It’s not just healthcare: nursery schools are also in crisis
What does the Ministry of Education's plan for nursery schools include and why private facilities are sometimes cheaper. The speech by Massimo Balducci
The decree of the Ministry of Education was recently issued which finances the new nursery school plan worth 734.9 million euros. The Plan, in line with the objectives of the PNRR, aims to increase the number of nursery schools in order to "improve the educational offer from early childhood and offer concrete help to families, to reduce territorial disparities". The fact is that in many municipalities, including my municipality of Florence, there are many unused municipal nursery places, not because there are no children but because private nursery schools cost less.
It is not the physical structures that are lacking but the management capacity. Nurseries, in the unified public accounting system, belong to "mission 12" which includes the entire social services side. In the municipalities of the Center and North, mission 12 accounts for between 20% and 30% of a municipality's current expenses. Despite so many resources, the results are poor. Let's try to understand why. I will mainly refer to the case of the Municipality of Florence which I know quite well in its details (where the devil usually hides).
We have already talked about nursery schools. Several hundred unused places for which citizens pay educators and facilities simply because the rates are higher than those found on the market. How come? Simply because municipal nursery schools are not managed with managerial competence but simply by slavishly applying laws and collective agreements with a passively bureaucratic mentality. Add to this the fact that social services are managed, for the most part, by social workers and not by managers. To provide a service, the administrative cost often has a value that exceeds 50% of the value of the service provided. The social workers of the Municipality (of Florence but also of many other municipalities) spend a large part of their working time developing the so-called PAP (personalized assistance plans) of which more than 90% are never implemented. This is because the individual assistant does not have a budget available but must limit himself to developing the PAP which is then, at the end of the month, taken into consideration together with all the other PAPs. The accountant on duty, at this point, cuts, with accounting logic, the most expensive PAPs. As a result, more than half of social workers' working time is spent doing useless things. It would be enough to assign each social worker a budget and make them directly responsible for cost/benefit choices.
A further fold where devilry is hidden is represented by the relationships between healthcare and social assistance. Let's imagine an eighty-year-old who lives alone and who shows up at the emergency room of one of the hospitals in the Florence area on a Saturday morning. Maybe he is diagnosed with pneumonia that can be treated at home with seven antibiotic injections and seven cortisone tablets. The fact is that the eighty-year-old in question lives alone and has no one who can go and buy his prescribed medicines. It's a Saturday and the Municipality's social services reopen their doors only on Monday morning. It follows that our octogenarian will remain occupying a hospital bed for the two days of the weekend at approx. 800 euros per day! There's worse. In search of an ideological-legal coordination, not a technical-operational one, between social and healthcare, the Tuscany Region has at the time established the so-called "health society" (regional laws 40 and 41 of 2005), a sort of consortium between municipalities and ASL called to deal with "the integrated happiness of citizens". This institution was the subject of interventions by the Constitutional Court, the last of which (order 267 of 2019) in fact resulted in the Tuscany Region's spontaneous renunciation of art. 8 of regional law 41 of 2005 (it turns out that the existing health companies they have a very dubious life).
One final observation. The provision of most social services is entrusted to cooperatives in search of savings. The members of cooperatives, in fact, are members and are not employees and, as such, are not bound by collective agreements that provide for minimum wages. The cooperatives that provide social services accept assignments (all below the threshold and therefore outside of public tenders) corresponding to an hourly remuneration of a few euros for their members. Given this paltry remuneration, the Municipality fails to control the services actually provided.!
The social sector is a chasm on which little attention is focused. Not only would INPS not have financial problems if it were freed from the burden of interventions in the social sector for which it receives no compensation. There is the whole area of social services provided by local authorities to keep under control! One wonders whether those who from time to time find themselves in opposition in the various Municipal Councils have ever turned the spotlight on mission 12 of the Municipality's budget.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/piano-asili-nido-ministero-istruzione/ on Sat, 25 May 2024 04:52:17 +0000.