‘Health Agenda’, a sustainable reform of the National Health Service, presented
Initiative of The Bridge Foundation, University of Milan and University of Pavia
ROME – The Bridge Foundation, University of Milan and University of Pavia > they presented a document containing some proposals for health policies with the aim of starting a real health reform in Italy and establishing a more equitable healthcare system, participatory and sustainable.
More than 150 stakeholders including scientific societies, parties, institutions, pharmaceutical companies, patient associations and other key figures in the sector were involved today in Rome, at Palazzo Brancaccio, during the ‘Agenda Salute’ event.
The themes addressed in the study (downloadable at https://www.fondazionethebridge.it/work/agenda- health-for-a-sustainable-and-equitable-participatory-reform/) concern the integrative healthcare system, health research and Italian clinical trials strong>, the promotion of preventive medicine, the health professions of the future and health strategies with a view to energy transition.
INTEGRATIVE HEALTHCARE
A multi-pillar health financing model has been developed for some years, highlighting a growing hybridization of the NHS. Unfortunately, this development has not been governed, while it appears necessary to regulate the process on the regulatory and organizational levels, ensuring adequate monitoring and supervision.
First of all, there is a need for greater transparency and the working group requests the Permanent national observatory of supplementary health funds, established in 2022, to publish the data from the ongoing experimentation, before the model becomes effective in 2025.
Among other proposals, it is requested to expand the financing function and reimbursement of services towards the subjects of the collective integrative system, protecting the interests of the patients in a logic of continuity of care.
Finally, it is necessary to implement a model that improves the collection of information on public and private health services, through the electronic health record.
HEALTH-PROFESSIONS OF THE FUTURE
Currently 30 healthcare professions are recognized in Italy, and the volume of professionals involved, who work both in public and private, is approximately 1,500,000 units. For the future, for example, it is expected that among the most requested professions, not yet recognized, there will be deep learning expert (algorithm trainer), lifestyle strategist strong>, the telesurgeon, the bioprinting expert (synthetic organs), the virtual reality therapist (mental health), the ‘health data analyst (big data). Among those already recognised, however, the professional nurse, the medical technologist and the home health assistant are expected to be in greater demand.< br>In order to adopt adequately reliable predictive logics and support a coherent development of the professional figures that will be most in demand, it is necessary to provide for a reform of specialist training and enabling three-year degrees and the establishment of a table interministerial body that deals with monitoring and identifies training trends useful in the short, medium and long term and makes them explicit in university training offers and Ecm courses.
‘The priority is to guarantee quality healthcare and bridge the territorial disparities present in our country. This means intervening on the accessibility of health services, enhancing local and community medicine and home care. This was said by the president of The Bridge Foundation, Rosaria Iardino, who reiterated the urgency of ‘reforming the National Health Service, with adequate services to address critical issues such as fragmentation of access to services, the weakness of socio-health integration, waiting lists’.
‘In this perspective – he continued – we have developed a document centered on five specific themes with various proposals for health policies to be implemented, a ‘Health Agenda that we ask you to sign in order to involve the institutions in a broad, shared and participatory way’.
According to Alessandro Venturi, professor of Administrative Law and Regional and Local Government Law at the Department of Political and Social Sciences of the University of Pavia, Alma Ticinensis< /strong>, ‘the themes present in Agenda Salute are revolutionary and fundamental for the future of the NHS. Supplementary healthcare is among the most important points. We have been reading for some time that private spending on healthcare in Italy has increased, but this is not true. Indeed, of the 42 billion that are often cited, given that they are estimates and no one really knows how much private healthcare spending amounts to, in reality only 17 is real healthcare spending, i.e. that which is not replaced by the NHS. A physiological expense. Of these 17 billion, then, we have 4 which are already intermediated by mutual or insurance funds, so they are reduced to 13 billion.
‘So – he then highlighted – with the first point of the Health Agenda, i.e. speaking openly about integrative healthcare outside of any ideology, we want to imagine a system that reduces spending from one’s wallet as much as possible, that out of pure pockets, while expenditure intermediated by insurance and mutual funds should increase. In a context, however, where the NHS with its 136 billion in spending still covers the prevailing needs of all Italian citizens.
For Aldo Bruno Giannì, Full Professor of Maxillofacial Surgery and President of the Management Committee of the Faculty of Medicine and Surgery, University of Milan, ‘the University of Milan has decided to be among the promoters of this initiative, which concerns the proposal of a fair, sustainable and participatory healthcare reform, because we think that the concept of the modern Academy is no longer that of past, separated from the territory, but it is an Academy that must be an active part of important changes. We have provided our proposals in the training field and on the skills of the health professions of the future, also taking into consideration the great changes taking place in the population, think of aging and chronicity , but also to all the technology that changes the way we approach these problems.
‘The Academy, therefore, and in particular our University – he concluded – actively participates in the healthcare transformation processes that will be able to change the way we deal with < strong>health‘.
ROME – The Bridge Foundation, University of Milan and University of Pavia > they presented a document containing some proposals for health policies with the aim of starting a real health reform in Italy and establishing a more equitable healthcare system, participatory and sustainable.
More than 150 stakeholders including scientific societies, parties, institutions, pharmaceutical companies, patient associations and other key figures in the sector were involved today in Rome, at Palazzo Brancaccio, during the ‘Agenda Salute’ event.
The themes addressed in the study (downloadable at https://www.fondazionethebridge.it/work/agenda- health-for-a-sustainable-and-equitable-participatory-reform/) concern the integrative healthcare system, health research and Italian clinical trials strong>, the promotion of preventive medicine, the health professions of the future and health strategies with a view to energy transition.
