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Waiting Lists in Healthcare: What Happened to the Promises to Reduce Waiting Times? Four Months of Silence and Disillusionment

The plan to reduce waiting times in healthcare, announced in August, appears to have run aground. Many implementing decrees have expired without results, and key tools such as the monitoring platform and the “skip the queue” mechanism are stalled, while waiting lists continue to grow

Waiting Lists in Healthcare: What Happened to the Promises to Reduce Waiting Times? Four Months of Silence and Disillusionment

What happened to the promises of cut waiting times of Health? It's been four months since anyone heard anything about it and the emergency continues to affect millions of Italians who are forced to postpone treatment or, even worse, to give it up altogether. While the Government is struggling to deal with the attacks on doctors and nurses with a recently approved decree-law, another emergency, older and perhaps more insidious, remains unresolved: the waiting lists. Ecosystem's staff is plan to take them down, presented with great fanfare on August 1st by the Minister of Health Horace Schillaci, seems to have run aground: all the implementing decrees are missing promised. According to the hospital doctors' union Anaao, out of 11 planned implementing decrees, 6 have already expired without any results, one expires soon and 4 do not even have a precise expiration date.

The great mystery of the national platform

One of the pillars of the plan was the national platform to monitor waiting times in real time. It was supposed to be ready by the end of August, but the guidelines for its operation were approved only recently and are still under technical examination by the Conference of the Regions. According to the Ministry of Health, the platform will not be operational prima di January, if not February 2025. Until then, it will be impossible to verify which Regions respect the promised times, making other measures to reduce waiting times ineffective.

Even the decree on substitute powers remains a mirage

Another crucial decree is the one on substitute powers of the state, which would allow intervention in Regions that do not respect the rules. Initially, this measure would have given the Ministry of Health broad inspection and sanctioning powers, even the possibility of triggering arrests in the most serious cases. But protests by governors led to a compromise, leaving the State with the simple role of taking over without real punitive tools. Without these powers, however, the entire plan risks falling apart, since the Regions remain their own controllers. The decree should have been approved by July 7, but there is still no sign of a text.

The same applies to the decree on the “Population Classification and Stratification”, a fundamental tool for planning care based on citizens’ needs. This too has expired for over two months.

Waiting Lists, More Missed Deadlines and New Delays

Among the missed deadlines there is also the creation ofCentral unit for the management of healthcare and waiting lists (expected by September 30th). To identify the Regional sole representative for health care (Ruas), there is time until October 30, but the deadline of August 31 for the nomination of the Ruas was not respected. Even the regional operational plans for the recovery of waiting lists, which were supposed to be ready by the end of September, are still in the preparation phase. In particular, the deadline for the definition of the action plan that was supposed to strengthen the service delivery capacity in the most disadvantaged regions, part of the National Health Equity Programme 2021-2027. Finally, measures such as theincrease in spending for the staff, the definition of the staffing needs and the approval of the three-year requirement plans for the regional health service they don't even have a set expiry date.

The “skip the queue” remains on standby

Another big unknown concerns the “skip queues”, a mechanism that would allow citizens to access private or intramoenia services if the waits were too long. However, the protocol between Health, Mef and Regions to decide how to use approximately 500 million euros of unspent resources is still missing. Some Regions have already given instructions to the CUPs, but others are completely at a standstill. John Better, president of Fiaso, reiterates that "this is an additional tool for companies", but warns: "Intervening on the appropriateness of requests is fundamental. Increasing performance is not synonymous with guaranteeing health".

An extraordinary commissioner for the Regions?

As anticipated, by September 30, the Regions should have set up a Central Unit for the management of healthcare and waiting lists, but so far only a few have taken the initiative. Tonino Aceti, president of Salutequità, expresses his frustration: “The delays in adopting the implementing measures of the law on waiting lists are unacceptable and unsustainable for citizens who every day have to deal with interminable waits for treatment”. If the situation does not change, “it may be necessary to think about a Special Commissioner for the emergency waiting lists, because delays cannot be tolerated when it comes to the right to health”.

I delays andlack of concrete measures They aggravate a problem that continues to affect millions of citizens, leaving the emergency of waiting lists without a solution and undermining the right to health.

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