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The Civil Protection has published an expression of interest to try to recruit up to 450 doctors in Campania, of various specializations, requested for a long time by the regional administration to respond to the second wave of coronavirus infections. The ad was also publicized with television commercials broadcast in prime time on the main television networks, but the way it was published leaves some doubts about its effectiveness and has received criticism from trade associations, as has happened. many other times because of the emergency hires made during the epidemic.
The advisory was published on Sunday and expires at 12:30 p.m. on Wednesday, and is used to locate 150 anesthesiologists, 100 infectious disease specialists, 100 pulmonologists and 100 emergency and emergency physicians, usually employed in emergency rooms. Doctors, like nurses, are lacking in almost all parts of Italy, but in Campania this shortage is particularly severe and is combined with a higher number of infections, absolute and relative to population, than in any other southern region .
At the end of October, Campania President Vincenzo De Luca had written to Prime Minister Giuseppe Conte to complain that he had requested “the immediate dispatch by Civil Protection of 600 doctors (with special attention to anesthesiologists) and 800 nurses.” , and instead “only 22 doctors and 81 nurses had arrived.” The notice should serve to respond to De Luca’s request.
The proposed contracts are for their own account, “including coordinated and continuous collaboration (co.co.co)”, expiring on January 31, 2021 and extendable if still necessary. There is also a monthly rebate for those arriving from outside the region, because the intention seems to be to attract doctors from other areas of Italy. But currently all regions need doctors and, therefore, the planned recruitments in Campania explicitly exclude doctors already employed in the public or private sectors, “so as not to jeopardize current service levels”. The principle is not to take power away from other regions, a phenomenon that has occurred in recent months and has caused problems. But inevitably the field of potential stakeholders shrinks.
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“It seems like a call made just to do it”, says Antonio De Falco, regional secretary of the CIMO-FESMED union, “because it is very late and above all it is only open for three days.” In addition, the contracts will not be for an indefinite or even fixed time: proposal defined as “becera” by Pierino Di Silverio, a Neapolitan doctor and head of the Anaao-Assomed Youth Sector, another doctors union.
The salary -45 euros gross per hour- according to De Falco is a bit low by the standards of the doctors who work in the Covid rooms, “but that is not so much the problem.” The main issue is that only doctors who have already obtained a specialization degree can respond to the call, thus excluding those from recent years, despite the fact that the regions have had the possibility by law to strengthen the workforce through recruitment of fellows in the last two years. According to Di Silverio’s estimates, there would be at least 350 in Campania for the required disciplines.
All these elements leave some doubts about how many accessions the expression of interest can receive. Also because in recent months there have been other similar tenders in the region, with more advantageous economic proposals: and “they have almost been deserted”, explains Di Silverio.
The fact that in Campania there are few doctors in relation to hospital beds and the population is nothing new: it is something that was known, a great problem that has become an emergency due to the epidemic. There was already talk during the first wave, in March and April, when the impact of infections in the region was much more contained.
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Last December, just before the epidemic, Campania’s health system had left ten years as commissioner, decided in 2009 by the then government of Berlusconi IV to bring regional spending within the planned limits, avoiding a deficit that had reached to 774 million. of euros. The objective was achieved, but with a series of large spending cuts that have laid the foundations for the current difficulties of Campania’s health system, starting with the insufficient number of places in intensive care: to date there are 590 against 962 in the Lazio, which has the same population, and Sicily’s 751, which has 15% fewer inhabitants.
The shortage of doctors and nurses is another consequence of these cuts. At the end of October, De Luca had said that “Campania is one of the regions that has fewer medical personnel: we have 43,500 employees, while Veneto has 59,302 with one million fewer inhabitants, Emilia-Romagna has 58,250 with 1.5 million fewer inhabitants. Compared to the population, we are the Region that has fewer work units in the health system. “Espresso, in 2011 in Campania there were more than 10 thousand doctors and 20 thousand nurses, in 2017 there were 8,869 and 18,145 respectively.
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In recent years, however, Campania had significantly improved its LEA (Essential Levels of Assistance), an indicator calculated by the government on the basis of the health services offered and the efficiency of spending and resource management, which allows access to more state funding. The sufficiency threshold that the regions must exceed is 160, also reached by Campania since 2018. It was the penultimate region among those above the threshold, ahead of Calabria with 162, but also ahead of Valle d’Aosta (159) , Sardinia (145) and the province of Bolzano (142).
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