INTEGRATIVE HEALTHCARE
A multi-pillar health financing model has been developed for some years, highlighting a growing hybridization of the NHS. Unfortunately, this development has not been governed, while it appears necessary to regulate the process on the regulatory and organizational levels, ensuring adequate monitoring and supervision.
First of all, there is a need for greater transparency and the working group requests the Permanent national observatory of supplementary health funds, established in 2022, to publish the data from the ongoing experimentation, before the model becomes effective in 2025.
Among other proposals, it is requested to expand the financing function and reimbursement of services towards the subjects of the collective integrative system, protecting the interests of the patients in a logic of continuity of care.
Finally, it is necessary to implement a model that improves the collection of information on public and private health services, through the electronic health record.
On research and clinical trials one of the proposals is that to support the development of a national health research strategy and clinical trial governance with the creation of a National Health Research Agency. By 2027, in fact, a strong growth in the number of new trials is expected, unfortunately due to constraints imposed by Italian legislation, especially regarding privacy, and a lack of national coordination, our The country risks losing ground at an international level.
According to the analysis of ‘Agenda Salute’, Italy ‘needs careful political, organizational and economic choices’, because ‘without interventions growth would be 5%, while with actions ‘soft’ regulations could reach 15% and rise to 30% with structural interventions.
To promote preventive medicine, it is necessary to access the information collected in clinical assistance activities and that held by the Ssn and Ssr< /strong>, but today there are serious delays due to the rigidity of application of the GDPR. It is important, then, to support the Bill, presented to the Senate in 2024, which regulates the management of health data with an innovative modality (sandbox), borrowed from the financial sector, which allows a protected and secure environment the limits placed on the use of health data by Dpos.
HEALTH-PROFESSIONS OF THE FUTURE
Currently 30 healthcare professions are recognized in Italy, and the volume of professionals involved, who work both in public and private, is approximately 1,500,000 units. For the future, for example, it is expected that among the most requested professions, not yet recognized, there will be deep learning expert (algorithm trainer), lifestyle strategist strong>, the telesurgeon, the bioprinting expert (synthetic organs), the virtual reality therapist (mental health), the ‘health data analyst (big data). Among those already recognised, however, the professional nurse, the medical technologist and the home health assistant are expected to be in greater demand.< br>In order to adopt adequately reliable predictive logics and support a coherent development of the professional figures that will be most in demand, it is necessary to provide for a reform of specialist training and enabling three-year degrees and the establishment of a table interministerial body that deals with monitoring and identifies training trends useful in the short, medium and long term and makes them explicit in university training offers and Ecm courses.
STRATEGIES HEALTH AND ENERGY TRANSITION
The impact of climate change on human health is now provenand the healthcare sector is responsible for an average of 4.4% of global CO2 emissions. The EU is the third largest producer after the United States and China and Italy is among those countries whose healthcare sector produces emissions slightly above average, with 4% of total national emissions.< It is therefore necessary to rethink the organizational and cultural aspect of hospital structures, for example, by including hospitals in the lists of energy-intensive and gas-intensive companies and by establishing a permanent table with the competent ministries (Environment, Health and Simplification), the regional representatives and hospital associations, to simplify the existing legislation, providing for the establishment of a corporate green team and the adoption of an annual environmental policy plan that promotes the use of renewable energy.
‘The priority is to guarantee quality healthcare and bridge the territorial disparities present in our country. This means intervening on the accessibility of health services, enhancing local and community medicine and home care. This was said by the president of The Bridge Foundation, Rosaria Iardino, who reiterated the urgency of ‘reforming the National Health Service, with adequate services to address critical issues such as fragmentation of access to services, the weakness of socio-health integration, waiting lists’.
‘In this perspective – he continued – we have developed a document centered on five specific themes with various proposals for health policies to be implemented, a ‘Health Agenda that we ask you to sign in order to involve the institutions in a broad, shared and participatory way’.
According to Alessandro Venturi, professor of Administrative Law and Regional and Local Government Law at the Department of Political and Social Sciences of the University of Pavia, Alma Ticinensis< /strong>, ‘the themes present in Agenda Salute are revolutionary and fundamental for the future of the NHS. Supplementary healthcare is among the most important points. We have been reading for some time that private spending on healthcare in Italy has increased, but this is not true. Indeed, of the 42 billion that are often cited, given that they are estimates and no one really knows how much private healthcare spending amounts to, in reality only 17 is real healthcare spending, i.e. that which is not replaced by the NHS. A physiological expense. Of these 17 billion, then, we have 4 which are already intermediated by mutual or insurance funds, so they are reduced to 13 billion.
‘So – he then highlighted – with the first point of the Health Agenda, i.e. speaking openly about integrative healthcare outside of any ideology, we want to imagine a system that reduces spending from one’s wallet as much as possible, that out of pure pockets, while expenditure intermediated by insurance and mutual funds should increase. In a context, however, where the NHS with its 136 billion in spending still covers the prevailing needs of all Italian citizens.
For Aldo Bruno Giannì, Full Professor of Maxillofacial Surgery and President of the Management Committee of the Faculty of Medicine and Surgery, University of Milan, ‘the University of Milan has decided to be among the promoters of this initiative, which concerns the proposal of a fair, sustainable and participatory healthcare reform, because we think that the concept of the modern Academy is no longer that of past, separated from the territory, but it is an Academy that must be an active part of important changes. We have provided our proposals in the training field and on the skills of the health professions of the future, also taking into consideration the great changes taking place in the population, think of aging and chronicity , but also to all the technology that changes the way we approach these problems.
‘The Academy, therefore, and in particular our University – he concluded – actively participates in the healthcare transformation processes that will be able to change the way we deal with < strong>health‘.