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Health reform, the world of healthcare: ” Great disappointment, demotivation at all levels ” but despite the technical and political rejection, the League continues

TRENTO. “You had to have the courage to suspend the discussion. A coup de grace to professionals and professions”. “We reiterate the critical position in terms of modalities and contents: a plan that is too generic and not very articulated, a purely medical model with few references to social issues and no word on psychology”. “Now it will be the councilorship to go ahead and make the decisions for which he will be responsible”. To say it Marco Ioppi (president of the Medical Association), Roberta Bommassar (president of the Order of Psychologists) e Daniel Pedrotti (President of the Order of Nurses). “A reform – continues the number one of doctors – can be an opportunity to review the system which, on the other hand, risks being put in difficulty for the next few years because intervening is complicated: a frame is not enough, content is not enough; only quantity, quality is also needed “.

A triple rejection in more or less 48 hours: prima i labor unions, then that technique with the “memory” of all Orders of the health professions (Here article) and then that politics with the negative opinion in the Fourth Provincial Commission with an overwhelming vote (Here article). They should be gods knockout shots but instead the League health reform goes on: the resolution will be brought to the council and then green light to the regulation.

In the meantime, he joined the front of the “stop” me too’Regional Order of Social Workers, “excluded from the consultations that have been held in recent days. Continue to consider health only a health issue – comments the president Angela Rosignoli – without taking into account the social aspects, he is shortsighted and decidedly short-sighted. Excluding the social means not hearing the voice of those who have to take care of an elderly relative who is discharged from the hospital and does not know how to move, of those who are alone without any support network and do not know their rights, of those who are more fragile and it needs even more to be protected “.

It was the first time in the history of Trentino that such an important decision that directly concerns the population arrives in the Province with a negative opinion from the competent commission. A non-binding opinion, albeit significant. Perhaps another anomaly is that that there will be no discussion in the Provincial Council. In conclusion, the proposal has filled upNobut apparently it doesn’t matter. A “polycentric hospital” to enhance the territories when the Cal he has not yet been heard by the health and provincial authorities.

A definite plan “lazy“, “indefinite” and with “criticalities that compromise the overall system“from the technicians, the experts and the political component. Faced with the assurances that the regulation would then be completed with the observations that emerged (but as mentioned there will be no discussion in the Province) to make a resolution even more superficial at this point arrived faded and that would have required more than a supplement of reflection on a fundamental sector, even more so today due to Covid pandemic.

“In these almost three years of legislature – says Ioppi – we have gone from the desire to cut resources (the hypothesis of efficiency from 120 million: 10 million euros in 2020, then 20 in 2021, 40 in 2022 and finally 50 million euros in 2023) to this reform but the reasons are not understood, the guidelines and objectives. There is talk of a widespread system and network, proximity and territory: beautiful and correct words, but in fact the contents and how the reform is to be implemented is not known. All too nebulous and generic: we are naturally open to innovation and improvements, but in this case we do not understand the meaning of the change “.

And now the uncertainties could also concern the implementation of the regulation which will require a great deal of work to convince a healthcare world that is skeptical to say the least. “Once again the mission of a professional at the base has been undermined. There is already a strong demotivation at all levels – adds Ioppi – the health worker should be central to decisions, have autonomy and responsibility. Instead, they are always the last to learn everything because the approach is still too top-down: even if there have been some meetings very late, but there is no space for debate. The tables are convened only for formality, the slides are shown and often there are no questions because there is a general mistrust or because there is a subordinate relationship that is too close that does not favor discussions and an employee does not always trust to contradict a superior “.

Method and way that do not add up. “We did not have the opportunity to participate in an activity. In particular – highlights Bommassar – the aspects bio-psycho-social are once again omitted: the proximity nurse is essential and should be expected proximity psychologist to be able to act at the first level. The Covid emergency highlights the importance of inter-professionalism and an integrated organization in favor of the citizen. There is disappointment about the reform and one cannot accept a vague presentation and wait for the regulation: technically we cannot accept to leave carte blanche and an act of trust for a measure that will affect the well-being and health of the population for the next few years “.

A plan close to the deadline. “We were heard only 8 days before the deadline and we gave our contribution – continues Pedrotti – while declaring that there are strong critical issues, also of method. We expect the councilor to carefully evaluate our requests and that integrate the resolution. These are proposals that have seen strong sharing among all the Orders and which concern important guidelines for Apss for its strengthening and for the enhancement of the health professions. The need is to involve professionals but the responsibility now lies with the department “.

The trade unions are also returning to this point. “The council wanted to forge ahead to get the reform to be approved, but with the rejection reached the fourth commission, the executive cannot go to the approval of a provision that risks making everyone unhappy, but above all not to improve in terms of efficiency and quality of the Trentino healthcare system, leaving the critical issues completely unresolved “, they explain Andrea Grosselli (CGIL), Michele Bezzi (Cisl) e Walter Alotti (Uil). “We hope that with humility the councilor Segnana takes note of the negative opinion expressed by almost all the majority and minority directors and initiates a concrete and not just formal discussion on the contents of the new organizational design. If this were not the case it would be a real slap in the face. Provincial Council “.

The doubts of the social partners remain. “Perplexity about an extremely vague and indefinite provision in many points, a real ‘mini counter-reform’, more attentive to the logic of electoral consensus than to improve health care for citizens; more oriented towards drawing a dividing line with respect to the current model rather than evaluating any dysfunctions in a critical and constructive way “, Grosselli, Bezzi and Alotti conclude.

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