1. Dr. Sanapo, until a few months ago there was talk of relaunching Hospital Fields, today we speak of conversion. What is the actual situation? What were the reasons that forced the Puglia region with a change of direction?
The Local Implementation Plan (LAP) of the ASL Lecce, prepared in accordance with the dictates of Regional Law No 8.23, predicted in the programming of the hospital network, the field hospital as a hospital base, ie a hospital with four operating units of hospitalization (Medicine, Surgery, Orthopaedics and Obstetrics) in addition to hospital services without beds (medical direction, radiology, laboratory, pharmacy, emergency, cardiology, administration, dialysis and day nursery). This programming was then cleared by the technical area. This was the will of the Department of ASL and the Regional Government of Lecce.
In the spring of 2010 the National Government took over in the economic accounts of the Puglia Region (and many other regions, including the Liguria) an infringement on the Stability Pact, as determined by the slippage of health spending, although the general budget in balance. As a result of the infringement, the Economy Ministry has activated the negotiating table in order to implement The Plan of Return. " This plan for Puglia, barred from the Ministry, includes a series of measures (hiring freeze and tournover staff, reduction in pharmaceutical expenditure, increased regional taxation, etc. ..), including the decommissioning of small hospitals and the overall reduction of about 2,000 shelter beds. In our district hospitals have been identified as "small", according to the flow of information ministers, those of Gagliano del Capo, Poggiardo, Jerseys, Nardo, San Cesario and Fields.
The ministerial requirements, if deviating from the Puglia region, providing a penalty of € 500 million of non-transfer of state funds the Region. Faced with such a penalty, which puts the knee in regional health systems, the regional government no choice but to accept the repayment plan imposed.
2. It is claimed that during the first five years of government Vendola the situation has worsened hospital fields. Can you explain how you characterize the current structure of hospital work field (facilities, beds, wards, etc..) Compliance with the provisions of the Plan of Reorganization Lease?
I think that on issues of public health can not be made political tool: the field hospital was, in fact, deactivated by the Plan of Reorganization Hospital 2002. Vendola the government, pending the new regional planning, we have to respect what this reorganization included, still in force: 28 beds for long-term care medicine with 12, 15 places and 10 psychiatrist of the day surgery surgery. These beds and related services Vendola the government has created a service with beds for the treatment of immune-mediated diseases (IMID). We can not say it's worse. Unfortunately it must be said that the current minister for regional affairs, author of the plan in 2002 that the hospital has reduced the field hospital, today, together with colleagues of Economy and Health, is forcing the government to review what Vendola scheduled for the enhancement Hospital, decreed the definitive closure.
3. Based on the recovery plan launched by the Health Region of Puglia, which is expected the new offer health care in the province of Lecce and how they characterize the new hospital network?
The repayment plan, imposed by Berlusconi's government to the Puglia Region, provides that for the public hospital network in the province of Lecce, the total reduction of 195 beds, the survival of six hospitals (Fazzi, Cupertino, Galatina, Gallipoli, Casarano and Scorrano) transformation in the health care of 3 Regional Hospitals by 12/31/2010 (Gagliano del Capo, Poggiardo and sweaters), other 2 Hospitals by 12/31/2012 (Fields and Nardo) and the transformation from hospital to hospital for acute rehabilitation hospital in San Cesario.
4. Because waiting times for specialized investigations are still so long? And what you're thinking of doing to reduce the problem?
Waiting times for health services feature all universalistic health systems: in America, Switzerland and other countries, a type of insurance benefit system (if your income is charged), this problem does not exist. In those systems who can pay, others make do.
Vendola Despite this, the government is making two important reforms to the system. The first requires the publication of the diaries of booking. Previously there was no waiting time for the simple reason that the diaries were not known. The second, creating a task force, headed by Professor Carella, with the task of reforming the entire system by creating a network of all the CUP (Central Booking One) of the region, the integration of the booking agreement with those studies public, the reform of the system of private providers, the reform of professional activity (ALPS) for the medical staff of the Regional Health System. Unfortunately, this reform is extremely complex, which tends to break a historically established mechanism, which sees citizens weak-performing in relation to access to health services and providers in a position of strength, he needs time to show off. Not escape anyone that the resistance of the system are very strong. These days are strong arguments, protests and affiliated medical staff, the change in place. It 's a battle we must win for a health system more equitable for all.
5. We talk about the transformation of the field hospital located in "House of Health". What will be the time for implementing such a choice? What is the House of Health and what activities take place?
The Plan of Return, which the transformation of the hospital field, it must be lived by the whole of the District as an opportunity rather than a shortage of supply health. Today in the territory of which Fields is reference, there is a paradox: on the one hand, a hospital in name only and that absorbs very considerable resources, the other a district that provides a low, messy and expensive care planning.
If the hospital turns into a House of Health (Presidio better to call health authorities) are likely to have a container that can satisfy all the demands of health that do not require hospitalization. The Presidio
territorial health (or House of Health) was standardized and characterized by the then Turkish Minister and provides a point of Early Intervention, a Specialized Clinic can perform as a whole and functional performance that today require hospitalization improper (diabetes, heart failure, chronic bronchitis, of 'hypertension and all other chronic diseases), outpatient surgery, dialysis, radiology, pharmaceutical services, medical assistance, family counseling, medical group of family doctors and pediatricians, all activities of the Center for Mental Health, Department Prevention, the Department for addiction and Rehabilitation Department, services for the integration social care, in addition to administrative tasks.
short: modern medicine, dropped from a nineteenth-century vision "ospedalocentrica", which prevents and cures disease in the territory more effectively. The timing of completion will certainly be short for the simple reason that it is not necessary to make significant investments in a structure that already exists and has all the requirements, including the human resources already present (doctors, nurses and technical and administrative staff) and in the current hospital in the district.
by Campintesta , November 2010
The Local Implementation Plan (LAP) of the ASL Lecce, prepared in accordance with the dictates of Regional Law No 8.23, predicted in the programming of the hospital network, the field hospital as a hospital base, ie a hospital with four operating units of hospitalization (Medicine, Surgery, Orthopaedics and Obstetrics) in addition to hospital services without beds (medical direction, radiology, laboratory, pharmacy, emergency, cardiology, administration, dialysis and day nursery). This programming was then cleared by the technical area. This was the will of the Department of ASL and the Regional Government of Lecce.
