Nothing good on the horizon for Italian doctors

by Filippo Maria Larussa


16 NOV

Dear Director,
beyond the initial, generic and obvious acknowledgments of appreciation and gratitude, the first signals that the new Government sends towards Doctors and Healthcare Managers of the NHS appear increasingly disappointing, and a source of dismay and concern among operators.

Some statements on the “behavior” (actually clinical-diagnostic activity) of the doctors in charge of inspecting the NGO ships and their “loads” of human despair, first defined by the Premier as “bizarre”, then by sen. Malan “subject to possible regulatory intervention” due to intrinsic logical inconsistency. At this rate, rather than the liberalization of access to the medical profession, one gives the impression of aiming at ex ante control of its practice!

On the other hand, the first public releases of the new Minister of Health, our medical colleague, arouse concern. Without going into the merits, the first provision, the reinstatement of no-vax sanitary ware, denoted the impression of a lack of “familiarity”, at least communicative, of prof. Schillaci with the complicated gears of the Healthcare Universe.

Claiming that the readmission to service was necessary due to the shortage of operators (employees less than 500 out of 4,000) and that the post-suitability relocation is in the hands of the Medical Directorates, and not, as is the norm, the Competent Doctors, did not arouse enthusiasm . But even if you want to reduce them to misunderstandings, hesitations, smudges from an institutional debut, it is on the economic, fiscal and social security front that the horizon appears nebulous, indeed gloomy.

On the economic front, the forecast of a drastic definancing of the NHS at a pre-Covid level already certified by the Nadef for 2025, is expected to be anticipated by 1, if not 2 years, based on the credible forecasts of primary Rating Agencies, on the estimated decline by 1.4% of GDP in 2023.

There would be little “material” other than the late renewal of the 2019-2021 CCNL, for further recognition, with an inflationary delta that erodes the purchasing power of wages by at least 15/20 points in the three-year period 2022-2024, and whose recovery appears today chimerical.

Even less clear and sufficient refreshment is the not better defined economic recognition for specialist training, or perhaps even for work activity in PS disciplines with limited possibility of free profession (but a specific contractual equalization fund is not already operating on the volume of corporate ALPS?).

On the fiscal front, a sort of legislative squint (or persistence?) emerges. On the one hand, the support measures (200 and 150 euro bonuses, reduced bills, etc.) are reserved for the socially disadvantaged, quantified in a range between 20,000 and 30,000 euro of verified or declared income, according to an unresolved Italian hypocrisy .

On the other hand, the raising of the cash ceiling and the flat tax, incremental or not, up to 85/100,000 euros per year only for the self-employed and for VAT numbers, effectively wink at the wealthier classes, and at those who can evade/evade, in spite ” to the convicts of 730″. Who in the PA could better be defined as “the outcasts of 730”, given that, unlike private employees, they are stubbornly denied tax-free fringe benefits of up to 3,000 euros, performance bonuses with a reduced rate of 10%, always up to 3,000 euros : those measures that President Meloni baptized the 13th supplementary, but it has the connotations of a mirage for the “heroes”!

To whom dulcis in fundo, the opportunity to remain in service is expected in these hours, once the pension requirements have been met, increasing the paycheck of the social security costs at their expense (8.85%), but without counting at the pension and TFS level / TFR years without contributions: a real deal, of course, only for the State Employer, however!

If the good day starts in the morning, the moonlight turns to striking and unprecedented protest actions.

The heroes feel downgraded to children of a lesser God and their impatience cannot be passed off as hostile ideological/political prejudice, or an instrumental disorder of the maneuverer.

Philip Maria Larussa

Anaao Assomed National Executive Member

November 16, 2022
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Nothing good on the horizon for Italian doctors

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