Healthcare, Mauriello (MI): “Immediate rethinking and reorganization of the accredited laboratory network”

The existing system could lead, in the medium to long term, to an increase in prices for the services provided

“There is an urgent need for intervention on the planned system of reorganization of the network of accredited laboratories, which today favors large companies and the concentration of a few players at a national level. The existing system could lead, in the medium to long term, to an increase in prices for services provided. But it’s not just this. Many structures will have to transform into mere Access Points; this will force them to dispose of equipment and technological resources
purchased thanks to huge investments or through the activation of leasing contracts still in existence”. Thus Walter Mauriello, national president of Meritocracy Italy.

“If the objective is to guarantee technological modernization – he continues – it is not clear why all the accredited structures with performances lower than 200,000 should be considered a priori non-compliant. Many have advanced instruments which, in addition to guaranteeing high quality standards on services offered, also allows us to speed up reporting times. The need to guarantee new efficiency is denounced, but already today many of the existing and accredited structures comply with the so-called verification programs. On balance, the requested reorganization pushes laboratories with annual performances of less than 200,000 to sell their business, before it depreciates and in anticipation of a transformation into Spoke”.

“It is added that: the downward updating of the tariff nomenclature, justified by technological innovation and an economy of scale, can only be guaranteed by companies that operate on a large scale and are able to provide their services at low prices, despite the evolution of a context which from 2007 to today has seen a succession of financial crises, dizzying inflation, and increases in the costs of energy, transport and raw materials; laboratory facilities are subject to budget limits determined by the Region on the services in agreement with the NHS, and this cap limits the production and growth capacity of the same, as well as determining the presence of waiting lists on the services requested by patients with serious pathologies”.

“We then ask ourselves – continues the national president of Meritocracy Italy – what the survival prospects are for all those new aggregations made up of territorial SMEs whose hubs will have to, among other things, ensure the management and administrative capacity of multiple entities (Withdrawal Centres) belonging to its own network, finding itself competing with large corporate structures which, following acquisition/sharing/merger operations, will in fact be represented by a single large company made up of Hubs and Collection Centers all belonging to the same company”.

“The ‘Hub’ Laboratories will hardly be able to relocate to their own structures and in the immediate future all the existing staff at those structures destined to become mere Access Centres, the hiring of which was previously encouraged by the Puglia Region through the valorisation in the Grid of evaluation for the division of the budget. There is no doubt that the issue can have a significant impact on the social and economic fabric, especially in the southern regions. Thousands of employees will lose their jobs. It will certainly not be possible to bring all the staff previously present in the various laboratories forcibly reduced to spokes”.

“If technologies can become obsolete immediately – he adds – disqualifying professional biologists, who for years have contributed to the growth of the territory, through entrepreneurial initiative and the acquisition of skills and experience over time, means depriving these professionals of their dignity “.

For Walter Mauriello “the inconvenience is now clearly evident. Last but not least, the promotion of the hub and spoke configuration implies a strong increase in the transport of blood samples. A measure that literally goes against the trend with the current measures aimed at energy saving. Meritocracy Italia calls for attention to a problem that is unfortunately underestimated. It requests that, first of all, clarity be made on the methods through which the new forms of aggregation will be able to reach the minimum efficiency threshold for access to institutional accreditation of private healthcare facilities. Yes furthermore, at least, provides that this criterion is achieved by the healthcare facilities either individually or in an aggregated form, where aggregation between them is foreseen by the new legislation”.

“For this purpose, we ask that art. 8 quater, paragraph 3, letter b, legislative decree no. 502 of 1992 be replaced with the following: «b) the assessment of the compliance of the structures with the needs, also taking into account of the criterion of the minimum efficiency threshold which, compatibly with the available regional resources, must be achieved by health facilities (single or associated), and the functionality of regional programming, including the determination of the limits within which it is possible to accredit quantity of services in excess of the planned requirement, in order to ensure effective competition between the accredited structures”, he concludes.