Interview to Dr. Stefano Biasioli,   new chairman of the Confederation

Biasioli:  It's a charge that continues my previous activity at the Cimo. Since many years I'm the treasurer of the Confederation and since17 years I'm the secretary of the Veneto region, second in size order, national level.  
Surely being the chairman is not easy, one must perform functions of co-ordination, mediation, and establish a kind of relationship with institutions and other syndicates. 

GFC:  Maybe the most difficult task is that of facing a certain demagogy by  Minister Bindi. 

B: In fact the minister has a good hand at any meeting she attends by inviting everybody to side with her, since she safeguards citizens, the public health, well then she safeguards everybody, even the government she belongs to.  
But saying a thing is a matter, doing it another.  
Since the reformation law 229 provides that minimum assistance levels are defined year by year in the financial law and basing on the available funds, citizens' health defence is not provided for once and for all, but it's always brought forward.  
So citizen are, as I believe, destined to pay ever more for health, especially the outpatient services. 

G.F.C.: So what must be done?  

B: It must be reduced the health expenditure, I agree, and supply at the same time complete assistance only to whom is affected by diseases strongly disabling that involve expenditures impossible to bear by anybody.  
In addition it must be fostered the adoption of the supplementary assurance.  
Rationing financing for health is a measure going against the single regional realities.  
We think that the situation requires a light central State, that must point out the general lines, while regions must draw from their GDP, getting from State only a solidarity quota.  
That would allow, among others, citizens to better control the way this money is spent. 

G.F.C.: Whereas it has been also inequality in behaviour...  

B: That's right. I know from experience that in front of situations alike there have been different behaviours.  
And that creates uncertainty among physicians, nursing personnel and patients. 

GFC: Which ways  can be attempted to create once again a climate of confidence?   

B: First it must be put the physician at the centre of the system. Within a health organisation, so remarkably modified, territory must be put more in contact with the health structure. 

GFC: Second? 

B: Stop to the ministerial conducting and start off a serious-minded negotiation about regional federalism. We ask a regional negotiating table giving binding rules about certain points and indications about others, a table that could later check the work done and its congruousness as respect to the starting planning out.  
Finally a slogan: “unique pension “, only one retirement plan institute for all physicians. 

GFC: What do you think about the unification of ministries early decreed by government? 

B: This is one of the few matters I agree with Minister Bindi: merging the health ministry with the welfare one will worsen the public health situation. That for the assistance expenditure will have always priority over the health one. 

GFC: How do you see the function of hospitals after the last reform? 

B: First of all it must be understood if there's the mind to transform them into structures for only acute patients: if it is really this way, I wonder if there are the conditions to start this transformation. Second, since the reform 229 involves a heavy reorganisation of the whole National Health Service, it's necessary to invest.  
On the contrary, there are not resources for new investments and they lack for the standing activities as well. 

GFC: Which way the CIMO intends to act in front of the perseverance of Minister Bindi in getting ahead with her project? 

B: What we ask the minister is the respect for our positions. If it will be this way we will respect the minister's action. Nevertheless the reform has almost passed and next implementation decrees, on our opinion, could in fact worsen the situation. 

GFC: On the other side the weapon of strikes ends rebounding on you since citizens tend to condemn it. 

B: Just so. Strike in health is surely few popular. Nevertheless the history of physicians in Italy is a history of strikes, of which it must be made a sparing use, taking into account also the economic damage for physicians.  
There are other measures that are successful against politicians as for example involving citizens in matters as the respect of the law 626 a bout safety in hospitals, that if it were brought up seriously it could really put the system in a difficult position.  
Its a Cimo's duty informing citizens correctly not so much about the nowadays health as about the one they will deal with tomorrow.  
Since the access to mass media is not easy for us, besides being very expensive, we would like to turn all the physicians rooms into an information mean. 

GFC: I thank you for your willingness and I wish you a good work for your new charge.  

It's evident that when it is attempted to make things clear about health expenditures, it rises a wall of “omertà”.  
Often remarkable funds are drawn from the health balance on the credit side, in order to make up a deficit in other sectors. That's why our suggestion for the CIMO is divided into two points.  
First the recovery of the professional ethics and the respect for patients within the medical class, especially hospital physicians, and restoring meritocracy.  
Second, it must be pretended even from the general managers, to make patients become the central point of the hospital activity.  
If ethics and professionalism would be applied steadily the economic problems would be certainly overcome.