 4% per year, with an average deficit of 4%, albeit with significant regional differences.
Since 2009, public spending has remained substantially stable and in 2013 the preliminary data show, for the first time since 1995, a reduction (-1.2% compared to 2012).
The decrease in spending is associated with the decrease in GDP (-0.4% compared to 2012), but more accentuated, so that the weight of current public health expenditure on GDP decreased in 2013, going from 7.3% in 2012 to 7.2%.
Even the the health deficit has decreased significantly and has now stood at 1-1.5 billion euros since 2011, therefore around 1% of current expenditure.
Indeed, the data show a surplus of 518 million euros in 2012 and 811 million in 2013, even if only due to a new and particular method used at the ministerial level for the accounting of the regional tax revenues destined to cover the deficits.
This is the picture that emerges from Oasis Report 2014 by Cergas and SDA Bocconi with the collaboration of Bayer, which also highlights the road that remains to be done.
“Healthcare companies – say the editors of the Report – they performed a small miracle: a balanced budget and no increase in spending for 5 years, with the system substantially stabledespite the aging of the population, the worsening epidemiological, new technologies and the increase in poverty. The system is now fully sustainable.
From the phase of rapid cost containment mainly with input based logic we must now reorganize the services, aligning them with the emerging epidemiology: it is a medium-term job, now possible, only because we have sorted out the accounts. This is the challenge that awaits the NHS and healthcare companies must play a central role".
Healthcare companies have been the silent protagonists of this difficult season of the NHS. Many of the contradictions of the system have been "downloaded" onto them, often leaving them with the responsibility for implementing the changes.
An improvement in the accounts that is not without costs, also in terms of quality, efficiency, safety and fairness.
The National Health System has having seen personnel expenses fall by around 1.5% per year over the last three years, due to the failure to replace retirees, the freeze on wages and the outsourcing of many activities to social cooperatives.
in the Tyrrhenian regions subject to a repayment plan (Lazio, Campania, Calabria and Sicily) on permanent staff decreased by 15% from 2006 to 2012 and temporary or temporary staff by 27%.
The dynamics of subsidized pharmaceutical expenditure was even more marked: it decreased by 7.6% per year in the last three years.
