Company balance sheets speak for themselves. The dates and amounts of the tenders reveal an unprecedented private takeover of the Sardinian healthcare sector. “Commercial” ads on Facebook and Instagram confess to a greedy rush to recruit doctors to be sent to hospitals on the island of Sardinia. Now, however, the curtain is being raised on the great business of "coin-operated" white coats in Sardinia. A map that increasingly appears to be a chessboard constructed on a drawing board, almost as if the competing companies have drawn boundaries and strategies, division of territories and prices to practice.
Very private affair
A jumble of documents, some hidden, others encrypted. Ares, the regional health agency, even introduces the X7z file, an IT extension reserved for experts and hackers, into the tender procedure for "coin-operating" doctors. The "doctors for rent" chapter in Sardinia is now a deal destined to break the bank in the Region's public accounts. The operation, which began to cover sporadic emergencies in some centers considered to be on the outskirts, is becoming more and more an entrenched system every day, taken for granted, destined to transform Sardinian hospitals into a truly private business.
The master key
The justification is always the emergency, the master key for transforming urgency into ordinary administration, transforming Sardinian emergency rooms into linguistic laboratories, very often entrusted to sign language. The nurse on duty, from Tempio to Sorgono, transformed into a medical interpreter, surreal dialogues for telemedicine consultations, with Sardinian doctors with their backs against the wall to interpret Cuban, Argentine, Ecuadorean, Venezuelan and more. The scenario that emerges is that of a large, almost planned business managed in Sardinia by a contract that turned out to be without any competition. For over a year and a half we continued with unpacked procedures for each individual local health authority, but with the same final result: Mst, tax residence in Vicenza, eastern Veneto, the company of the two anesthesiologists and the accountant.
Exclusive dominion
They are the ones who won the contract which is still undefined from the Ares official website, but which the Regional Health Agency has already awarded to the absolute dominus of the privatization of the emergency rooms of most of the hospitals on the island. A victory without competition, almost as if the other companies active on the market had abdicated to the Po Valley in Sardinia. It cannot be explained otherwise given that in other areas of the peninsula the competitors are multiple and competitive. Not in Sardinia. Only Mst Po Valley participates, with the only attempt at competition failing in the bud, with the company Moka srl excluded due to "substantial errors that cannot be remedied in any way".
The mystery
How we arrived at this sort of direct assignment, with a single competitor in the race, for an amount of almost ten million euros, is not easy to explain. Certainly, however, the Venetian company's big coup risked being ruined by the appearance on Sardinian soil of another leading contender in the "token holder" market. In fact, something certainly happened in the karst war for the private governance of emergency rooms. On 23 December 2022, the tender for the privatization of the emergency services of the island's hospitals was sent to the European Journal for publication. On January 2, 2023, the announcement is published. The deadline for offers is set for January 31st.
Doctors on Facebook
It's January 6th when the underground war to manage the Sardinian emergency rooms breaks out on social media. Facebook and Instagram, thanks to the algorithms of the two social platforms, reach without intermediaries all the Sardinian doctors and not only those registered in Mark Elliot Zuckerberg's main square. The "commercial" product, sponsored according to the canons of the two social networks, is a surreal announcement precisely because of its health relevance. The content we publish in the central photo is an unprecedented appeal: Gap Med, a Spa in the Po Valley, this time from Milan, is urgently looking for doctors for Sardinian hospitals.
Explicit message
Stuff you wouldn't believe: doctors wanted on Facebook and Instagram. The message is functional to the contract which has been in the public domain for a few hours: «Gap Med selects profiles of freelance emergency doctors for collaborations in hospital facilities in the Sardinia region. Contact us for any further information and apply by sending your CV." Strangely, nothing will be done about it, despite the fact that the Milanese spa could count, through a partner, on powerful ramifications in the Sardinian entrepreneurial system with well-identified corporate connections. The field for Veneto-Po Valley society is, therefore, free. Running alone for a major contract is a company that wins million-dollar tenders despite having a share capital of just three thousand euros, one thousand for each of the three partners.
Slot machines Sardinia
What speaks are the budgets of the Vicenza team, that of the two anesthetists and the accountant. Even before the ten million contract with the Sardinian Region, declared still in the definition phase, they mark a business curve worthy of a millionaire slot machine. The 2022 budget was made official on August 28th. They cannot be hidden: what they call health benefits reach the figure of four million and 700 thousand euros. And they explain the reason: «the sales trend was characterized by an increase in revenues of 3,636,163 euros compared to the previous financial year. The increase is mainly due to the tenders won by the company for the management of some emergency rooms in Veneto and Sardinia".
White coats for sale
What they call "sales" is nothing more than the rental of doctors "for a fee". Not bad for a company that in the first year of activity, 2019, could count on a turnover of 3,500 euros. The mechanism of "token operators", foreigners and others, is routine management in many Sardinian hospitals. What is being generated, however, is a perverse system, destined to increasingly bring Sardinian healthcare to its knees.
Risk of escape
To understand this, just read the communications that the contracting authority, Ares, published among the answers to the questions of potential participants in the tender to privatize the emergency rooms of Sardinian hospitals. Ares writes: «With reference to the tender documents published in the European Journal for the tender procedure in question, although considered obvious, it is specified that the staff who will be entrusted with the service by the Economic Operator will not be able to:1 ) Be a fixed-term or permanent employee of one of the Public Health Authorities of Sardinia, even if on leave for any reason; 2) Have an existing contractual relationship with one of the Health Authorities of Sardinia". Just having had to explain it is the most obvious symptom of the very serious fracture that is taking place in the world of Sardinian healthcare.
Doctors ready to say goodbye
The risk, in fact, is that public doctors choose to place themselves on the "coin collector" market, resigning from hospitals, to earn as much as their current monthly salary with just a few days of work. There are quite a few Sardinian doctors who have already made this choice, but there are many who are thinking about it. Just one figure is enough: in Italy, according to a survey proposed to the Cimo-Fesmed doctors' union, four out of ten doctors are ready to leave their permanent position in the hospital to work as "coin dealers". For Sardinian public health, the risk of default is around the corner.
