Former mayor of Casale Monferrato, former vice president of the Province of Alessandria and with a long experience in the “res publica”, Federico Riboldi is the new councilor with responsibilities for Health, Essential levels of assistance, Prevention and health safety and Health construction of the Council led by president Alberto Cirio.
Interview with the health commissioner
Councilor Riboldi, you have a long history as a local administrator. What is your idea of Territorial Health for Piedmont?
«The experience as a local administrator was fundamental to understand and know the needs of a territory and how important the careful and targeted use of resources is, both human and economic – financial.
For this reason I am absolutely aware and convinced of the importance of local healthcare and this is why we will try to give an extra boost to services, so that citizens, especially the weakest, do not have to be left behind or, even worse, excluded”.
Despite absorbing 80% of the regional budget, Healthcare is the one that suffers the most from the effects of the cuts. How can we reverse the trend?
“When I was mayor of Casale Monferrato, the careful use of resources allowed me, with the same budget, to carry out more projects than the previous administration; therefore I am convinced that with the “first citizen model” excellent results can be achieved also in healthcare. The high-quality professional figures are there, so I am absolutely confident”.
In recent weeks, funds have been allocated to reduce waiting lists by increasing visits and tests at affiliated facilities. How do you see the public-private relationship? An opportunity or the surrender of the National Health Service?
«First of all, I would like to reiterate once again that the solution to the problem of waiting lists is a priority of my mandate: for this reason, thanks also to the intervention of the Government with an ad hoc provision, we have asked the General Directors to work with maximum commitment to find a solution to share at the beginning of September.
As for the relationship between public and private, I would not speak of a surrender of the National Health Service: the two sectors must guarantee integrated healthcare, one must never prevail over the other, but work together always having as their primary objective the health and well-being of citizens”.
The Chivasso case
In recent weeks there has been much talk about the crisis at Chivasso hospital and ASL To4 in general, from the lack of a 24-hour haemodynamics unit to the lack of doctors on duty on 118 ambulances, even though in this case Azienda Zero has taken action by guaranteeing almost all shifts until the end of the month. Don’t you think that the logistics and offerings of what remains one of the largest ASL in Piedmont could be reviewed?
«I am sorry to repeat concepts that have been expressed at various levels for years now, but we cannot even pretend that there is not a clear shortage of medical personnel, and more generally health personnel, at regional and national level.
Having made this necessary premise, on the specific case I would like to point out that the Chivasso Hemodynamics service has always had a 24-hour organization since it existed (which the ASL guarantees in Ciriè and Ivrea) and to bring it to that number of hours, the medical equipment should be increased. However, let me say that Chivasso is still a good service that provided over 700 coronary angiography and 378 angioplasty in 2023.
As for 118, we will have a specific meeting at the beginning of September and, after the discussion and sharing that will take place, we will certainly be able to give concrete answers.
To conclude, I am convinced that the provision of health services in the ASL TO4 can and must be improved, as in all other Piedmontese companies: since the beginning of my mandate I have already met several times with the General Directors and, for the first time, also with the Directors of the regional hospital facilities, asking them all for a concrete and lasting commitment to put citizens at the center, especially the weakest ones”.
With the construction of the future hospital in Ivrea, will the services provided by Chivasso, which has already seen its urology department shrink and risks seeing its ophthalmology department close at the end of the year, be further reduced?
«I believe that there is no correlation between the two things: we will give the citizens of Ivrea a new, more functional and cutting-edge hospital, all within ten years or so when, I sincerely hope, the availability of health personnel will no longer be a problem and we will be able to guarantee, as we are already trying to do now, equal care for all citizens.
However, returning to the present day, I would like to reassure you about ophthalmology since, just in the past few months, thanks to an internal reorganization, the company has managed to strengthen the structure with an additional professional to the only resource that was present since its establishment. An intervention that has already led to the doubling of the activity. Added to this are the technological investments made to increase the surgical – ophthalmology activity, including cataract surgery sessions.
As for urology, however, like other facilities, it has significant difficulties in finding specialist staff, despite numerous selections, and continues to provide its service partially reorganized in the summer period as it has historically happened. Among other things, the latest investments in technology (laser, instruments for calculosis, etc.) are underway to ensure uniformity of care and make the facilities attractive for professionals as well”.
And again on Chivasso, why despite having a catchment area equal to half of the entire ASL, does it not manage to have the dignity of a large hospital?
«The Chivasso district (which also includes municipalities in other provinces such as Crescentino, in the province of Vercelli) represents approximately 20% of the population of the ASL TO4 and the hospital has been at the center of some improvement interventions to guarantee precisely the dignity mentioned. In the last three years, for example, the number of beds has been expanded based on actual availability, in particular 10 OBI (Intensive Short Observation) beds have been added in the Emergency Room and 3 Semi-Intensive Therapy beds in Medicine and with the activation of the new intensive care beds it is possible to hypothesize to allocate the old ones to an additional eight beds. In addition to this, the entire diagnostic imaging part has been completely updated (magnetic resonance imaging, traditional radiodiagnostics, ultrasound, mammography, etc.) and new heads of strategic specialties have been appointed in Chivasso, who are expanding the offer also for complex pathologies (General Surgery, Gynaecology, Gastroenterology, Anaesthesia and Resuscitation) and others will be appointed within the year (Paediatrics, ENT).
Furthermore, the Director of the Emergency Department is now completely dedicated to Chivasso, given the new appointments of the equivalents in Ivrea and Ciriè, thus allowing for an increase in the number of doctors employed in all the ASL Emergency Departments. Finally, through funding from the Development and Cohesion Fund, it will also be possible to complete the renovation of the “monumental” part of the hospital.
As I repeat and reiterate, we do not hide the evident critical issues of the entire sector, but I am confident that all together we can reverse the trend”.
118. According to the law, there should be one medicalized ambulance for every 60 thousand inhabitants, while the one based at the Red Cross of Chivasso covers double the inhabitants on first exit. Do you think you can find solutions? Could the medical car card be played?
«As previously mentioned, some meetings are scheduled for early September, together with the General Manager of Azienda Zero, with some representatives of the territory to also address these aspects, which are fundamental to guarantee the population essential services that, however, could certainly be structured differently, also through medical cars».
Speaking of the future, what is your position on Health Houses and Community Hospitals, given that from many quarters, due to the lack of staff, they are seen as potential empty boxes or structures to be handed over to private individuals?
«It is precisely because of the lack of personnel that the Health Houses and Community Hospitals can be an opportunity to rationalize resources and guarantee more efficient and less dispersive territorial services. Furthermore, as regards the Community Hospitals, 20 additional beds will be available for each of them.
As for the private sector, as previously explained, I have no preclusions, the important thing is that there is a real and effective integration with the patient at the centre”.