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 the AFT (Territorial Functional Aggregation) representative, if applicable, and then distributing the remaining hours among the doctors working in the Community Home'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 (NRRP) for the entry into operation of the 1,038 new community care facilities. After weeks of discussion and controversy, the impasse has been resolved in preparation for the full operation of the Community Homes. Already this morning, when an initial basic agreement was reached, Health Minister Orazi Schillaci expressed his satisfaction at the Farmindustria public assembly: "We strongly want general practitioners to be within the Community Homes, because they are the ones who know the patients best. This will show us a more modern and local healthcare system, closer to the citizens, and I hope this will also lead to decongesting 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 funding of the National Health Service and, therefore, for citizens. Those who pay the highest price would once again be the most fragile, 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 a mandatory work schedule of up to six hours per week in the Homes," the union argues, "transforms general practice into a mere coverage of the residual working hours required 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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