Two anesthesiologists and an accountant. A motion as a mantra: «Ingenuity finds solutions and resolves situations». Vicenza is not around the corner, the extreme tip of eastern Padania. Nine hundred kilometers from San Camillo di Sorgono, the heart of inland Sardinia. Yet, even in this medically no man's land, they, the two anesthesiologists and the accountant, from Vicenza to Mandrolisai, got there. To land on Sardinian soil they relied on their "MST Group", an acronym for Medical Support Team.

Padani in Sardinia

They founded the company some time ago, but in Sardinia they have been taking root for a few months, since Ares Sardegna, the Regional Health Company, on mandate from the regional council, decided to "rent" doctors to try to cover holes and emergencies. Only by chance is another Venetian, Annamaria Tomasella, managing the Po Valley "fall" into the land of Sardinia, head of the Sardinian healthcare system since January 1, 2022, after having led the Vicenza healthcare company in the past, again by chance and that of the Alto Vicenza area.

Ingenious at making money

Their ingenuity, that of the two anesthetists and the accountant, is simple: let's set up a company, a modest provincial limited company, and recruit doctors without borders, foreigners and others, to privately cover the gaps in the staffing of a public health system who did everything to create sinkholes in the island's hospitals. Ingenuity, in reality, is an operation with many zeros, almost a healthcare slot machine. In these parts, the Region and Ares, the "healthcare for rent" solution is quite popular. With the declared excuse that hiring doctors is the only solution, white coats without borders are multiplying from north to south of the island. Very often these are foreign doctors, Cubans and Argentinians above all, with a more than dull Italian, making the relationship with patients and colleagues daring. The company name of the Po Valley people who landed on Sardinian land is explicit: we work with contracted services offering teams of doctors at public health facilities.

"Right thing"

The promo they show off is from Ikea marketing: «Doctors for emergency services and first aid, medical guards and anesthetists: specialists in doing the right thing». It is not known what the "right thing" is, certainly for Venetian society it is certainly the most convenient "thing". A millionaire business, capable of multiplying day after day, as a panacea for a system destined to be privatised. Healthcare turnover, the replacement of retiring doctors with new ones, continues to mark a structural deficit which, if significant interventions are not made on training, risks extending beyond 2030.

Prairie to privatize

Therefore, a prairie for companies and cooperatives established with the sole purpose of "renting" doctors from here and there. Especially in Sardinia, where if we exclude the local health authorities of Cagliari and Sassari, all the others are affected by this new "token" recruitment model. And the lords who came from Padania rage without borders. The Sardinian contracts with the MST Group are a tangle that is chased from the most disparate local health authorities to Ares, a real landing planned in every detail, with shifts and tasks, services and bank accounts of new doctors to be replenished galore. The final chapter of these renewed and extended, expanded and multiplied assignments is a tender protected by state secret computer codes. To access it you need to contact the hacker on duty capable of extrapolating deeds and documents of an Arabian Nights race.

No red and orange

The promotional message of the Venetians collapses with the progress of the tender data: they win everything there is to win. Everything except lots one, four and five, those which concern the San Martino di Oristano, Mastino di Bosa and San Francesco di Nuoro hospitals. The contract is divided into lots to such an extent that the Venetian company can afford not to participate in those three lots where coverage of all emergency room intervention codes had been requested.

They win everything

The summary is simple: the MST Group participates and wins all the lots where only doctors capable of treating the white and green codes are expected. No doctor is proposed to treat the most relevant emergency codes, from orange for non-deferrable urgency to red for emergency with absolute priority. A disgrace for that slogan published on the home page of the Po Valley residents who landed on the island: «Since its inception the company mission has been to provide medical and nursing services in the field of urgency and emergency of the highest competence». That very high competence seems to have been lost on the journey between Vicenza and Sardinia. Goodbye to that declared "scrupulous selection of highly qualified personnel" clearly stated in the presentation which boldly dominates the company CV.

Avalanche of money

The avalanche of money confiscated by the very private Venetian company is entirely or almost entirely aimed at the minor codes, but still at a very high price. As if they were sure they had no competitors, the Po Valley people presented offers with a discount ranging from one to two percent without fear of any competition. For the San Martino di Oristano lot, for the minor codes alone, they had 468 thousand euros available, they were content to take home 462 thousand, leaving not even six thousand euros in the Region's coffers. They were no more magnanimous at the Delogu in Ghilarza: they had 655 thousand euros available and they offered to carry out the supervision of the minor codes of the emergency room for 646 thousand euros, just 9 thousand euros discount.

Discount alms

The San Francesco di Nuoro lot included an allocation of 655 thousand euros, they settled for 647 thousand euros, another begging discount of eight thousand euros. For San Camillo di Sorgono they could have had an amount of 468 thousand euros and they settled for 462 thousand, a downward "effort" of six thousand euros. At the Sirai di Carbonia Ares had planned to spend 748 thousand euros, but will save just nine thousand. For Iglesias for the CTO, 468 thousand euros are expected, with a reduction of six thousand. In Lanusei, at the Nostra Signora della Mercede hospital, a cost of 655 thousand euros was expected, they will use "only" 646 thousand. Olbia, with the Giovanni Paolo II was not among the tender lots, but, with the use of a part foreseen by the increase in the starting price, they will spend another 483 thousand, again for doctors usable only for white and green codes.

The doubling of earnings

All figures that should almost double. In fact, the contract provides for exemptions and extensions. There is an option to increase up to a fifth of the obligation of one million euros and a 4-month extension for another million and 691 thousand euros. An option to increase the supply by 25% could not be missing in the (certain) event that further needs not foreseen in other hospitals arise, another one million and 268 thousand euros. The overall total is nine million euros for "coin" doctors.

Plots of gold

Finally, the fees, those of rented doctors. They write it in the contract: for each doctor the Po Valley company will receive from the Sardinian Region the sum of 75 euros per hour for "minor triage", green and white, and 85 euros for all codes, including red and orange . The shifts indicated in the assignment are 12 hours, night and beyond. It means that it will go from nine hundred to over a thousand euros per day. They will probably miss Sundays too. Each of them will earn between 25 and 30 thousand euros a month. So much for the salaries of Sardinian doctors forced to work in the trenches, day and night.

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