From freelancers in a convention regime to a contractual regime of direct dependence on the National Health Service. A radical change for family doctors, with their greater involvement in the new Health Houses, contained according to what Corriere della Sera reports in a draft reform of the General Medicine sector.
A perspective that divides the trade unions and that gathers the opposition of the president of the Federation of Medical Associations (Fnomceo) Filippo Anelli , who however underlines that at the moment «there is no confirmation or knowledge of any text that goes in this direction».
According to the national coordination Fp Cgil General Practitioners "after the numerous declarations of the Minister of Health, Orazio Schillaci, in support of the transition to the Management contract also for family doctors, we would have expected a serious bill for an integrated and multi-professional organization of the Community Homes that to this day remain empty buildings, without staff. And instead a bill appears from the hat that in reality proposes a hybrid of the current system, in which family doctors, moreover seriously understaffed, will have to do the spinning tops between accredited practices, patients' homes and Community Homes, to the detriment of assistance to people. An unacceptable proposal ".
The Fnomceo president rejects the hypothesis , according to whom «with the dismantling of the current system of the agreement, the levels of protection of citizens' health would be reduced and the autonomy of professionals would also be reduced». First of all, he specifies, «we are not aware of any proposal to date on the issue of the transition to dependence, so we are talking about nothing». «As Fnomceo - he clarifies - we protect the relationship of trust that exists between doctor and patient . Various studies, in fact, highlight how precisely this direct continuous relationship, of trust and loyalty, and which is linked to the possibility of choosing one's own doctor present in the territory, produces an improvement in health and survival rates. For this reason we believe that the current model of the agreement with the NHS is useful to the country and to the citizen». On the contrary, with the transition to dependence, « doctors could no longer guarantee that relationship of trust and personal , since they would be present in the Community Houses or in the Health Houses in rotation and the possibility of guaranteeing assistance by fiduciary choice by the citizen would be reduced».
The president of the Federation of General Practitioners (Fimmg), Silvestro Scotti, is also against it : «This step - he warns - would actually mask a privatization of general medicine. This hypothesis would be rejected by young doctors due to the lack of attractiveness of the public system and this would inevitably determine the spread of private structures and cooperatives of paid family doctors. If it were to happen, I would personally resign from the NHS and resignation could be a gesture carried out by many doctors».
At the moment, however, Scotti assures, «the Minister of Health denies his interest in the transition to dependency, as he confirmed to me in a recent meeting, but there is pressure from some Regions, which are asking to resolve the problem of the need for doctors to guarantee the functioning of the new Community Houses». In this regard, however, he recalls that «already in the last agreement contract with the NHS, signed in 2024, there are the tools to define the hourly participation of family doctors in the Health Houses».
Criticism also from the Italian Doctors Union (Smi): "A general practitioner already evades an average of 75 visits per day. Multiplied by 40 thousand family doctors' offices, it is about 3 million, 750 million per year. I do not believe - says the secretary Pina Onotri - that there is much time left to carry out additional hourly activities in the Health Houses".
(Online Union)
