In the hours in which the Region of Puglia is in the eye of the cyclone to media inquiries related to the alleged relationship between politics and health, which involved the addition of Nichi Vendola, we tried to understand a bit 'more about the structural reasons that characterize the nature of this relationship.
And the circles close to the junta Vendola someone points out that should probably be claimed by the junta itself that during the term there were very few cases of involvement in criminal investigations of politicians or administrators of ASL and ongoing investigations are at an early stage. Nothing to do with the flurry of arrests and indictments of the past legislature's center-right. Here too, the health management is not a paradise but it is seriously difficult to speak of widespread moral issue in health Puglia. But why then
health becomes the black hole for many Italian regions? And because every now and check out some Lady Asl, or alleged?
answers to our questions Francesco Saporito, professor of organizational design and quality systems at the University of Bari, and former Councillor of the Region Report Vnedola until October 2008. "Health care, as everyone knows, is 80% of the budget of all regions. This flood of public money but is not handled directly by the regions, but from companies they controlled and that the filiate Asl. "There is a second and a third node, defined by structural Professor Saponaro. "The first is the corporatization of health care began with the 1992 reform. From this arises the figure of the reform of local health managers. These figures, which have the task of managing the huge river of resources from the regions, are appointed by a political body which is the region itself. We are therefore faced with an uncertain process of corporatization that does not help the system to function properly. "But there is also another node, said Saporito, who is just as important and determines that one of the phenomena that most contributes to the" red "Standing in the accounts of the regions, namely the number of operators that act, and direct spending account of the ASL. "Only in Puglia - Saponaro continues - are present among general practitioners, specialists, pediatricians, and so much more than 6000 professionals. Each of these requires daily care, appliances, medical treatment, medication, hospitalization and so forth, without having actually the real constraints and spending limits. It's like if a business owner would give thousands of employees of the books of blank checks, it is obvious that the accounts of this company that may not be perpetually in the red. "The last point, not insignificant, as indicated by 'Former Minister for the Budget of the junta Vendola, is related to the training of local health managers. "They find it difficult to extrapolate the data and give a correct reading from the perspective of effective control in order to verify prescriptions requested using what statisticians call indicator or sentinel or warning threshold. As just one example, in the report that I played by Councillor Budget in December of 2007, I had pulled out of the data on the excessive increase in spending on so-called prosthetic (+12%). This figure of course could also be the result of particularly zealous or orthopedic requirements of a change in the epidemiological or fraud or embezzlement or "combine." It 'clear that some phenomena can be discovered only by the criminal court (ASL leaders do not make the interception ...) but surely the local health authorities are completely lacking in professionalism able to transform that data into information and information systems in decision support. Indeed, in the same report of December 2007 I suggested that even the CEOs of the ASL had the cognitive tools to assess the trends. "But how to identify fraud and embezzlement Saponaro has no doubt the professor and said:" This is a very serious because any irregularities are not self-evident, and clearly are the tools that are available only to those investigative bodies. In my statement on the increase in spending for hearing also notes that the local health authorities were not able to verify that data, and thus engage functionally correct and control the task entrusted to them. "
Among the roads to be taken to correct a course of undefined Francesco Saporito indicates two: the first is a proposal already made at the time of Livia Turkish, and is that relating to the establishment of a national register of the top managers of local health services, and its establishment of the state and training linked to it. The second involves the other hand experts and persons engaged in the performance of control systems. On this staff, which is of great importance within the system, and should preferably come from the same medical world, we must invest in training and transparency, making public the dossier analysis and evaluation of products in the local health spending. Only then can put in more security or less insicurezzale resources for our health.
