The case of Cardarelli of Naples is the tip of the iceberg of a healthcare system in crisis

The case of Cardarelli of Naples is the tip of the iceberg of a healthcare system in crisis

When that pandemic exploded in 2020 that has upset and continues, albeit to a lesser extent, to upset our lives, the phrase we kept repeating to ourselves is “we will come out better”. A slogan focused mostly on people that sounded like a wish for a better and more civilized world when everything would be over, but which in reality also referred to the economic, social and political fabric in which we find ourselves operating.

There is no doubt that the pandemic has found its way smoothed by a series of mistakes made in previous years by those who have the fate of the country in their hands. The hope was that the Covid-19 lesson, the worst of all possible lessons, could serve to avoid falling back into those traps and to invest where for too long we had deliberately turned away. A reference above all is to health, that public health that has been dismantled in certain areas of the country and which has instead made us feel all its absence in these terrible two years.

The fact that even today the issue of medical malpractice is all 'agenda, with stories of hardship and inhumanity such as those of the Cardarelli hospital in Naples where it seems we have reached a point of no return, is the proven proof that what we have lived up to now has not been an accident. but a system problem. And that solving it doesn't seem to interest anyone.

What is happening at the Cardarelli in Naples There is a photo that is circulating on the internet and which explains better than any word what is the situation of the largest hospital in Southern Italy, the Cardarelli in Naples. A corridor of the emergency room invaded by dozens of stretchers, effectively transformed into a real ward in which one cannot even pass since no distancing is respected. But it is only the most shocking postcard of the situation, behind which there are many other stories of hardships that fully describe the concept of medical malpractice.

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Patients report that they spend hours, up to 18, abandoned in the common areas waiting to be examined. La Repubblica tells of people outside the hospital with the urine bag attached to the catheter, while in the facility the screams of the patients' families resound, railing and in some cases attacking the medical staff. There is a problem of overcrowding at the Cardarelli: too many people arrive who cannot be sorted elsewhere in what therefore appears to be a scarce supply of emergency rooms in the city. The Nas of Naples has announced an inspection of the hospital but the situation is so desperate that 25 doctors have announced their resignation.

"This decision is necessary due to the very serious and repeatedly reported working condition of the emergency room which in the last few days has reached a point of no return - they write in a letter -. All the conditions for exercising our profession, which consists in assisting patients, to guarantee them the dignity of care and the right to health, have no longer existed ”. A symbolic gesture that is unlikely to materialize, but which certainly has few precedents.

A national problem The situation at Cardarelli is certainly extreme, but in reality it is only the tip of the iceberg of a precarious healthcare context that concerns everything the country. From the Veneto, which denounces the lack of over a thousand doctors, to the hole of 20 thousand nurses in Lombardy, the whole national health service is floundering, the one where the 18 hours of waiting in an emergency room are the preview of the two years that one must wait to be able do a mammogram or a year for ultrasound scans and scans, as Cittadinanzattiva illustrates in its Civic report on health. Citizens' rights and federalism in health care, released just in these hours. The consequence is that one in ten citizens in Italy renounces treatment and this is a problem, in a country that wants to be democratic and where the right to health is constitutionally guaranteed.

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The pandemic has exploded thanks also to the difficulties of territorial medicine, brought to its knees by years of cuts and suppressions due to corporatization of healthcare. In the decade 2010-2019, public health lost 37 billion euros, all money that would have been used to strengthen first aid and to better reorganize basic care for the person. Today with the pandemic in the middle, which has turned the spotlight on the issue more than ever, the problem is not solved and the scarcity of human resources, health centers under constant pressure and a general disorganization continue to cause situations like those of Cardarelli, which he wished he would no longer have to see when, between the rushing of the ambulances and the saturation of the intensive care units, there was a chorus of shouting that we would come out better. In short, Italy, just like three years ago, remains that country where if you really have to end up in hospital, you should hope to do so to receive specialized treatments, where wild privatization and the resulting business ensure that the service offered is always the best. and not for a banal blood sampling, the gateway to hell.

It is a bitter taste to see that while a crisis of this magnitude is raging in the most important social sector of a state, health care, the government find nothing better to do than increase military spending from 25 to 38 billion per year. The clearest demonstration that after the most critical health phase that the country remembers, that pandemic full of promises and slogans, health is once again the last stage of priorities, even overtaken by tanks. And even when you tried to patch it up, it hurt. In the National Recovery and Resilience Plan (Pnrr) the good news lay in the financing of community houses, a form of reorganization of territorial medicine that was supposed to take the pressure off the hospitals and avoid the occurrence of Cardarelli-style situations. Too bad that in most cases these new structures have been set up without any public consultation, in places where there was often no need, continuing to leave areas uncovered which instead are in great difficulty from the point of view of health services. br>
If the biggest problem in Italy is, in short, that of cutting resources which for years has dealt a blow after another to the national health system, on the other hand there is a problem of organization and coordination that does not guarantee an improvement of the situation even when the resources are there. Difficulties that have been repeated for time immemorial and that illustrate well how efficient healthcare is the least of the concerns of rulers.

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