2023-12-13 19:29:43
“We are delighted that new services have been included in the Essential Levels of Assistance (Lea), but this cannot make the activity of diagnostic laboratories unsustainable. We ask for a meeting point with the Ministry of Health to review the list of outsized services, with costs that exceed reimbursements. The Lazio Regional Administrative Court rejected the request to suspend the provision. Around two thousand structures are ready to appeal to the Council of State”. This was assured by Luca Marino, vice-president of the Unindustria health section, illustrating to time.news the activities that the private and accredited structures that provide tests and services on behalf of the National Health Service are carrying out to avoid the entry into force of the new Tariff Nomenclature, scheduled for 1 January 2024 and guarantee not only the “sustainability of the system, but also the health of the citizen”.
The main category acronyms, which have formed a common front in the Union of outpatient clinics and polyclinics (Uap), after a meeting at the Ministry of Health, have “sent a letter to the government and the regional bodies” asking “to reinstate the review table of the tariffs” because the parameters taken into consideration are not appropriate. “We ask – continues Marino – that the application of the new tariffs be suspended in order to review at least the most anomalous ones – such as pap tests and outpatient visits – to arrive at more sustainable values”. thousands of new services, in genetics and prosthetics, but also in laboratory medicine and diagnostics – explains the Unindustria health section representative – This has led to cuts which have mainly affected the analysis laboratories for 20-70%”.
For example, “the determination of a thyroid hormone has dropped from 6.40 euros to 2.65 – explains Marino – The pap test, an oncological prevention, which requires a slide reading by anatomopathologists, has gone from 11.16 euros at 5.55: practically 50% less”. Just consider that “only the reading of the test by the professional costs 6 euros” to understand how the value is off. “It is true – he observes – that there are mechanized methods that have reduced costs, but a reading under the microscope, as in the case of the pap test, requires expertise and time: there is no mechanization as for other analyses. Our work is not industrially produced: we have laboratory reports that require a customer care service, professionals who have to evaluate the report and administrative costs. A fee cannot be determined by considering the cost of producing the exam alone. The accredited private laboratories that the government has chosen to have within the NHS – reiterates Marino – provide a public service. We accepted the tariffs, but these substantial changes have too much impact and make the relationship between the NHS and the private provider unsustainable.”
All this also has repercussions for the citizen. “With these tariffs – highlights the representative of Unindustria Sanità – we risk the exit of the affiliated providers from the system with consequent even longer waiting lists due to the reduced availability of healthcare services in the area. But there is also another consequence: the lowering of performance levels. A specialist visit is paid 22 euros. The professional is therefore asked to make an examination for 15 euros.” There is therefore “less service, increase in waiting lists and lower quality of services”.
Beyond the contingent problem linked to tariffs, “there is, however, a broader, systemic problem – explains Marino – We would like there to be a discussion in which the role of these structures was adequately recognised. We are more than 8,000 diagnostic laboratories on Italian territory and we participate in the provision of health services to citizens. The virtuous public-private collaboration offers a unique service for citizens’ requests. By applying these new tariffs, the asset for the sustainability of the system itself will be altered. We cost little: we provide 30% of local diagnostic services with 8% of NHS spending. If we lose this value, the impact is on the health of the citizen who will not be able to access visits and tests efficiently and at low cost, or even free of charge. Without this service – he adds – the waiting lists for hospitals and local health clinics will become longer and the quality of service to citizens will be reduced”.
The new price list issued by the ministry has negative consequences not only for analysis laboratories, but also for “the multinationals of mega laboratories with millions of tests per year”, given that not everything can be mechanized, but, paradoxically, it also impacts on same public structures, because “providing services at costs higher than reimbursements”, and the “debt that must be repaid” is increased. The invitation is then to think “about a broader discussion, about the role and usefulness of these structures, seeking – concludes Marino – a meeting point to avoid the collapse of the network of private laboratories that support the Health Service”.
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