Waiting lists continue to represent "a structural criticality of the Italian healthcare system", linked not only to the effects of the pandemic, but also to organisational, management and planning factors.
Despite the strengthening of the regulatory and financial framework "implementation difficulties, staff shortages and territorial differences persist which limit the effectiveness of the interventions". The Court of Auditors states this in the report on "The implementation of measures aimed at reducing waiting lists", also underlining that "the increase in funding has not always produced proportionate results in terms of services provided and reduction of waiting times".
In the period 2022-2028, the resources allocated to containing waiting lists amount to approximately 3.71 billion euros, while in the four-year period 2022-2025, according to data from the Ministry of Health, against state allocations amounting to approximately 1.845 billion euros, approximately 1.58 billion were used, underlines the Court.
"The lack of completeness and uniformity of the information transmitted by the Regions, however, makes a precise evaluation of the use of the funds and the results achieved difficult", it is highlighted.
In this context, the measures introduced by Legislative Decree 73 of 2024 outline a new governance model, based on the strengthening of control systems, digitalisation and the timely availability of data. A system which, according to the accounting judiciary, "could favor a structural improvement of the system, the effects of which can be fully assessed only after the full implementation of the planned interventions".
From the National Waiting List Platform (Pnla), "particularly relevant for the interoperability of regional systems and the availability of comparable data, critical issues emerge in the regional use of the 'P' (scheduled) priority class, differences between the appointment dates proposed and those accepted by citizens, as well as delays between the prescription and the first contact with the CUP and gaps between the prescriptions issued and the bookings registered".
The analysis confirms "difficulties in expanding the healthcare offer, even in the presence of adequate financial resources, due to the shortage of personnel, especially specialists, and therefore recalls the need to complete the reform of local assistance envisaged by the Pnrr and by Ministerial Decree no. 77 of 2022, to improve care, reduce improper demand and lighten the pressure on hospital structures and specialist services".
The accounting judiciary therefore recommends accelerating the implementation of the 2024 decree, completing the interoperability of the Pnla, strengthening control over the use of resources and the results obtained, improving the planning of care needs and adopting structural interventions to overcome staff shortages.
For the Court, "it is also necessary to make the accountability mechanisms more effective, promptly identifying non-compliances, applying the foreseen sanctions and exercising, when the relevant conditions are met, the substitutive powers".
A lasting reduction in waiting times and timely and equitable access to healthcare services "require - concludes the document - transparency, continuous monitoring, institutional responsibility, efficient use of resources and timely reporting of results".
