As usual, and as always indeed, the Civil Community, given the constant and guilty absence of the Institutions, constantly and cyclically refractory to any hypothesis of decisive confrontation, assumes upon itself the weight of an initiative that we can define as "dignity", while the absence of any regulatory continuity in the organization of the health sector continues to reverberate its negative effects in the medium and long term on users, that is, on the sick and needy, and on all health workers, obviously mutilated in their ability to intervene. It will do so on Friday 24 September 2021, on the initiative of Fabio Rosas, in the City of Nuoro who will undertake to send a strong and clear signal in conjunction with the event organized in Cagliari in support of Public Health through the closure of all commercial establishments from 12.00 to 13.00.

Furthermore, the political / managerial alternation (erroneously considered as a resolving measure of an exclusively internal nature), conducted along the lines of a structural oscillation based when on "centralization", when on "decentralization", as studied and exploited on a political level to achieve - it would seem - of "other" objectives than the dominant one of "cure", it constitutes with good verisimilitude, and at the same time, the origin and the contributing cause of the "evil", and betrays the need to achieve a useful "efficiency "Of the services provided, as well as the equally important need to mend the relationship of trust between citizens and the" administration "of services commonly understood in its" human "declination. Those who would be delegated, in principle, to define the contours of a necessary and no longer postponable "intervention" on the territory, in its various articulations, and through the preparation of a realistic and readily usable Planning Plan, appear totally detached from the context, completely unable to understand the dynamics and areas of operation and control because, probably, at least this has led us to suspect, without any managerial experience in the sector and simply placed in the top positions of respective assignment and destination only to satisfy (it would seem, and the conditional is a must considered the merely argumentative plan of the confrontation) political dynamics centered on unspecified party power relations.

In other words, and in some way more simply: all Sardinians, but above all those who still populate the inland areas, are more or less unaware victims of an illogical circuit that condemns them to "abandonment" to be considered as the now gangrenous portion of a device operating at alternating currents, which seems to have deliberately abandoned the "functionality" of one of its "engines" (the island's hinterland) to explain its driving force (or at least what remains of it) in the context of the most lucky metropolitan realities. What happened to all the speeches on the need to intervene on the level of territorial medicine in view of its necessary strengthening? Why in a notoriously "depressed" reality does one continue to want to invest only, and badly, in "hospitalizations", neglecting the offer of alternative services of a territorial nature and practical compliance? With what courage do we fail to provide adequate responses to a population in need of care and controls of any kind and intensity? Why do we continue to want to stubbornly deny the problem from the “button room” of regional importance (the reference is to the very latest statements by President Christian Solinas) by-passing and ignoring the discomfort of ordinary people? Who will be called to "answer" (because someone will have to answer) of the wicked choices made in the sector in question by the political sector of the island past, recent and present?

Because the subjects from time to time "responsible" for the good governance of the territory are systematically concerned with dismissing their own health reforms by proposing unrealistic management formulas as they are inspired, due to the total absence of their own skills and knowledge of the territory, by regional systems in all and totally different from ours? “Mystery of Faith”: the exclamation may be permitted to me. It is customary to say that "whoever gets off to a good start is half the battle", but, to be honest, we can not see a "beginning", much less a work. Yet, the key to reading the whole problem, in my opinion, lies in the understanding and conscious controlled implementation of the mechanisms of "territorial assistance", by their nature oriented to guarantee both the internal integration between the health care levels and different degree, that is from the base to the apex, and the external one that manifests itself, more effectively, in the relationship between the communities concerned and the healthcare structures of reference which, probably, and in a truly functioning system, should constitute the last stage of care, the last visit of the patient.

In other words, it would be necessary to progressively achieve a project to abandon the “hospital-centric” trend, which still today seems to dominate the island territory, to study and establish organizational and instrumental models suitable for filling the lack of useful resources. The "integration" and "coordination" of the intervention actions in the territorial context of reference represents the optimal solution, as well as the "partnership" between public and private articulated in the dynamics of complementarity. It is up to our political representatives to implement this: once again, inertia cannot be tolerated.

Giuseppina Di Salvatore

(Nuoro lawyer)

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