From Usca to Uca, why is territorial medicine collapsing?

Coordination of medical personnel Usca toscane


04 JUL

Dear Director,
the Tuscany Region saves on health, but it is the citizens who pay for it. In these days what we have been denouncing for days is happening: the Usca offices are remaining uncovered in many areas of the Region. What caused this situation?

The Tuscany Region has proposed to the doctors who have so far worked in the Usca, a new assignment (in the new Uca) increasing, however, the tasks and reducing, at the same time, both the staff and the salary (by almost half), making it fact inferior to that of the Continuity of Assistance (the so-called medical guard). The proposed framework, however, is precisely that of daytime Care Continuity, with a contract that does not include exposure to biological risk from Sars-Cov2, global care of and patients, daily telephone monitoring of the people taken in care, instrumental diagnostics with ultrasound and blood gas analyzer. All tasks required, however, of the doctors of the new Uca.

Furthermore, this decision was taken unilaterally by the regional government and by the Usl, without the involvement of those who, for years, worked in the Usca, often making up for the systemic deficiencies of territorial medicine and of the whole NHS.

Faced with these working conditions and the unworthy attitude of the Region and the Local Health Authorities, most of the colleagues refused the new post.

The Tuscany Region is thus giving up thousands of months of professional experience accumulated in the field, a service that worked and the possibility of truly protecting the health of the population. All this for a supposed economic saving that will probably never happen.

We believe, in fact, that in a moment of resurgence of infections, deciding to save on the main territorial service for the management of positive cases is a sign of lack of foresight and of little attention to the needs of the population. Primary Care will hardly be able to make up for the lack of service in the Usca where we have worked so far, not due to lack of will or lesser skills, but due to lack of time to devote to this further task. All this will predictably translate into an increase in access to the emergency room and, consequently, hospitalizations.

An example of this is what happened in the North West Usl where an exemplary system of Intermediate Care facilities was dismantled, a national unicum including sub-intensive therapy services, palliative care and hospice. A completely discovered service that has led to the transfer of patients to Ps.

All this could have been avoided if, as has been done in other regions, for example, in Emilia-Romagna, the service in place had been confirmed with the same personnel, equipment, offices, duties and remuneration. For our part, as always reiterated also to the Usl and the Region, there is the availability at any time to resume the service, as long as our professionalism is recognized, those who have worked in the Usca in recent years are involved in the decisions concerning our work and the health of patients.

Coordination of the medical staff of the Tuscan Usca

04 July 2022
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From Usca to Uca, why is territorial medicine collapsing?

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