The last two years have undoubtedly highlighted the need to rethink and renew the health system, redefining its responsibilities, identifying more efficient and effective recruitment and training methods, articulating in new forms the relations between public and private.

This is a priority issue in several respects. In the first place, with regard to the reform of university studies: the Universities are, in fact, called to change the organization of the Faculties and Schools of Medicine to ensure that young people have a more rapid academic path, strengthening the skills needed to find, select and use the ever-expanding knowledge, now available and shared thanks to technological innovations and their global dissemination. They are called, that is, to train competent and flexible doctors, able to grasp the unstoppable development of research, technology, the production of new drugs – excellence of many Italian companies.
The effects of COVID, which have dramatically affected the elderly, have highlighted the problem of an ageing population as never before, making it necessary to develop coherent and innovative actions to manage its consequences, starting from the construction of suitable structures to host in a dignified way those who lose their capacity and autonomy. This issue involves almost all Italian families and can not be addressed with partial interventions and, in any case, strongly differentiated depending on the region or even the city in which you live, even considering precise articles of the Constitution often recalled, almost always disregarded.
With regard to the proposal to introduce new structures and territorial garrisons, such as community homes and hospitals, the strengthening of home care should be carefully considered, which should complement the development of telemedicine and the real and comprehensive integration of all health and social services. Similarly, the usefulness and effective implementation of a single point of access to healthcare, especially for the chronically ill, should be monitored. A shared model for the provision of home care should be identified, taking into account the need to strengthen the supply of intermediate care entrusted to the constituent community hospitals, community homes and perspectives related to telemedicine.

The strengthening of the national health service in providing innovative services, that is, should be achieved through a series of legal instruments aimed at reducing bureaucracy and providing more expertise.
The reorganization of the IRCCS, Instituto di Ricovero e Cura a Carattere Scientifico, hypothesized by the end of 2022, seems deprived to the state of a regulation that provides and regulates the relationship with the Universities and Faculties and Schools of Medicine. A realistic assessment of the situation does not reveal any significant results in the exploitation of research within these structures, and in any case create a preferential relationship with the Region has no reason to be since it is to the entire SSN that the IRCCS should respond.
Furthermore, the need to provide management skills for health professionals is evident, in order to “face current and future challenges in an integrated, sensitive, innovative, flexible, always result-oriented perspective”, according to the words of mission document 6 of the PNRR. In this regard, the idea of setting up a body that would be largely representative of the NHS leadership should be carefully considered.

We must not forget the strengthening of the technological and digital structures of the SSN at central and regional level, since the organisational innovations of the digital revolution take on full significance only if they involve all the medical-health personnel. The enhancement of telemedicine in fact implies an important intervention also on current professionals, called to respond to change and to a medical-organizational update now indispensable.

Last but not least: the problem, exploded with the COVID, of the quality of communication to citizens when collective health runs an immediate risk. In the context of the pandemic, the circulation of controlled information has been disrupted by the dynamics of misinformation and misinformation, not only by people without specific knowledge and knowledge, but also by scientists and experts who have dominated television and other living rooms, contradicting each other almost always in a disorganized way.


Fabio Roversi-Monaco
President Fondazione per la Promozione e lo Studio della Scienza Medica