Healthcare, visits and exams, Lombardy sets time limits: how it will work

A resolution has been approved in Lombardy which aims to considerably reduce waiting lists in Healthcare. 61 million euros are expected to be allocated to guarantee more than 7 million services by December 2024, of those included in the National Waiting List Management Plan.

Two million of these are first visits and the Region also aims to allow visits and diagnostic tests to be carried out in the afternoon, as well as on Saturday morning. On paper a real revolution, complete with compliance with execution deadlines and priority classes, which the recipes correctly report. Why then are harsh controversies breaking out?

The triggering reason is given precisely by the imposition of a sort of chronometer, albeit more or less flexible, in order to fall within the meshes of the new organization. All this while ignoring, say Lombardy healthcare professionals, the real and devastating problems that have been reported for years.

Lombardy, the health protest

The main union of hospital doctors, theAnaao Assomed However, he said he was profoundly against the resolution. The criticism leveled at the Lombardy Region is that of wanting “market treatments”, indicating standard times, as if they were products. Something not guaranteed, since each patient has their own medical history and specific needs.

The focus, therefore, is on respecting the “execution times” of both tests and visits. What could be an advantage for some patients could put healthcare personnel under pressure and create clear problems for other people seeking treatment, suffering from serious pathologies or requiring particular care.

Visits and tests, timing

Planning of services should be entrusted to the expertise of doctors and health facilities, not to regional offices. So let's see what they are expected minutes from the resolution:

  • abdominal ultrasound: 15 minutes;
  • first cardiological visit: 20 minutes;
  • first gynecological visit: 20 minutes;
  • MRI: 30 minutes;
  • polypectomy: 45 minutes.

A line indicated to streamline the use of the resources made available. The Welfare councilor expressed his opinion on this matter Guido Bertolaso: “This is not a timetable that we drop from above. We're certainly not going to check with the stopwatch, as some people think. You will certainly find the doctor who will say that he was not consulted, but we are giving general indications, shared with the experts.”

Healthcare problems

Bertolaso's thoughts are clear. Lombardy has some excellences, which however are obscured by an often poorly organized system. However, the response is not long in coming Pierino Di Silverionational secretary of Anaao Assomed.

One of the long-standing problems of healthcare in Lombardy is represented by waiting lists. A drama that vanishes with the sound of euros paid into the coffers of the private sector, which is also finding more and more space in the public sector.

According to Di Silverio “it cannot be solved by increasing the work of doctors or timing the treatments, as well as attributing the cause to intra moenia. The causes are clear, namely lack of operators, organization and infrastructure. If we don't reorganize, if we don't combat improper performance, if we don't increase staff by paying them better and if we don't improve infrastructure, the problem will not be solved.”

Region and Healthcare do not seem able to communicate at all, but find common ground. The problem is unique and well-known, Anaao Assomed points out, but we continue to blame the professionals.

Opinion shared by Roberto Carlo Rossi, president of the Milan Medical Association. He defined the times as unacceptable. Different people, with different pathologies, cannot submit to indications coming from a circular: “Time, after all, is an element of care”.

Test results and treatments: what is expected from healthcare

Although Bertolaso ​​spoke of indications in order to direct the sector towards change, the resolution is extremely precise and detailed. One is expected reduction in delivery times for exam results screening, for example. An example is given by the mammographic one, with release within 5 days of the service. However, within 3 days, you will need to be notified of a positive outcome (and in any case no later than 5 days).

There are 7 days guaranteed for the colorectal screening file, with notification of a positive result within 3 and no later than 6 days. Furthermore, all eligible subjects will be invited to carry out breast, colorectal and cervical screening. Also reference to in-depth exams, connected to these services. They must respect specific deadlines:

  • colon rectum: within 30 days of the first level test resulting positive;
  • mammography screening: within 28 days of the first level test resulting positive;
  • cervical screening: within 45 days of the first level test resulting positive.

Looking at the number of total services performed, 4.1 million services are requested of the over 7 million total. Instead, 3.1 million are expected from accredited private individuals. On the economic front, however, 2/3 of the 61 million euros indicated will be allocated to public providers. A third instead to private individuals.

The Region is placed in absolute command, quantifying the number of slots needed. Here is what Bertolaso ​​said on the matter: “We will establish for the first time in Italy the places to be made available on the agendas, from now until the end of 2024. Based on the waiting lists, staff and timescales that we have identified, each facility will have to perform a specific number of services”.

In the meantime, the ATS is expected to highlight other services that require immediate improvement in terms of waiting times. We will proceed with monthly monitoring in order to understand whether the measures adopted are sufficient and effective.