Medical commission for the certification of disability, the paralysis in Sardinia continues. «On 2 September 2023 I presented to the INPS, through a patronage, an application for aggravation for my sick wife, requesting the application of the benefits of law 104»: since then PED, who wrote to the editorial staff of L'Unione Sarda, signing and by providing numerous details, he began to deal with inefficiency. No one has visited his wife in six months. The INPS says: «Practice in progress, it's not our fault». The Cagliari Local Health Authority throws the ball back the other way: «We have not received any requests». At home the situation worsens: husband and wife are abandoned.

Anger

"I feel like I'm being led astray," says PED, resorting to a polite and outdated formulation of disappointment, "I don't understand and I'm trying to ask around." And he comes across rumors «that whisper that the heroes of Covid, the doctors making up the medical commissions, have blocked all visits, establishing a dispute with the regional administration because they want to have paid, in addition to their salary, an attendance fee for the collegial meetings of medical visits to the frail. I hope it's not true."

But it is, true. Only the situation is more complex.

The block

Oncology patients wait up to 130 days for the recognition of disability: the law says that it should be a maximum of between 15 and 30. Those without cancer, on the other hand, waited 180 days, compared to the 30-40 that would be imposed by the norms. And there were 11,500 requests for visits on the waiting list, almost 1,800 from cancer patients. And some of these, unfortunately, did not have time to be "patient", because the disease did not allow them to do so. These are the numbers of the disaster of the medical commissions of the ASL of Cagliari, the most important in Sardinia. Across the island it is estimated that this situation affects around 20 thousand patients.

The activities had been blocked since October, when the resolution of the regional council was implemented which required the doctors who were part of it to carry out visits only during service hours. Result: everything stopped, because the workforce was and is stretched to the bone, and thousands of disabled people awaiting certification have been abandoned. The "good" news is that the health company's forensic medicine department raised the alarm in January and prepared a plan to deal with the drama. The bad news is that the program, once approved, must become fully operational and deal with the lack of personnel.

The paralysis

The numbers contained in the proposal for an extraordinary intervention program proposed by the Prevention Department of the Local Health Authority to the general director Marcello Tidore outline the disheartening picture. The document, which dates back to January, also traces the causes of the stop. In summary, the Region adopted a resolution in August, the manager implemented it in early October: it was decided that the members of the commissions would have to carry out the activity within the service hours and not outside, with a token for the remuneration, because those tasks were already included in the salary. Until then, under the old regime, the service had been guaranteed. Then it was discovered, as was obvious, that "there is not sufficient availability of human resources (doctors, social and administrative workers) to cope with the functioning of the commissions". It was the beginning of the blockade, with waiting lists that swelled out of all proportion: no certifications, no accompaniment, rights denied to those with disabilities. In short, it was proposed to return to the old system. To arrive until "February 2025 at an average of 3,488 monthly assessments, with a progressive decrease in the following months, reducing to 2,300 assessments per month by March 31 of the same year".

The stakes

DG Tidore set some limits, declaring the imposition of commission work during working hours to be obsolete, but gave his approval, underlining "the importance of respecting the criterion of rotation of each member of the commission". The work to put a patch is underway and the results are awaited. Meanwhile, thousands of Sardinians do not have their rights recognised.

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