Cancer, what the new national cancer plan provides
World Cancer Day is celebrated on 4 February: it's a good time to discuss the new national cancer plan. The intervention of Alessandra Servidori
February 4 is the day dedicated to the fight against cancer all over the world: World Cancer Day.
This time too, as we have already begun to do for some years as associations and as TutteperItalia, it would be an opportunity for real information and training on this devastating disease . We are trying because not all Italians have been duly informed that on 26 January the new national cancer plan was finally approved, already ratified by the State-Regions Conference, which aims to profoundly innovate the social and health instruments dedicated to this scourge disease that also has dramatic repercussions on work.
WHAT THE NATIONAL ONCOLOGY PLAN PROVIDES
The national cancer plan, planning document and guideline for the prevention of cancer 2023-2027, approved after a long process , is linked to a Fund for its implementation, which was born in the milleproroghe decree, with an endowment of 10 million euros for each of the years, and is intended to strengthen the strategies and actions for the prevention, diagnosis, treatment and assistance of cancer patients, defined in the plan.
The potential of this plan is represented by a global intersectoral approach, with greater integration between prevention, early diagnosis and management, including the improvement of treatment and the prevention of recurrences, focusing on the centrality of the patient and on the reduction or elimination of inequalities in access to prevention, treatment and rehabilitation interventions.
Measures to “facilitate social integration and reintegration into the workplace, including the adaptation of working conditions for cancer patients – reads the Plan – should be integral parts of the patient's journey”.
THE OBJECTIVES OF THE EUROPEAN COMMISSION
It is fair to point out that this document only establishes the guidelines to be pursued to reduce the impact of cancer on society. To confirm the willingness to play its part in reducing the cancer epidemic, the government needs to make adequate financial coverage available because through the Mission on Cancer and the European Plan against cancer, the European Commission has asked all member states to make concrete efforts to save at least three million lives and increase the survival rate for all cancers from 47 to 75 percent by 2030.
Goals which, according to the action plan drawn up by the Commission, can be achieved by acting along clear guidelines: by strengthening prevention services (almost 4 out of 10 cancer cases are avoidable), by improving access to even the most advanced therapies and the quality of the life of those who have passed the acute phase of the disease (over 1.2 million people in Italy).
To follow up on these objectives, individual member states can also count on a series of initiatives and funding made available by Brussels for a total of 4 billion euros. Support which, in order to be disbursed, requires each country to specify the items of expenditure necessary to achieve the objectives set in the Plan. It is time to allocate the financial coverage necessary to comply with every single item indicated in the Plan to strengthen prevention, increase early diagnosis, improve access to therapies and guarantee all survivors the health and social services of which we continue to provide need even once the acute phase of the disease has passed.
DISCRIMINATION AT WORK TOWARDS CANCER PATIENTS
Despite the protections guaranteed by law, many people suffer penalties at work due to an oncological disease: discrimination, mobbing , demotion or in any case lack of career advancement. These are subtle forms of discrimination, often difficult to counter because they escape the control of the law: the change of a role, the removal from responsible tasks covered before the illness, excessive rigidity in the application of the rules. And things are more complicated for self-employed workers who enjoy less protection: in this case, the disease can be seen by customers as a cause of poor reliability.
The law considers punishable discrimination where one person is treated less favorably than another would be treated in a similar situation because of a personal condition (for example, not getting a promotion for health conditions), or where apparently neutral behaviors implemented by the employer are actually aimed at penalizing a specific person (assigning a productivity bonus exclusively on the basis of the number of days present at the workplace).
The various oncological disabilities in the workplace can be addressed and managed, identifying the most suitable tasks and possibly adapting the methods of carrying them out to the specificities of the individual worker, even in smart mode, thus recovering professionalism that could otherwise be lost. Precision medicine or personalized medicine must correspond to "personalized arrangements" in the workplace.
THE RISKS OF REGIONAL AUTONOMY
A reasonable concern is the recent approval of the bill which allows the differentiated regionalization of all 23 subjects; provides for a start of regionalization with financing of the transferred services calculated on the "historical expenditure", when fully operational it prefigures regional taxes and the withholding of taxes on a territorial basis, breaking any idea of equalization. For example, greater legislative, administrative and organizational autonomy in the matter of setting up and managing supplementary health funds would give rise to an insurance-mutual system outside any, even weak (as currently), national legislation.
The request for regional supplementary bargaining for NHS employees, to which is added an autonomy in personnel management and the regulation of freelance activity, puts in place competition between Regions and will cause a further transfer of personnel to the richer Regions , leading to an increase in interregional mobility, in particular from the South to the North and an increase in inequalities; already at present the regional differences, especially for the nursing staff, are very significant and must be reduced, certainly not increased. Furthermore, it would put a brake on collective bargaining at a central level, the stipulation of fixed-term contracts of "work specialization" for doctors, as an alternative to the path of specialization schools; the planning of scholarships for medical specialists and their operational integration with the corporate system; the adoption of decisions based on therapeutic equivalence, between medicines containing different active ingredients to which AIFA will have to respond within 180 days on the merits by adopting a mandatory and binding opinion on the entire national territory.
In the context of a National Health Service aimed at ensuring the right to health for all people, if different needs do not have to be answered with the same criteria, it is essential to offer unified solutions at the national level for identical problems.
Differentiated autonomy in healthcare, giving rise to a multiplicity of organizational systems, runs the risk of eliminating any coherence between some "regionalized" systems and the founding principles of the National Health Service, which validate article 32 of the Constitution; in the absence of a "principle of supremacy" present in the constitution of the federal states, it initiates an irreversible fragmentation of the health service, even in the face of major emergencies of a national nature.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/giornata-cancro-piano-oncologico-nazionale/ on Sat, 04 Feb 2023 08:37:10 +0000.