Tuscany, towards the dismantling of the medical guard in exchange for a call center. FISMU: “Attack on the right to health”

Rome, 25 August 2022 – In Tuscany, we are moving towards the dismantling of the medical guard, more than a halving of the offices and the service: a serious cut, a very serious mistake. This is the denunciation of Francesca Muti, regional secretary of Fismu and Marco Bruni, national manager of Fismu Continuità Assistenziale (medical guard) and head of primary care of the southeast ASL: “According to reports from many media, in a few weeks 116117 will start, a call centers to ask for telephone consultations from 8 pm to 8 am and on holidays, that is when family doctors’ surgeries are closed “.

“This new call center – the Fismu executives explain bitterly – will however be accompanied by the dismantling of the continuity of assistance, with a cut of more than 50% of the medical guard offices: there is talk of maintaining about 50/70 positions on the current coverage of 160 stations and there will be 3/4 doctors per large area who will answer the phone. So no longer the doctor on call that each territory is used to having for any direct access for outpatient visits, for home visits and for the request for medical prescriptions and certifications, but a telephone consultation and consequently the (improper) recourse to 118 or to the emergency room (PS) “.

“Yet the assistance continuity service – underline Muti and Bruni – is not a substitute for 118 but constitutes an essential filter on a territorial level against improper access to the ER and the local emergency system 118. The continuity assistance service also has, and precisely, the purpose of intervening in all those pathologies for which 118 is not indicated and which equally have the same right to be assisted as those that put the patient at risk of life, above all maintaining the principle of the proximity of the medical relationship -patient (element that cannot be maintained with the telephone advice!). In short, a leap into the dark! “.

Also questionable are the justifications with which the Region would explain the need for this “involution” in the service, among these in particular there would be the lack of doctors. “Lack – reply the Fismu executives – which with the necessary incentives would certainly be overcome, just think of the solutions adopted with the Covid emergency, specific models (used for the USCA), and that for example other Regions are proposing for the ordinary coverage of the service. Why not in Tuscany? ”.

“Many doctors – they add – are leaving the system voluntarily by resigning and showing an intolerance and profound professional discomfort. But the concrete proposals put forward by FISMU to remedy this situation were rejected, because the Tuscany region, instead of encouraging territorial assistance that is in extreme difficulty, and which would need investments, is desperately trying to get married with dried figs: a model that is fundamentally based on an increase in the workload for the same or with a smaller workforce. This can only create a worsening of territorial assistance and a further disaffection from the profession ”.

“This is the Trojan horse that will be offered to Tuscan citizens starting from the return of the summer holidays – conclude Muti and Bruni – a container well decorated by regional policy, and even sold as an improvement of the current organization of territorial assistance, which it will even offer citizens one more service: the call center! But no one has paid attention to the fact that this container is devoid of direct medical assistance to the citizen: the one we are used to since the birth of the NHS. FISMU therefore asks to radically review the project and invites the Region not to change the current organizational structure and to extend it to additional day care using the simple way of extending the continuity of care contract to 38 hours / week instead of the current 24, provision already contained in the current national employment contract “.

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