Health care and 2023. From Covid to Pnrr to staff shortages: these are the biggest challenges Quotidiano Sanità

by Luciano Fassari

From fighting the virus to vaccines to solving some chronic problems like staff shortages and long waiting lists. But not only that, the Aifa reform, the reorganization of the Ministry of Health, the new presidency of the ISS and the implementation of the Pnrr have to do with the fate of the community houses and the reform of general medicine. Here’s what is being cooked for the New Year.


02 JAN –

From continuing the fight against Covid, going through the waiting lists, the lack of staff, to implementing the Aifa reform and much more. Also for 2023, the health menu is quite rich and the challenges that await the government and the Minister of Health, Horace Schillaci they are diverse.

Let’s start with Covid. The government’s line has been to phase out restrictions. Partly to send a political signal and partly to speed up the process of coexisting with the virus. However, the news from China is worrying, mainly because a high circulation encourages the creation of new variants that could become dangerous. At the moment the situation is not alarming, but it is clear that there is a need to strengthen the sequencing network, which is still missing despite the almost 3-year pandemic.

One sore point that needs work is vaccinations instead. Minister Schillaci has always defended the importance of vaccination and launched a communication campaign, but it is clear that the political majority, which it is the expression of, has always viewed vaccination with a certain reluctance. All you have to do is read the Secretary of State’s statements again Marcellus Gemmato and also that of the Prime Minister himself Giorgia Meloni that never seems so clean.

But obviously there is not only Covid. Another crucial element will be the interventions aimed at restoring waiting lists. The ad hoc funds envisaged by the previous government were not confirmed in the maneuver (although the measure was not as successful). Apart from Schillaci’s declarations of intent, there is not much to be done at the moment, but it is legitimate to expect initiatives, also because visiting and examination times are becoming longer and the patient flight from the public is progressing (those who can afford it, of course). ).

The crucial point for the future of the NHS is then to solve the staff shortage. There is a shortage of doctors, nurses and health professionals everywhere. Regions are now defining it as a national emergency and the minister has announced the issue is high on his agenda. A first (timid) signal has arrived in the budget law with 200 million grants for emergency personnel, but only from 2024 (the ministerial attempt to bring everything forward to 2023 has failed). Something else is expected at this point.

But not only shortages, there is also the extension of contracts at stake. First of all, the 2019-2021 medicine and health management that sparked the doctors’ protests ahead of the Christmas holidays must be closed. At the moment the address document is stopped at the MEF and the negotiations cannot start without a release. However, there are also many clouds over the 2022-2024 renewals, which currently do not see any allocation.

Aifa, Iss, Agenas and MinistryOne of the first items on the agenda is the implementation of the AIFA reform that has just been passed. It will be an executive order, to be discussed in the country regions, that will set the rules for the appointment of the agency’s new board.

The presidency of the ISS expires in the summer. Silvio Brusaferro he can be re-elected by law, but it is clear that the Institute’s leadership has always whetted the appetite of political forces.

Regarding Agenas, the confirmation of Dominik Mantowan Driving was a matter of course, even if there seem to have been a few breakdowns in the last few days. In addition, the implementation of the reorganization of the Ministry of Health is expected, where it is very likely that there will be many changes at the top.

The implementation of the Pnrr then hangs on top of everything. In addition to all the milestones to be reached in 2023 in order to release the money from the EU, it will be necessary to understand what the government will do in practice, which has always rejected ministerial decrees, especially with regard to the reform of territorial aid 77 on this topic and for example the Houses of Community project. In this sense, the possible reform of general medicine is awaited.

Another issue is the amortization of medical products. For now, the government has gone straight, but given the volume of appeals filed by companies, the picture could be changing.

In this scenario, the broader context also needs to be looked at, starting with inflation and high energy prices, to see if it is possible to increase Health Fund allocations.

Also pay attention to the topicdifferentiated autonomy which also affects the healthcare system and where there is no uniform view of the majority powers.

Luciano Fassari

January 02, 2023
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