The agreement regulating the presence of family doctors in community homes was signed this evening. Negotiations accelerated, with the agreement being signed by Sisac, representing the Regions, and the FIMMG and FMT unions. The contract mandates family doctors to work up to six hours per week for 48 weeks per year in community homes between 8:00 a.m. and 8:00 p.m., with a minimum of three hours of continuous shifts. For each hour of work in community homes, doctors are guaranteed a salary of €38.72, according to a uniform pricing system nationwide.

To ensure continuity of service, the Conference of the Regions explains, it will be the responsibility of each individual health authority to determine the facility's hourly requirements, after deploying the staff already assigned to hourly activities and consulting with the AFT (Territorial Functional Aggregation) representative, where applicable, and then allocating the remaining hours among the doctors working in the community center's area. The agreement reached today must now go through its procedural process to enter into force by June 30, in compliance with the deadlines set by the National Recovery and Resilience Plan (PNRR) for the entry into service of the 1,038 new community care facilities.

After weeks of discussion and controversy, the impasse has finally been resolved as community centers begin to fully operate. Already this morning, when an initial basic agreement was reached, Health Minister Orazi Schillaci expressed his satisfaction at the Farmindustria public assembly: "We strongly believe that general practitioners (GPs) are present in community centers, because they are the ones who know the patients best. This will allow us to see a more modern, localized healthcare system, closer to the public, and I hope it will also lead to less congestion in emergency rooms."

Filling the new facilities with an adequate number of doctors to provide residents with the necessary local care was the priority: this is why Schillaci had proposed a specific decree, a proposal later shelved following controversy and opposition from doctors' unions. The agreement now reached thus resolves the situation by providing a national framework, as the minister himself had hoped, and preventing each region from proceeding independently. In recent days, Schillaci also opened the possibility of hospital doctors also being able to work in community homes on a voluntary basis and outside of working hours, eliminating certain incompatibilities. The agreement has been given the green light by the FMT union and the largest family doctors' union, the FIMMG, which believes this will ensure the profession's sense of responsibility prevails. Because "at this stage," the organization explains, "it is necessary to balance multiple needs: the sustainability of general practitioners' work, the country's need to achieve the objectives set out in the National Recovery and Resilience Plan (PNRR), and the duty to avoid the restitution of resources, which would have dire consequences for the National Health Service (NHS) funding and, therefore, for citizens. Those who would once again pay the highest price would be the most vulnerable, the most alone, and the most vulnerable."

On the other side are the Smi and Snami unions, which have not signed the agreement. The Smi denounces "a distortion of the legal nature of the employment relationship that currently governs the practice of general practitioners with the National Health Service within the framework of private, contracted practices." Indeed, "the imposition on all practicing physicians of up to six hours per week in the Homes," the union argues, " transforms general practice into a mere coverage of the residual hourly needs structured by the Local Health Authority. This introduces elements of a subordinate relationship, while at the same time maintaining the lack of protections afforded to employed workers. This creates a very serious contractual imbalance."

(Unioneonline)

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