The warning of Crea Sanit: National health service on the verge of collapse if human resources (doctors and nurses) and economic resources (50 billion in 5 years) are not invested
More and more compatriots they give up treatment; there is a sort of parallel pandemic among the very old that they are progressively losing their autonomy; it is hard to recover the lost performance during the health emergency, with possible future damage to people’s health. To cope with staff shortage about 15,000 doctors and 30-40,000 nurses should be hired every year over the next 10 years; and, to align our National Health Service (NHS) with those of European countries 50 billion should be invested, 10 billion a year over 5 years. It focuses on the legacies of the pandemic and the future of public health, also in light of the PNRR-National Recovery and Resilience Plan and the ongoing shortage of current resources, on 18 Sanit Report Without reforms and growth, NHS on the brink of crisiscreated by Crea Sanit – Center for applied economic research in Sanit, with the collaboration of over 30 researchers and experts, and curated by Federico Spandonaro, Daniela D’Angela, Barbara Polistena.
At the infirmary not just a “cost” but a investment – underlines Barbara Polistena, scientific director of Crea Sanit – Tor Vergata University of Rome -. If you want to guarantee a universal healthcare service, it is necessary bet
to the growth of the country’s gross domestic product (GDP).; also because not aligning health spending levels with other European countries means both losing human resources, with doctors and nurses going to work elsewhere if they earn more, and a decrease in innovations in the health sector (from drugs to devices).
Waiver of care is on the rise
The National Health Service must guarantee universal access to health care and adequate levels of equity, which implies the reduction of inequalities between citizens, linked both to socio-economic conditions and to residence, recall the editors of the Report. Well, in 2021 with the public funding of the system, our country it covers 75.6% of total health expenditure, much less than the average of the reference EU countries, which reach 82.9%. In Italy theprivate spending has reached 41 billion, an average of over 1,700 euros per household, or 5.7% of total consumption: a far from secondary item in family budgets. In this way, reasoning the editors of the Report, they are discharged unfair burdens on families: for example, over a billion spent on medicines, included among those reimbursable by the National Health Service.
The equity indices then worsen: in 2020 (latest data available) over 600,000 families had to bear so-called “catastrophic” expenses (unsustainable compared to budgets); almost 380,000 families have become impoverished due to health care costs: over 32 thousand less than the previous year. Apparently the indicators seem to be improving as fewer people become impoverished due to private healthcare expenditures, in reality denials of care are increasing – points out Barbara Polistena, one of the editors of the Report -. an indication of serious hardship and iniquity of the system.
Specialist services lost and hospitalizations collapsed
Among the legacies of the pandemic there are also specialist services lost and hospitalizations collapsed. As the report’s authors point out, any damage to the health of the population will emerge over time. In the two-year period 2020-2021 there was a 65 percent reduction in specialist services. Last year we returned to pre-pandemic levels but for now without being able to recover the lost services: not all of them are “recoverable” and not all those provided before the pandemic were really appropriate, the Report highlights. For now, the funds allocated for the recovery of benefits do not seem to have given the desired results. Also shelters have collapsed: in 2020 ordinary ones – despite hospitalizations for Covid – decreased on average by about 18 percent, even by 27% in Calabria and by almost 20% in Liguria. The reduction of hospitalizationsaccording to the researchers, is significant because Italy is already the country with the lowest hospitalization rate in Europe.
Consequences of the pandemic on the elderly
According to a survey conducted by Crea Sanit on a representative sample of the over 75 population (about 600 individuals), 70 percent report a worsening of the state of healthespecially in the major centers and in the North-East, about half of the sample, after the pandemic, he spent more privately on health and social needs. a pandemic is underway within the pandemic – underlines the scientific director of CREA Sanit -. Many of these elderly people don’t go out, they are locked up at home because they are afraid of getting infected, even giving up the daily walk. And their health is deteriorating, with a progressive loss of autonomy. Many need more social aid Polistena reports.
Lack of doctors and nurses
Compared to staff shortage, the alarm was also recently launched by the Regions. According to Crea Sanit calculations, our country would have to invest around 30 and a half billion euros if it wanted to align itself with the workforce of healthcare professionals in the European countries of reference. Costs would increase even more if wages, which are lower than those of European colleagues, were to be aligned. NeverThe savings made on the “backs” of professionalspoints out the Report, in perspective generates significant problems for the survival of the National Health Service. It would be necessary to hire around 15,000 doctors and 30-40,000 nurses every year over the next 10 years, but the problem of finding them, especially the latter – says Barbara Polistena -. With regard to doctors, the shortage mainly concerns emergencies and local medicine: the PNRR is focusing on the latter, a pity that there is a lack of personnel – points out the scientific director of Crea Sanit -. The suggestion? Don’t think that the problem can be solved by increasing the places in specialization schools or by removing the limited number of universities. To increase personnel, work must be done to encourage “vocations” and modify personnel policies, making the public system more attractive.
Funding of the NHS “under” by at least 50 billion
According to the authors of the Report, it is necessary at least 50 billion for a progressive realignment of health resources to the levels of European countries. the estimate of what it would take to align ourselves with the other European countries of reference since currently the per capita health expenditure is more than 40 percent less – explains Barbara Polistena -. An annual growth in funding of 10 billion over 5 years should be expected.
In public finance documents are expected less than 2 billion per year, therefore about a seventh of what is necessary for the realignment, reports the Crea Sanit Report. The only possibility to go beyond the foreseen funding is that you register one national economic growth sustained and higher than the average of the other comparison countries. If adequate growth is not determined or conditions are not created to stop the loss of human resources
and pave the way for access to innovations– conclude the editors of the Report – we will have to move on to a logic of “selective universalism”, which privileges access for the most vulnerable (but with a significant impact on the equity of the health system).
January 25, 2023 (change January 25, 2023 | 12:19)
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