Covid in Campania, directives de Luca: “Doctors are not far from patients”

General practitioners, private specialists, ASL medical guards who work in SSR clinics, and independent practice dentists. In addition, doctors, nurses, and staff at RSA and in some clinics that specialize in diagnosis work without the need for hospitalization for patients. In short, in Campania the broad public of scam doctors does not work in public hospitals. Less than 0.3% of the members, the president of the Naples Medical Association identifies Bruno Zuccarelli Who signed since yesterday to cancel the suspension of service for unvaccinated white coats. “These are national laws and we enforce them,” he said. But the region continues the hard line, moreover, already announced by Governor Vincenzo de Luca, who, no later than 48 hours later, described the rule passed by the government as “extremely dangerous and disrespectful to doctors and patients” and which effectively cancels this obligation to vaccinate (against Covid) For doctors and health workers.

The question immediately seemed very divisive and not even the chiefs of the Northern District (like Veneto .) liked it Luca Zaya) But the legal approach was different. That is why de Luca decided yesterday, after bringing together his legislative assistants, not to completely ignore national governance (as the Puglia region did) but to delegate the application of the rule to the national health companies and hospitals: so doctors who do not enforce the law will do so. Re-service (as stipulated by government decree) but they will not be able to work in the ward (this relates to the corporate organizational model). “A directive has been sent to the general managers of ASL and hospitals – clarification of the Campania region – according to which it is required to limit the use of unvaccinated health workers against Sars-Covid-19, in conjunction with the desire to reintegrate into the service of protecting the health of vaccinated patients and operators. Therefore, it will be Take the necessary measures to counter any hypothesis of infection, and avoid direct contact of unvaccinated staff with patients.” However, the case is still far from peaceful in terms of litigation because some regional administrative courts have accepted appeals against doctors who were not suspended or “degraded” because they did not receive a vaccination, they were assigned other jobs. For the Puglia region, which has declared non-compliance with the ordinance of the Government, the Under-Ministry of Health Marcelo Gemato It has already been announced that the decision of the Emiliano junta will be appealed. In short, space for stamped papers.

On the one hand, labor unions, operators and orders seem to agree: reintegration of (a few) irregular doctors working in public structures into service will have no effect on the now chronic shortage of personnel in the wards. As of October 31 — Fnomceo notes — 4,004 doctors and dentists have been suspended, or 0.85% of the 473,592 members. Of these, there are 3,543 physicians (0.82% of the total 434,577), 461 dentists and 325 dual members, who, for the vast majority of them, work as dentists. However, we will see the age of the arrestee, a little less than half, and specifically 47% of the 3,543 doctors, that is, 1665 – confirms Fnomceo – are over 68 years old and that is why they are outside the National Health Service.” From the remaining 1878, the perception was that Most of them are self-employed.The data reflects the situation in Campania: the audience of doctors consists of about 400 doctors (half of them in Naples, 80 in Salerno, 20 in Caserta), added to the 500 nurses (only 246 in Naples), like many other specialists. Physiotherapists, laboratory technicians, speech therapists, radiology technicians and other white coats registered in the nineteen health professions registries not counting some hundreds of other obstetricians, psychologists, pharmacists, biologists, veterinarians and food technicians who all report to their orders.But the shortage of white coats, especially Specialists (emergency surgeons, anesthesiologists and resuscitators in particular) in Campania is still very high.For Campania, the balance between new specialists and doctors leaving the SSR by 2025 is negative by 1090 units. The main shortcomings are emergency/urgency with 800 doctors, pediatrics with 278, general surgery with 129, internal medicine with 119, orthopedics with 98, cardiology with 69 and anesthesia with 43 doctors. Even in Campania, the declared need by the region is greater than the real needs until 2025 in almost all disciplines, to the point that it seems unjustified especially in some branches such as anesthesiology and resuscitation (an estimated surplus of 321 doctors by 2025), general surgery (+138 ), Elderly (+242), Natural Medicine (+129), Oncology (+132), Radiodiagnostics (+288), Radiotherapy (+165). Although both regions in Italy fund most of the additional contracts (105), this effort appears useless at least for the purpose of compensating for the shortfall of specialists in the most suffering sectors. But what is even more worrying is the indicator of the turnover of doctors, which is not enough in Campania to cover operational needs. According to Agenas, in order to calculate the turnover, the number of appointments was compared with those who left each year: this coefficient, if greater than 100, indicates that there is an expansion of resources; On the contrary, if it is less than 100, there is a decrease in the workforce. Well: Campania’s number is 69 for the turnover of doctors and 57 for the nurses.


But general practitioners are also in short supply. In Naples alone, more than 120 general practitioners are missing, and more than 400 across the region according to official data, an even more serious shortage in the peripheral and most disadvantaged regions. The region has tapped into coverage and has raised the number of grants for Mmg training (three-year period for training is needed): 140 in 2019; 111 in 2020; 319 in 2021.

Phil Schwartz

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