PALERMO (ITALPRESS) – “As representatives of the private law component of the national and regional health service, we can only applaud the suspension of the competition discipline in health care, aimed at its comprehensive revision. An opportune and unpostponable intervention on which, however, we have read everything but the truth. “Barbara Cittadini, president of AIOP Sicilia, thus comments on the approval of the Annual Law for the Market and Competition 2023, which took place in double reading in the Senate on Thursday, December 12. Specifically, Article 36, suspends the effectiveness of provisions on accreditation and entering into contractual agreements with the NHS until the outcomes of the Working Table for the development and implementation of the national accreditation system and, in any case, no later than December 31, 2026. The Law, following its publication in the Official Gazette, has just entered into force._”When the narrative, from Sicily to the entire country, revolves around concepts such as “oligopoly” and equates this, indispensable, measure to those related to beach concessions or local transportation, it culpably overlooks the nature, regulatory structure and characteristics peculiar to our SSRs, which have a highly regulated nature and are not structured according to market criteria but to public service criteria of provision of services at the expense of the State.The consequence is that, with Law 118/2022, contrary to and insanely contrary to the provisions of the European directive, which in Art. 2.2 lett. f) of the Bolkestein Directive that excludes health services from its scope of application, it is the right to health of all and everyone that is being put out to tender.Despite this, in itself sufficient to understand why this sector has been excluded at the European level, it must be made clear that as entrepreneurs we cannot, ontologically, be against the concept of competition. We are,” the AIOP Sicilia president points out, “against undefined and manifestly illogical rules and criteria. Criteria, in this case, potentially dangerous in terms of the quality of services and care that we are able to provide to the population, to whom we will no longer even be able to ensure continuity of care.When competition implies, for example, a race to the bottom with tariff discounts, it translates, inevitably, into a reduction in the quality of care guaranteed to users._ Especially if one reads all this in the perspective of a system in which providers are remunerated on the basis of dated and anachronistic rates and are subject to spending caps that, this year, for the first time in more than twelve years, have been slightly revised._Which is completely incongruous and unsuitable–the uncertainty of the periodicity of the awards–to ensure the continuity of care services to patients and the proper assessment of business risk that requires careful reflection, not only on the value of the investments made (whether technological or employment), but also, on the time required for their amortization which, surely, cannot coincide with short-term planning.When I speak of the risk to continuity of care, I am also referring to the possibility that the right to free choice of place of care by patients who, from one day to the next, could be forced to move from their chosen place of care, diverted – not of their own will – to other facilities.From these few considerations, the effect that if not corrected risks being markedly distorting of the new competition discipline in health care, which intervenes in what cannot even be called a free market, clearly emerges.This is the reason why it is necessary to make a clear distinction between the two.This is the reason why it is necessary to pay the utmost attention at the national and regional levels.We, as Sicilian facilities directly targeted by these interventions, are, as always, willing to collaborate with the Department, which had already set up a working group on the issue, so that the sustainability of all facilities, which operate substantial technological investments in order to ensure the highest standards of effectiveness of care, thus safeguarding the resilience, also qualitative, of our SSR, can be safeguarded. The comprehensive review and identification of the principles of reform of the entire legislation is essential not only for the sustainability of our companies but for the protection of the population’s right to health,” concludes Barbara Cittadini.-photo press office AIOP Sicilia -(ITALPRESS).
