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December 20 – “The new Health Pact for the first time in a decade, part of a policy framework that does not require linear cuts to the health sector. That’s why the Covenant will be a tool of madder for a rational use of healthcare resources and the elimination of waste in the system. The theme of the reorganization of the hospital network and the review of recovery plans will form the nodal points through which you will be able to rethink redevelopment of the NHS to have a homogeneity of provision of service levels throughout the country. ” This is the New Covenant according to the Minister for Health Beatrice Lorenzin which illustrated this morning for a hearing to the members of the Social Affairs Committee of the Chamber.
Lorenzin explained the work done in recent months and reported that since it took office “were put in place the conditions for a major reform of the national health system that can be implemented in the Pact for Health.”
The assumptions are two essential. “The first – reported Lorenzin – is to restore confidence and stability to the national health fund, and this was also the case with the law of stability in which there were no linear cuts, even for the first time the fund has stabilized.” And this according to the minister, “gives certainty to a new phase of programming.” The second element “not secondary, are standard costs.” And here Lorenzin recalled yesterday as the regions have approved the allotment. “With standard costs have a new method of division of the fund.”
After having referred to the regulatory environment within which you place the new Pact for Health Lorenzin reported that “the the fact that in recent years has not been realized has meant that there has been no planning, programming homogeneous and shared on the national territory. ” So today the situation has changed, “we have a great chance that the Italian State can not afford to lose because it will give us the certainty of a program that provides security for the sustainability of the NHS, and it gives answers to Lea also gives a long-term perspective to work on the challenges we face. “
These are three challenges for the minister,” the longevity of the population, and the personalization of medicine, with more and more health care that will dwarf the current costs and finally the cross-border care, already existing, in which competition is not only between regions but also between states. “
significant issues of the new Pact for Health
“First of all – reported Lorenzin – the determination of needs and standard costs of the NHS. Among the most important topics of the Covenant deserves to be mentioned requirements planning standards and requirements of the NHS regional standards in the context of compliance with Community obligations of the objectives of public finance. So preliminary issues are the definition of the economic and financial programming framework of reference, the determination of the measures of shared pharmaceutical care and other services provided by the NHS, the update of Lea (this priority to ensure proper performance in our territories , the update will also result in savings will be removed as no longer current performance). “
Another point in the center of the Covenant is the reform of hospital . “With the regions we are setting the standard of quality and technological structural quantities for hospital care in relation to the reduction in the number of beds. The initiative provides for adequate regeneration processes of hospital care and the initiation of synergistic actions between hospital and territory. The measure is part of the maneuvers that the Regions should implement a retraining of the network and to restructure the health care costs. ” On this clarified Lorenzin “We’re not a year zero, but it is necessary for this to happen in a uniform manner throughout the territory and not patchy.”
Next to this there is the “territory, theme important because you can not imagine without a reform of the territories. We rely on a series of initiatives to be implemented to ensure the continuity of hospital care in the patient’s home. “
Regions in repayment plans. ” There is no doubt that this issue should be subjected to a thorough review bearing in mind that the plans are plans of reorganization and upgrading of the SSR not only to re-finance. The Pact will therefore opportunity of revisiting the regulatory framework. The experience of the last four years, focuses attention on the need for action alongside the technical ministries of accompaniment in the regional choices. You need to review the system of guidance to focus attention on improving the quality of the SSR to ensure the control and efficiency of health spending. On the one hand should be raised the level of institutional occurs particularly in regions commissioner in view of the fact that the ad acta commissioners are extraordinary bodies appointed by the government. On the other resources must be addressed in terms of accompaniment and training in the field of health protection and guarantee of Lea as well as aspects of lack of Governence of the regional administrative structure. “
In essence, the problem of the current legislation is that those who enter into repayment plans do not go out anymore. “It’s like an irreversible process. What we imagine to put it in a simplified way is a kind of Sos company you arrive, you put the efficiency of the system, and you go. Obviously keeping spending under control and efficiency. Of this we are discussing with the MEF also to give greater focus to the Ministry of Health. ”
interregional cross-border mobility This is a complex dynamic, recognized Lorenzin, “since the European directive applies a concept of Europe of the peoples and not just the economy in which the welfare systems open up and give the opportunity to citizens to choose and be able to move. This must calibrate with a homogeneity of services and cost of services. “
Last point on which the new Covenant Health is the healthcare construction. “ The planning policies of public investment in the equity structure and technology of the NHS have been following the progress of regeneration policies in the provision of care. Offer is characterized by an increasing focus true effective and efficient allocation of investments for the purpose of containment of public health expenditure. The objectives identified by the legislature for the building renovation and modernization of the technological assets public health and the construction of nursing homes for the elderly and dependent persons were integrated over time for specific purposes. These include the adjustment of the safety standards of buildings and facilities as well as the rebalancing hospital-territory “.
In recent years, recalled Lorenzin Parliament has allocated to the financial years 2007, 2008 and 2010, investments about 7 billion euro that were shared between regions with different purposes. “I asked the Minister of Territorial Cohesion, Carlo Trigilia to allocate the 2014 portion of the funds at its disposal even in health infrastructure that are infrastructure assets in the system.”
At this point it will be ready when the new Health Pact “The times are very short – concluded Lorenzin – was already done all the work of marking the ten technical tables, so I guess we could have a meeting to get to a document synthesis in mid-January, and begin to discuss it. “
The debate
debate with parliamentarians, however, was a quota for the simultaneous calls for Members of the vote on the law stability. And there was time for only a few banter. So much so that Lorenzin has committed to return to the Commission for a wider confrontation on the many issues raised by the Covenant.
Among the few answers given in particular on the reorganization of the hospital and the hospital pharmaceutical expenditure .
“We must find a balance between the ideology of the bed and the need to give a performance – the minister said – taking into account a Territorial compliance such as ours, and that has rural realities mountain, so simple.’s theme is not the hospital’s performance evaluation, because if a department does not have a minimum performance required to meet the standard that apportionment becomes dangerous. “
As Pharmaceutical grade “there is no intention to stay within the spending limits, and we must understand why the hospital pharmaceutical expenditure is not in the parameters. will need to make some corrections in order to understand what does not work. Why in front of a work of containment very strong, 9 billion, we can not kill an industry that provides employment. then try to hold together the two things that expenditure restraint and attention to companies that employ, with intelligence. “
Watch the video of the hearing.
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