Waiting lists, what the bill provides in 15 points

Among the main measures: a national register for citizen reports, reward measures or sanctions for failure to achieve objectives for the Regions and general directors

ROME – Green light from the Council of Ministers for the bill to combat waiting lists. The provision, with “guarantee measures on health services” and in which the more operational aspects that require financial coverage are conveyed, was illustrated today by the Minister of Health, Orazio Schillaci, during a press conference at Palazzo Chigi. Among the main measures of the bill, made up of 15 articles, a national register for citizen reports, reward measures or sanctions for failure to achieve the objectives for the Regions and general directors, first level diagnostic tests available in family doctors’ offices and some services also in pharmacies. A law decree was also approved with “urgent measures to reduce waiting lists for healthcare services“.

WAITING LISTS, WHAT PROVIDES THE BILL IN 15 POINTS

But returning to the bill, these are the points in summary:

– Article 1: Prescription and provision of outpatient specialist services. 1) In the case of a first visit or diagnostic test, the doctor has the obligation to assign the priority class and indicate the diagnostic suspicion. This indicates the time within which the performance must be guaranteed. 2) The Regions promote organizational measures that allow the specialist doctor, if he deems further tests or checks necessary, to take charge of the patient until the end of the diagnostic process. In this way, unnecessary tests are avoided unless indicated by the specialist. 3) The Regions must implement all initiatives useful to guarantee the effective provision of services in the accredited public and private structures within the established times, monitor and ensure compliance with the times and otherwise provide measures against the general managers of the healthcare companies. 4) To guarantee the provision of healthcare services to their patients, local healthcare companies can make use of the offers of accredited hospitals and private providers, as well as the activation of first level diagnostics in general medical practices. 5) The regional directors of health must draw up directives to the general managers of the companies who must define plans with the analysis and forecast of the demand and supply of services. The annual plans and the achievement of the objectives indicated in them affect the evaluation of the activity of the regional directors and general directors.

– Article 2: National waiting list governance system for greater effectiveness of national level coordination to reduce waiting lists and overcome regional inequalities. A control room, chaired by the minister, is entrusted with the task of supervising the development of the national plan for governing waiting lists and supervising its implementation.

– Article 3: National register of reports active on the portal of the Ministry of Health where citizens can report inefficiencies in the provision of services.

– Article 4: Economic treatment of healthcare personnel. Measures to increase the remuneration of staff involved in reducing waiting lists. Additional services of doctors and staff in the healthcare sector: possibility for companies to increase the hourly rate of additional services by up to 20%, especially in services with greater needs; the regions can allocate additional resources for supplementary collective bargaining by privileging the most deficient medical specialties or with the most difficult working conditions, within the limits of their budgets.

– Article 5: To recover waiting lists, companies can also make use of internal outpatient specialists. Also in this case the hourly amount of additional services up to 100 euros applies (budget law 2024).

– Article 6: Possibility for trainees to have freelance professional positions in the health services of the national health service for up to 10 hours per week (and no longer 8 hours per week). The role of specialists is enhanced to contribute to the reduction of waiting lists.

– Article 7: To curb the phenomenon of ‘token holders’, companies are allowed to hire staff even with self-employment contracts.

– Article 8: The spending limits for the purchase of healthcare services from accredited private individuals are increased by 1 percentage point for the years 2025 and 2026 compared to the increases already foreseen by the budget law 2024.

– Article 9: University hospital companies that cannot meet healthcare needs with university-type functional staff may stipulate contracts with medical or healthcare personnel not only with the for a fixed term, but also with permanent contracts.

– Article 10: Again with the aim of reducing waiting lists, the possibility of carrying out some services also in pharmacies (with adequately trained staff) and affiliated laboratories is envisaged.

-Article 11: The reorganization of the laboratory network is also envisaged to overcome the difficulties of offering local assistance in the most disadvantaged areas (for example mountain areas).

– Article 12: Provides reward measures and sanctions for the Regions, the regional directors of health and the general, administrative and health directors of the companies and bodies of the National Health Service, to encourage the reduction of waiting lists and compliance with maximum waiting times. The reward shares of the health fund for the Regions are linked to compliance with the objectives of reducing waiting lists. The Regions, integrating individual contracts, assign specific annual objectives on the reduction of waiting lists for the evaluation and verification of the activity of regional health directors and general directors of companies. The general managers, in turn, assign the objectives to the administrative directors, medical directors and complex structure directors. Rewards: increase in performance pay of no less than 10 percent for achieving the objectives for reducing waiting lists. Sanctions for failure to achieve objectives: reduction of performance pay equal to 10%; possibility, after notification and in compliance with the adversarial principle, of revocation or non-renewal of the assignment. For general managers, failure to achieve targets may result in suspension from the National Directory General Directory for a period of 12 months.

– Article 13: Starting from 2026, 60 million euros, for a three-year period, for the strengthening of mental health departments.

– Article 14: Establishment of the National School of Higher Health Administration for the top management of the National Health Service.

– Article 15: Measures regarding the approval of the financial statements of professional associations.