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Speaking of Welfare Directors. The controversies of the Doctors who continue to want to remove spaces from Nurses and Health Professions are sterile.
To scroll through the recent contribution of CIMO-FESMED [LINK] on the merits of the institution of non-medical care directors, he seems to find, behind new slogans, nothing more than a trite and retired anachronism.
In fact, after the famous sentence of the Lombardy Regional Administrative Court – Milan, section III, n. 274 of 19.02.2007: “You do not need a medical manager within SITRA to ensure coordination between doctors and nurses” and after the sensational “rejection” of paragraph 566 of Law 190/2014, with the well-known formulas “Sorcerer’s apprentices” (FNOMCeO) and “Assault on diligence” (Anao Assomed), the non-medical health professions collect only a new formulation of an already known complaint.
We are therefore in the “blitz” of a “clientelist poltronificio”; it will sound strange and paradoxical, yet in all this we can see progress. Because from the costumes of shamans and brigands, at least now we have moved on to the military dress (as per RD n. 1265/1934), or to the more elegant modern civilian, to finally sit down in the “armchair”.
Could it therefore have been an overall Freudian slip that of the Federation of Medical Executives?
Let’s check it out …
First of all, the assertion “weaken the remaining managerial figures”. And in any case “it is in sharp contrast with the current ones” “, it seems a very little understandable hyperbole: it is not understood what the discrepancy is and where to place it, whether towards the previous historical organizational structure or even towards the regulatory one, which however should be better specified .
Even the expression “on the part of those who certainly do not have a professional title” should be corroborated by elements of objectivity: the establishment of the classes of master’s degrees in the health professions (Ministerial Decree 8 January 2009 – Official Gazette of 28 May 2009 no. 122) and the most recent approval of 90 first and second level specialized master courses (paragraph 1, art.6, ln 43/2006 + paragraph 7, art.16 of the CCNL of 23 February 2018 Health Section) leave no room for defamation, worthy of more than a conservative legacy and approach, children of that phenomenon, in many respects as brazen as it is reprehensible, which characterized and in fact monopolized the healthcare of the last century: the so-called “medical dominance”; all this without taking into account the extremely limiting and almost unconstitutional – the so-called “expense invariance” clause under art. 6, l. 251/2000, which already heavily penalizes the healthcare management.
Similarly, if the assertions according to which master’s degree graduates from the non-medical health professions determine “no concrete benefit” and a “useless new political figure” were true then, simply, it was not necessary to establish the figure of the “professional manager” as also confirmed from the same paragraph 1, art. 6, Law No. 43/2006, where the role and function of the management are precisely those of improving the functioning of the health care providers.
If this regulatory pool – moreover of a general nature – of the management of the healthcare sector (so-called “operational management”), also fully represented by Legislative Decree n. 165 of 2001 (Consolidated Law on Public Employment), by Legislative Decree n. 502 of 1992 and subsequent amendments, by Legislative Decree n. 171 of 2016 and the subsequent Legislative Decree corrective no. 126 of 2017, represents a “legislative abuse,” then much of this country’s recent health history has been misspelled.
Still, even if only in purely historical terms, the claim of an increase in “harassing effects of management on doctors” (doctors previously defined as “managers”) seems completely surreal: in any case, by definition, management is conceived to general pursuit of the objectives set by a company, not the particular persecution of anyone, doctor or non-doctor.
Last but not least, if “health structures are in trouble”, it is precisely because Italian health care has been in need of an important structural intervention for some time to make it much more efficient in the extremely complex and sensitive field of constitutionally guaranteed social rights, which mandatorily require positive actions by public authorities for their actual satisfaction; criticality also dramatically highlighted by the consequences of the pandemic. And a lesson as hard as that of covid-19 will not be easy to forget at all, as well as fully learning …
Well, to be realistic, these somewhat incredible, reiterating affirmations of this Federation of Medical Trade Unions – all together – denote such incompetence mixed with confusion and malpancismo, that in truth they are the first to discredit the senders and never the recipients of the same.
Therefore, if there is “an unacceptable and authoritarian initiative” and if there is an “old policy that the country hoped to have left behind”, these are precisely – and very typically – represented by initiatives similar to those that such CIMO-FESMED should now be undertaking, worthy of suspicious and perhaps even conspiratorial minds.
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