Welcome to the Far West of cooperatives that supply coin-operated doctors
About 4 out of 10 white coats would be ready to resign as NHS employees to work with a cooperative as token doctors (and earn double). But how do these private companies that nobody controls operate? Facts, numbers and controversies
Between assaults and often inadequate wages, more and more doctors are choosing to work with cooperatives, increasing the number of so-called "co-operated doctors", a phenomenon that endorses a prohibited procedure and which goes against the European legislation on safety of care.
COOPERATIVES AND DOCTORS
With the shortage of doctors afflicting the National Health System (NHS), hospitals and emergency rooms are increasingly turning to private companies or cooperatives that provide token doctors, or freelancers on call, to cover shifts and services that would otherwise risk to remain uncovered.
It is a phenomenon that began before the pandemic but exploded from the health emergency onwards.
ESCAPE FROM THE NHS
According to asurvey by the Cimo-Fesmed Federation, out of a sample of 1,000 doctors, 37.6% said they were ready to resign as an employee of the NHS to work with a cooperative. That's about 4 out of 10 doctors.
The highest percentages are found among the youngest white coats. 50% of those under 35 and 45% of doctors between 36 and 45 are willing to work for the Cooperatives. Figures which, understandably, decrease among those who are closest to retirement, in fact, among the over 55s only 28% would prefer to work with tokens.
“The picture that emerged from the survey cannot fail to arouse concern – commented Guido Quici, president of the Federation that brings together various trade associations -. It is the plastic representation of the discomfort of the doctors employed by the National Health Service who are beginning to see in the co-ops the only lifeline to get out of a now unbearable system and organization of work”.
The survey also observed that the most eager to flee to cooperatives are doctors who work in the service area (who represent 46% of those who declare they want to work as coin collectors), followed by those who work in emergencies ( 42%), by surgeons (40%) and, finally, by the medical area (32%).
THE REGIONS WITH THE MOST COUNCIL DOCTORS
With the exception of Abruzzo, Sicily, Calabria, Basilicata, Alto Adige and Valle d'Aosta, all the other 15 regions resort to coin-operated doctors.
This was confirmed by a survey conducted for La Stampa by the Scientific Society of Emergency and Urgency Medicine (Simeu): "In Piedmont, 50% of hospitals call them, in Veneto 70%, in Liguria 60% and in Tuscany the 50%, but in Friuli Venezia Giulia, Marche and Molise there is no hospital where they are not present”.
THE PAY THAT MAKES THROAT
Rightly or wrongly, it is obviously the pay that attracts an army of doctors, which has nothing to do with that of contracted colleagues in a public facility.
"It's a dream – one of them, 30 years old, with no specialization, told La Stampa – I decide when and how much to work and with 10 shifts a month I already earn twice as much as an employee". To give an idea, according to what was written by the Turin newspaper, "with three nights in a month, you pocket the salary that an employee doctor collects in a month" and, another example, "the local health authority of Modena for a night shift releases 1,400 euros gross to the company that wins the contract”.
A paradox considering that healthcare never has enough funds but pays dizzying sums to cooperatives that operate without common rules and selection criteria.
RISKS FOR THE NHS
But this phenomenon is already creating serious consequences. As Quici observed when commenting on the Cimo-Fesmed data, "if these percentages were to turn into real resignations, we would find ourselves facing the definitive decline of the National Health Service, emptied of many of its professional skills and largely entrusted to private companies that no one regulates or check it out".
This, specified the president of Simeu, Fabio De Iaco, means facing two problems: "first of all the high costs for the national health system, considering that the wages of doctors on call also reach 1,000 euros for a night shift, much more than what the structured ones receive. And then there is the question of experience: non-specialist doctors often do not have adequate preparation and it is not uncommon for non-specialised recent graduates to work in the emergency rooms”.
Furthermore, with the emptying of the NHS, the national secretary of Anaao Assomed, Pierino Di Silverio, observes that the future of health care is increasingly moving towards a "semi-private model of care, a model which in addition to being unconstitutional would also be a harbinger of a social and professional revolution ”.
WHY YOU PREFER TO OVERPAY INSTEAD OF HIRING
As Di Silverio explained, companies decide to recruit medical personnel in this way instead of hiring because "on the one hand, the company that hires for services has an economic advantage, on the other it is faced with the impossibility of hiring permanent contract due to a hiring cap".
An obstacle that can only be removed with a decree law and more funding for healthcare recruitment.
LEGAL OR ILLEGAL PHENOMENON?
The outsourcing of medical work in the health sector had become illegal in 2018 and was then rehabilitated with the emergency caused by Covid.
Now, however, that level of emergency has passed and according to Quici the phenomenon of coin-operated doctors is circumvented by hospitals by turning to cooperatives and entering the expenses for compensation in the budget under the item "goods and services", such as canteens, and not "staff", which in fact cannot be exceeded due to the hiring ceiling.
ANAC'S INTERVENTION
The situation is now so out of control that the National Anti-Corruption Authority (ANAC) has decided to intervene with the Ministries of Health and the Economy in order to request a ministerial decree that sheds light on the issue of "token holders" and gives price fairness.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/benvenuti-nel-far-west-delle-cooperative-che-forniscono-medici-a-gettone/ on Thu, 12 Jan 2023 06:49:35 +0000.