10.00 pm on any day. Summer or winter makes no difference. Carloforte, the extreme periphery of public health. Island in the island. The incident is a red-code one. Ferries too slow and always far away. We need the helicopter rescue, the indispensable one to save life. The intervention is cataloged among those "Employee Time". Translated it means that the time factor is the decisive element for the quality and outcome of care, if not the "life-saving" factor in the presence of conditions with a high risk of mortality. The closest helicopter is in Cagliari. The air rescue contract, however, provides that that vehicle can fly only in the time slot delimited by sunrise and sunset. Nothing, the only helicopter enabled for night flights to reach Carloforte is based in none other than Olbia, Costa Smeralda airport.

Odyssey Carloforte

The air line marks the beauty of 224 km between the Gallura capital and the Island of San Pietro. It takes no less than an hour from departure to arrival in southern Sardinia. Pretending that the helicopter can easily land in Gianni Morandi's hermitage, it will take another 30 minutes from Carloforte to the Brotzu garrison in Cagliari, the only emergency hospital with a night landing. The time factor marks the downfall. An hour and a half is considered out of any emergency timing, let alone in an intervention where the patient's salvation derives entirely from the speed of intervention.

La Maddalena, the ordeal

Let's assume the opposite side. 10.00 pm, midsummer day, La Maddalena archipelago. Similar intervention. The operational base for the night flight is always and only that of Olbia. Between the activation and arrival times we can assume, according to the rosiest forecasts, 15 minutes to land on the island. Given that the only two centers where one can intervene for certain emergency pathologies are located one in Cagliari and one in Sassari, there are only two aid hypotheses. The patient, however, at that time cannot reach Sassari by helicopter, because, after 3 years from the activation of the service, that hospital unit still does not have a base for night landing. From La Maddalena, therefore, he must go to Alghero, to the airport. From there, an ambulance will pick him up from the plane and along the road, only for a part with four lanes, he will be able to arrive, after over an hour and 15/30 minutes. In this case too, times are beyond all grace of God. The hypothesis remains for departure for Cagliari. Again another 70/75 minutes to cross the whole of Sardinia. It is the paradox of the most expensive service: the night service.

Night scandal

Paid all year for a base of operations on the other side of the only hospital with a night landing. A madness. Airport enabled for night flights, the only hospital capable of landing it in Cagliari, 200 km away. Of course, needless to say, that night-time helicopter costs a bang. It is available 24 hours a day but, given the totally unbalanced location with respect to the distribution of the population, to serve central and southern Sardinia, the most populous area has to travel kilometers and kilometers of sky, with the stopwatch that makes the hands proportionally to the rotating blades.

Golden minutes

And every minute that spins, adding up costs and costs, are 150 euros of public money that take the path of Airgreen, the company that was awarded the multi-million dollar tender in 2018 to manage this rescue service. Therefore, the more along the path to take, the more interesting the game becomes. The more you fly, the more you earn. It matters little if the irrationality of the service puts the intervention time factor at risk. It is not explained otherwise that after 1,000 days the night landing areas have not yet been set up in the garrisons, in the meantime in Sassari and Nuoro. Anyone would understand that without that equipment for the arrival of the flight after sunset, not only the lives of patients are put at risk, but the costs will continue to rise exorbitantly. The helicopter tender slot machine, however, is a grind. Just think of the location of the three helicopter bases.

Time wasters airports

All three inside civilian airports. A choice that borders on the imponderable. To pay for the parking spaces of the three helicopters inside the airport facilities, the Region spends no less than one million per year, for eight years this means 8 million. Except in Alghero where the air force hosting the helicopter does not ask for money but for construction works. The military airport of the Riviera del Corallo, in fact, sees continuous renovation and maintenance works. The state does not pay, but it is the emergency agency that renovates the Commander's house, warehouses and the like. The choice, however, hides two other elements well beyond the limit of the unlikely.

Helicopter rescue only afterwards

At civil airports, civilian flights have priority for take-off and landing. This means that, for example in the summer months with a higher frequency of landings and take-offs, the first aid helicopter must stop waiting for the airliners to perform their maneuvers on the runway. All this means losing decisive and precious minutes, given that on an airport runway there is no vertical take-off, but all the procedures must be deployed, like an airliner. This means that, assuming the runway is free, there will in any case be at least 3 minutes for each take-off and landing. Those three minutes mean at least 450 euros per take-off. By accounting for 1,200 / 1,300 take-offs a year, it means that, only in wasting time resulting from positioning inside the airports, instead of having autonomous helicopter rescue stations, rationally located in the regional territory, we end up squandering no less than 500/600 thousand euros structural per year for the sole loss of time in the starting maneuvers. Therefore, a service created for emergencies and urgencies based, instead, on irrational locations, just think that two out of three helicopters, one of which is qualified for night flight, are dedicated to northern Sardinia and only one, which cannot fly at night, for the rest of Sardinia, the most numerous.

Money counter

That minute counter clicks as soon as the rotor starts spinning. The rationale of the contract and its management, to earn more money, is not to arrive first at the rescue site, but to travel the greatest distance, in the longest time. And, in fact, every month that passes, in absolute silence, the service continues to cost more and more. The helicopter of Olbia, the h24 one, in January 2020, had cost for a month, between fixed and variable, 294 thousand euros, in the latest data available, before the summer, the expenditure for the month of June 2021 had jumped to 420 thousand euros. It makes no difference in the Covid periods: the same helicopter in April 2020 cost 296 thousand euros, in April 2021, however, 424 thousand euros. We are talking about an annual increase of 43%.

The mystery

The mystery remains: the night helicopter, that of Olbia, located in the farthest point from the main catchment area, Cagliari. The secrets of the millionaire helicopter rescue contract, however, are not over. The red thread between northern Italy, Sardinia and the rotating propeller business is just starting. In wardrobes and desks, the accounts do not add up. And very often those helicopters fly for a sprained ankle. But this is another chapter of the golden helicopters.

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