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To make the hospital sector less attractive than the private sector, we find the poor flexibility. “In practice, a hospital doctor today can only do that – Di Silverio urges -. When signing a contract in the hospital you can choose between the option infra-moenia or extra-moenia. In the first case, I can only carry out my freelance activity inside the hospital, outside working hours. In that case a high percentage of what I earn goes to the hospital. Otherwise there is the so-called extra-moenia, that is, I work as a freelance in a private practice. In that case, however, by law, I lose about 25-30% of my salary because there is an allowance for the exclusivity of the relationship that if I do extra-moenia it is no longer recognized“.
In the analysis conducted by Assomed there is also one non-assignment for 12% of the total contracts: 74% of the contracts for microbiology, 63% for clinical pathology, and 54% for community medicine and primary care were not awarded in the recent specialization competition. Currently, the trade union explains, the trainee doctor carries out his training in departments where the shortage of specialists is chronic and is obliged to compensate for these shortcomings by working together with medical managers “with one of the lowest salaries in Europe, side by side with colleagues hired through cooperatives who receive almost as much as their monthly salary every day“.
Orazio Schillaci, rector of the University of Tor Vergata, defined the green pass as essential to guarantee safety. But he is not the only one in the new Meloni government to have a positive view of the certificate and even the premier has expressed himself in favor
Clouds on the horizon
The future is uncertain, above all because these missed contracts assigned, which put the medical profession of the future in difficulty, are joined by the resignation of those of working age and the failure to fill places left by retirees. In the last 3 years, the union, the National health service has lost nearly 21,000 medical specialists. From 2019 to 2021, 8 thousand white coats left the hospital for voluntary resignations and 12,645 for retirements, deaths and various limitations. Every day 7 doctors and health managers resign and if the trend of voluntary dismissals were confirmed also in the following three years, from 2022-2024 another 9 thousand doctors would be fired, reaching an overall loss of 40 thousand specialists who cannot be replaced immediately.
So who will cure the new sufferers of tomorrow? “It is the question we all have to ask ourselves because this is the future – concludes Di Salverio –. It takes a non-contractual financing to invest in the professional. There may be incentives, such as the tax exemption of a part of the doctor’s activity and then you need to have fewer constraints. Today being a doctor means not having room for loved ones, a family or a life. We will soon get to the point where that ethical sense that allowed us during and after Covid to continue working as animals over hours, in defiance of all the rules, will soon be replaced by a sense of survival, which will then lead the doctor to resign. , as we are already seeing now. They give us the pennant but nobody does anything to improve our working condition“.
A crucial node for the national health system of the future which is now in the hands of the new government led by Giorgia Meloni. “Politicians must understand that the doctor no longer wants to stay in hospital because he is underpaid and works poorly. The hospital organization needs to be reformed putting his hand to a decree that is 40 years old while in the meantime the world has changed – says the trade unionist -. The problem is that the ministry of health is now de facto commissariat by the ministry of economy. Let’s hope this government understands how profound the emergency room problem is and does something to fix it. We have already asked for a meeting shortly: we hope it will happen as soon as possible“.
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