Covid-19: A Perspective For The Italian Health Service

The COVID-19 epidemic has highlighted the structural shortcomings of the national health service, mainly attributable to the gradual reduction of public funding for the sector. An expenditure policy that finds its motivation both in the need to contain public finance aggregates due to EU constraints and in the allocative choices made in recent years between the components of welfare services expenditure. The possibility of accessing the new and greater resources made available by European programs as a result of the COVID-19 epidemic opens up new perspectives both in terms of funding sources and interventions on the service. The choice in the allocation of resources becomes crucial for the future sustainability of the health system where investments must be such as to guarantee an increase in productivity greater than the increase in current resources. To achieve this, the privileged areas of intervention are represented by the hospital network, post-acute residential network and long-term care services as well as territorial and home care services. Prosecution of regulatory interventions on the rules governing the decision-making processes of public investments is also a condition for the feasibility of the expected prospects for the national health service. In the same way, it is necessary to re-establish the balance in terms of accountability in the actions of public administrations bringing the judicial risk (accounting, civil and criminal) to the true pathological behaviour of the actors of the system. COVID 19: una prospettiva per il sistema sanitario italiano L’epidemia di Covid 19 ha messo in evidenza le carenze strutturali del sistema sanitario nazionale riconducibili soprattutto alla progressiva riduzione dei finanziamenti pubblici al settore. Accanto alla definizione dei corretti obiettivi allocativi per i nuovi programmi di investimento è condizione di realizzabilità delle prospettive attese per il Sistema Sanitario Nazionale anche la prosecuzione e il consolidamento dei primi interventi normativi effettuati sulle regole che presidiano i processi decisionali degli investimenti pubblici e a quelli tecnici e finanziari legati alla loro attuazione. Allo stesso modo si rende necessario ristabilire a livello normativo l’equilibrio in termini di accountability nell’esercizio dell’azione delle amministrazioni pubbliche, riconducendo il rischio giurisdizionale (contabile, civile e penale) all’ambito dei comportamenti effettivamente patologici degli attori del sistema.