In the spring of 2010 the National Government took over in the economic accounts of the Puglia Region (and many other regions, including the Liguria) an infringement on the Stability Pact, as determined by the slippage of health spending, although the general budget in balance. As a result of the infringement, the Economy Ministry has activated the negotiating table in order to implement The Plan of Return. " This plan for Puglia, barred from the Ministry, includes a series of measures (hiring freeze and tournover staff, reduction in pharmaceutical expenditure, increased regional taxation, etc. ..), including the decommissioning of small hospitals and the overall reduction of about 2,000 shelter beds. In our district hospitals have been identified as "small", according to the flow of information ministers, those of Gagliano del Capo, Poggiardo, Jerseys, Nardo, San Cesario and Fields.
The ministerial requirements, if deviating from the Puglia region, providing a penalty of € 500 million of non-transfer of state funds the Region. Faced with such a penalty, which puts the knee in regional health systems, the regional government no choice but to accept the repayment plan imposed.
2. It is claimed that during the first five years of government Vendola the situation has worsened hospital fields. Can you explain how you characterize the current structure of hospital work field (facilities, beds, wards, etc..) Compliance with the provisions of the Plan of Reorganization Lease?
I think that on issues of public health can not be made political tool: the field hospital was, in fact, deactivated by the Plan of Reorganization Hospital 2002. Vendola the government, pending the new regional planning, we have to respect what this reorganization included, still in force: 28 beds for long-term care medicine with 12, 15 places and 10 psychiatrist of the day surgery surgery. These beds and related services Vendola the government has created a service with beds for the treatment of immune-mediated diseases (IMID). We can not say it's worse. Unfortunately it must be said that the current minister for regional affairs, author of the plan in 2002 that the hospital has reduced the field hospital, today, together with colleagues of Economy and Health, is forcing the government to review what Vendola scheduled for the enhancement Hospital, decreed the definitive closure.
3. Based on the recovery plan launched by the Health Region of Puglia, which is expected the new offer health care in the province of Lecce and how they characterize the new hospital network?
The repayment plan, imposed by Berlusconi's government to the Puglia Region, provides that for the public hospital network in the province of Lecce, the total reduction of 195 beds, the survival of six hospitals (Fazzi, Cupertino, Galatina, Gallipoli, Casarano and Scorrano) transformation in the health care of 3 Regional Hospitals by 12/31/2010 (Gagliano del Capo, Poggiardo and sweaters), other 2 Hospitals by 12/31/2012 (Fields and Nardo) and the transformation from hospital to hospital for acute rehabilitation hospital in San Cesario.
4. Because waiting times for specialized investigations are still so long? And what you're thinking of doing to reduce the problem?
Waiting times for health services feature all universalistic health systems: in America, Switzerland and other countries, a type of insurance benefit system (if your income is charged), this problem does not exist. In those systems who can pay, others make do.
Vendola Despite this, the government is making two important reforms to the system. The first requires the publication of the diaries of booking. Previously there was no waiting time for the simple reason that the diaries were not known. The second, creating a task force, headed by Professor Carella, with the task of reforming the entire system by creating a network of all the CUP (Central Booking One) of the region, the integration of the booking agreement with those studies public, the reform of the system of private providers, the reform of professional activity (ALPS) for the medical staff of the Regional Health System. Unfortunately, this reform is extremely complex, which tends to break a historically established mechanism, which sees citizens weak-performing in relation to access to health services and providers in a position of strength, he needs time to show off. Not escape anyone that the resistance of the system are very strong. These days are strong arguments, protests and affiliated medical staff, the change in place. It 's a battle we must win for a health system more equitable for all.
5. We talk about the transformation of the field hospital located in "House of Health". What will be the time for implementing such a choice? What is the House of Health and what activities take place?
The Plan of Return, which the transformation of the hospital field, it must be lived by the whole of the District as an opportunity rather than a shortage of supply health. Today in the territory of which Fields is reference, there is a paradox: on the one hand, a hospital in name only and that absorbs very considerable resources, the other a district that provides a low, messy and expensive care planning.
If the hospital turns into a House of Health (Presidio better to call health authorities) are likely to have a container that can satisfy all the demands of health that do not require hospitalization. The Presidio
territorial health (or House of Health) was standardized and characterized by the then Turkish Minister and provides a point of Early Intervention, a Specialized Clinic can perform as a whole and functional performance that today require hospitalization improper (diabetes, heart failure, chronic bronchitis, of 'hypertension and all other chronic diseases), outpatient surgery, dialysis, radiology, pharmaceutical services, medical assistance, family counseling, medical group of family doctors and pediatricians, all activities of the Center for Mental Health, Department Prevention, the Department for addiction and Rehabilitation Department, services for the integration social care, in addition to administrative tasks.
short: modern medicine, dropped from a nineteenth-century vision "ospedalocentrica", which prevents and cures disease in the territory more effectively. The timing of completion will certainly be short for the simple reason that it is not necessary to make significant investments in a structure that already exists and has all the requirements, including the human resources already present (doctors, nurses and technical and administrative staff) and in the current hospital in the district.
by Campintesta , November 2010
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