The
reorganisation of the health care system was included in a Bill that is
currently being discussed at the Parliament's Commission of Social Affairs,
and will have to be turned into a law within June 30, 1998.
There also is a distortion
of the concept of legislative power on the part of the Parliament as the
Government Bill's text includes no less than 17 delegations for the Minister
of Health who will be empowered to issue a series of delegated laws that
will completely change the current health regulations. These delegated
laws will not have to go back to Parliament to be approved. The Bill, in
fact, lays down a series of delegations at article 2 that could be summed
up as follows:
1) Reconsideration of the
role of municipalities, with the addition of another body of the Local
Health Care Unit and of the Region to organise and manage Health Care;
2) integration of health
services with social and welfare ones, with the risk of confusing roles;
3) greater power for the
private law in the employment of managers, with the possibility of fixed-term
contracts, mingling different work schemes within the same facilities;
4) homogeneity in treating
general, administrative and health managers;
5) guidelines for health
care staff training directly devised by the Ministry of Health;
6) connecting research in
the health field with research in the biomedical one;
7) reconsideration of the
levels of assistance to be performed by the National Health Fund;
8) integration of general
medicine and paediatrics in the regional organisation subordinating the
physicians' per capita share to cure their patients to the levels of spending
fixed for the region with a strange mixture between expenditure for the
sick and expenditure for the Region's organisation;
9) mixing levels of competence
in the integrative forms of medical assistance among the various bodies;
10) revision of the procedure
as for issuing the authorisations to set up health care facilities;
11) assessing and promoting
the quality of assistance;
12) obligation to credit
the facilities having an agreement with national and regional health programmes;
13) redefining the principles
for locating Local Health Care Units and hospitals according to the territory
and to the costs-benefits ratio;
14) redefining the financing
to Local Health Care Units and hospitals;
15) control of the Ministry
of the Local Health Care Units and hospitals' activities through the Agency
for regional health services;
16) determining procedures
and guarantees to perform the controls of the Ministry of Local Health
Care Units and hospitals through the Agency for regional health services;
17) determining procedures
and terms to lower the pensionable age for managers working in the medical
field and suspension of the welfare activity on the part of universities'
personnel
as well as: the “suspension
of conventional relations” in the field of general medicine.
So, the Ministry of Health
can legislate in the health care field without accounting to no one.
Poor Parliament of the Republic,
dominated by a government that refuses all criticism towards its work!
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Italian
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Mensile di scienza medica e attualita`
