The Democratic Party announced in recent days a further reform of the Sardinian regional health system. The objective would essentially be to overcome the critical issues of the current system as outlined by the Todde Council.

According to what has been possible to learn from the media, the Reform would consist of the creation of two macro ASL, which would find their respective convergence in Cagliari and Sassari. More precisely, on the one hand, in Cagliari, the Health Authority number 8 would be merged with Brotzu and Aou, while in Sassari the Local Health Authority number 1, the University Clinics and the Santissima Annunziata would be merged. On the other hand, Olbia, Nuoro and Lanusei, for their part, would configure the first of the planned double vast area, since the other, the second, would group together Oristano, Sulcis and Medio Campidano.

No question: whether the territorial organisation logic conceived in this way would be closer to the citizens so that it could be, so to speak, shared by them.

But will the merger (if that is what we want to call it), in and of itself considered, as imagined, really be able to affect the efficiency of the current system by guaranteeing continuous levels of assistance and the reduction of waiting lists throughout the region? Will the announced organizational structure allow for a numerical increase in medical and paramedical personnel in force, or will the health personnel be the same as they were and will they remain in the individual hospital facilities and in the territory? Will the hypothesized merger (centralization?) affect, and if so how, the financing costs of the system by improving its efficiency in terms of service use? Will the reform proposal put forward by the regional Democratic Party, which would seem to foresee a topographical change in the organization of the system, also be substantiated by a redistribution of, and/or, by competences of Hospitals and Territories?

It would be important, to put it more simply, to better explain what real advantages in terms of health service provision, the Democratic Party's proposal will be able to guarantee. First of all, because, every territorial assistance reform should have as its primary objective that of guaranteeing a service closer to the people and aimed at overcoming inequalities. Then, because the identification of the two macro Local Health Authorities and of as many so-called large areas, should, if implemented, be able to ensure the so-called uniformity of levels of assistance throughout the regional territory, equal conditions of access to services for all potential users of the service and the continuity of care where conditions of fragility are identified.

The design of the hypothesized new organizational structure, if implemented, in the contingent circumstance, could be called upon to guarantee the immediacy of the response to contingent needs by substantiating high-performance organizational forms that are purposefully oriented towards the maximum valorization of healthcare personnel to meet the needs of the end user, i.e. the citizen. From many quarters, at a national level and therefore not only at a regional level, it seems to have been noted that the material quantity of resources allocated to the healthcare sector is no longer suitable to guarantee the adjustment to the ever-increasing demand for healthcare services. And this circumstance would seem to have contributed to determining, in recent years, continuous changes in the healthcare sector. At present, there seems to be a need to develop an organizational system for the healthcare service, specifically Sardinian, that can be configured as suitable to be perceived as citizen-friendly due to its immediate perceptibility.

Giuseppina Di Salvatore – Lawyer, Nuoro

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