DDL health services, prizes to managers who will break down the waiting lists and « vigilantes » patients: the news

Prizes to the managers of the hospitals who will prevene the queues of the patients waiting, while the latter will be able to dress the clothes of the « vigilantes » and report problems and disservices directly to the Ministry of Health. It can perhaps be imagined with which mood the health managers have accepted these two measures which, in some way, give legitimacy to a very Italian passion: that of complaining about the state (and health, in general, is in first place). Be as it may, with the « DDL health services», Approved on April 15 by the Senate (with 78 votes in favor, 47 against and no abstention), citizens will be able to fill in their staff Cahier de Doléance directly to the Ministry of Health through its institutional website. These complaints will then be analyzed by a specific Observatory, where technicians from the Ministry, regions and associations of patients will sit.

The measure, wanted by the Meloni government, is the tail of the plan against the waiting lists approved last June by the Council of Ministers. On that occasion it was decided to give life to a decree law for the most urgent interventions and leave everything else to a future bill, in the hope of finding the necessary covers. Evidently these resources have been found and, after the ok of the Senate room, The text now passes to the examination of the room.

How the reward mechanism works

The reward mechanism introduced by the bill provides for economic recognition to the regions that respect the maximum waiting times. To obtain the award, these must award specific annual objectives relating to the reduction of waiting lists. The objectives, in turn, will weigh on the achievement of the managers’ allowance of managers, both at regional and single Asl level. In parallel and according to the same scheme, the General Asl directors will also assign the same objectives to the administrative, health and primary directors, and which result allowance will be conditioned to waiting lists.

The institution of the singles

But the innovations contained in the « DDL health services » do not stop there. The national government system of the waiting lists (Single) is also established, which will have the task of coordinating national actions, managing the balance between supply and demand and supervising the appropriateness of the services and on the intramoenia of doctors. On paper an excellent thing, however, its grounding seems more complicated also because, as we know, the health has been the head of the regions, since 2001, when, under the Berlusconi II government (Fi-An-UDC-Lega Nord), Title V of the Constitution was reformed after the yes to the referendum. And always to try to break down the waiting lists, the spending limit for the purchase of health services from accredited private entities ( +0.5% this year and +1% from 2026) is raised, giving priority to those structures with first aid and included in the emergency-urgency network.

The new indicator for « therapeutic adherence »

Motivating it as a testimony of greater attention to the quality of the care paths, the bill inserts a new indicator to measure therapeutic adherence in the monitoring of health care. According to the World Health Organization, therapeutic adherence can be defined as « the degree of effective coincidence between the patient’s individual behavior and the therapeutic prescriptions received by the careful healthcare personnel ». The new classification should, in government intentions, improve control over the correct hiring of medicines. In addition, article 1 of the DDL provides that the doctor, who compete for the diagnosis, prognosis and therapy regarding the specific clinical situation, attributes the appropriate priority class (in the case of the first visit or diagnostic examination) and indicate the question or the question or the diagnostic suspicion (in the case of first access or subsequent accesses) when prescribed services.

Recruitment of health personnel

Given the chronic deficiency of personnel, the users are given the possibility of obtaining freelance assignments up to 10 hours per week (today they are up to the maximum at 8 hours), as the possibility of retaining the primaries, especially to carry out tutoring activities, is expected to keep in service up to 72 years. The measures introduced with the decree of 17 June 2024 are then confirmed to limit the use of doctors and nursing nurses in public hospitals, encouraging hiring with coordinated and continuous collaboration contracts and medical and health workers. The ASL, on the other hand, is expanded the possibility of resorting to outpatient specialists with time rates that rise up to 100 euros. Also planned for psychiatrists, childhood neuropsychiatrists, psychologists and educators are also planned, while the high health administration school is created to form the leaders of the NHS.

Political reactions

According to the senator Elena Murelli of the League, the DDL « is a large, structured and ambitious measure that represents an important step forward to fight waiting lists, which is not a question of funds but of organization to prevent the patient from dealing with an obstacle course ». For the Pd Senator Sandra Zampaon the other hand, it is « a DDL that does not have the courage to face the heart of the problem: the medicine of the territory, that is, a real taking charge of the patient. And that it does not even make available the resources necessary to face a problem that led 4.5 million Italians to give up care ». For the Green and Left Senator of Alliance Tino MagniFinally, « the provision on health services is useless, it is without money and does not respond to the problems of Italians. Indeed, it is worse, it continues to encourage the private sector, removing forces and funds from public health, a true pillar of the right to health for everyone ».