In 2022, there really is no reason, no reason, for healthcare in Puglia to be any different than any other part of the country in terms of efficiency, productivity and competence. Medical science is one. From elementary school to nurses, everyone has studied somewhere in Italy – often abroad – and many have returned to their respective cities, provinces and regions. Their training paths intersect with those of thousands of colleagues who have arrived in university classes from other regions: they share studies, books, professors, universities. Passion. It is not the quality of the professionals that is discussed, but the average level of performance. So?
Why, then, do we move from South to North and not have the reverse? Why this intolerable surplus of pain that are the journeys of hope? Why is Puglia sinking under a mountain of debt (412 million in just two years, the latest figure) for services supported elsewhere? Why do the notions of “care” and “take care” have value in certain centers and less, much less, in others? Why do so many people jump on cars, trains and planes to leave Puglia even for modest interventions? Why more than 50% of cases, according to official accounts, concern low (low!) complexity services? What makes the difference? What do we not trust? What are we afraid of? The disaster doesn’t start today, of course, although today is the indefinite (and infinite, so good for any season) time when plans are announced and changes are announced.
If the problem is not (or is not all) in the training of health professionals, it must be somewhere. It may be in us, it may be: we often think that elsewhere is a reliable place to even lose weight. But that is still not enough. It is perhaps in the territorial imbalance for the distribution of funds, so that outside – and not here – it is easier to engage in virtuous paths that catalyze attention, attract patients and therefore hoard more resources (and in any case the eternal glory of places and people of excellence, wherever they are on the ground). It will be true, all of that. And there is no reason to doubt it. Or maybe, more realistically, only partially true. And it is on this, the remaining part, that of the abyss and despair, the bad part of inefficiency, the not exactly residual part of insufficiency, it is on all this – therefore – that he will have to ask a few questions. Necessarily.
For example: overall organization, assistance to users, proximity to suffering people (including relatives), okay? The selection of the ruling class, the allocation of resources, the delivery of services, nothing to complain about? Patronage, favouritism, familism and the whole suite of “isms”, all under control? The complaints of the sick, the accused mistreatment, the attributed insignificance and the inattention reserved for the evil and the discomfort of others, always far-fetched? Really? Are you sure?
They say that when there is health, there is everything. Extraordinarily true in times of war and pandemic. But health is not given once and for all, like an indestructible, unassailable and immortalized inheritance. It must be preserved, safeguarded and, if necessary, restored, when possible, with the tools available, with professionalism in service, all, here and elsewhere, without distinction. Back to acceptable and decent levels. But to do this requires structures, efficiency and dedication, prerequisites necessary for health, in fact, to exist and really be everything for the simple fact of enjoying it to the full, and certainly much more than any other physical situation and condition of listening. Otherwise, in the absence of minimum levels, popular sayings also inevitably stumble and crumble. With all the complications of the case, at least in these regions. For known issues.