Cuts, waiting lists, new tasks in the area, progress of the nurses: the summer that is pressing with the wards closed for holidays seems to postpone the real confrontation on at least four issues to September. The first is paragraph 566. Doctors want to change the incipit of the 2015 Budget law, which relegates them only to "complex and specialized acts", but nurses - who see the new skills relaunched - cannot wait any longer.
After the Fnomceo National Council has given a mandate to defend the leadership role of the doctor, there is an open clash between doctors and health professions and especially nurses are threatening unrest and actions to protect the law. Meanwhile, there is a pressing need to enforce the cuts decided by the state-regions conference on the supply of goods, services and medical devices, both in hospitals and on the territory, and also in the coverage of outpatient diagnostic tests: these, with specialist visits, will be responsibility of the NHS and not of the patient only if the prescription from the family doctor or hospital follows validated guidelines; those who do not comply with the "guidelines", if a hospital doctor lose a share of ancillary treatment, if a mmg a part of the variable share.
Florence Corti Fimmg spokesman points out: «The guidelines for the prescription of outpatient services have yet to be the subject of an ad hoc ministerial provision. And the penalties for the doctor who does not follow them will be discussed later in the negotiation for the national collective agreement, until that is approved they will not be in force ». It will therefore take some time even if restrictions on the patient are foreseeable, and overload of work for doctors forced to use new prescribing criteria.
To start negotiating the conventions of local medicine again, we will have to wait for the definitive composition of the councils and the sector committee, and probably of Sisac itself. It is difficult to understand what the counterparty will choose between keeping or not an extra quid for group doctors and who have invested the most in enhancing studies or starting all over from the "white belt".
Last background question: the regions in the recovery plan are not complying with the decree to save precarious workers and in fact they do not offer places to compete even among fixed-term contracts, if not minimum quotas: in this way the waiting lists grow and with them doctors and nurses overtime, improper duties and strains on each other's skills.
Mauro Miserendino – Saturday, 01 August 2015 – Doctor33
Related news: The aberration of paragraph 566 of the 2015 Stability Law
Note: Law 23 December 2014, n. 190
Paragraph 566. Without prejudice to the skills of graduates in medicine and surgery in the field of complex and specialist acts of prevention, diagnosis, treatment and therapy, with an agreement between the Government and the regions, after consultation with the scientific, professional and trade union representatives of the health profiles concerned, are defined the roles, skills, professional relationships and individual and team responsibilities on tasks, functions and objectives of the nursing, midwifery, rehabilitation and prevention health professions, also through complementary training courses. The implementation of this paragraph must not result in new or greater burdens on the public finances.
