On July 31, the controversial system of "gettonisti" - doctors and
nurses hired by private cooperatives to work shift by shift - was
halted: Italy's local health authorities (ASL) are now forbidden to sign
new contracts with the cooperatives employing these professionals.
Existing contracts, however, remain valid until their natural
expiration. ---- This is a measure long hoped for, but its sudden
implementation inevitably sparks concern and uncertainty, given how
deeply embedded the gettonisti have become in Italy's National Health
Service (SSN). Today it's estimated that doctors on these temporary
contracts cover 20-30% of Italian emergency rooms - in some cases up to
80% of shifts.
The shortage of healthcare personnel is often framed as an emergency,
but in reality it's the predictable outcome of a deliberate strategy to
dismantle the SSN.
Austerity policies have hit healthcare with some of the harshest cuts.
Since 2004, no fewer than seven measures have limited new hires by
imposing spending caps on staff; none of the governments over the past
20 years have tried to reverse course, even while hypocritically
lamenting the SSN crisis and claiming urgent structural reforms were needed.
Symbolic is Law 191/2009 of Berlusconi's third government, which decrees
that "personnel expenses[...]shall not exceed for each of the years
2010, 2011 and 2012 the corresponding amount of 2004, reduced by 1.4%."
As with this measure, other restrictions were initially temporary but
then renewed and entrenched by successive governments - the classic
script where the normalization of an "exceptional state" paves the way
for a new paradigm. And the paradigm is precisely the shift from public
to private healthcare, from a universal system to an exclusionary and
unequal one. As in many other sectors, health services are being
forcibly outsourced, with strategies that, in the case of the
gettonisti, border on the absurd.
Gettonisti are paid by the ASL (through cooperatives) salaries up to
five times higher than those of permanent employees, often working
beyond the hours allowed by national contracts and sometimes providing
mediocre service: understandable, as they don't live the daily life of a
ward and often lack the right qualification or the psychophysical
stamina needed (it's not uncommon to see doctors over 70 years old in ERs).
A brief "anthropology" of the gettonista is worth sketching: the
category contains impulses not always to be condemned, from a spirit of
protest to the desire for greater economic and social mobility. There's
the fresh graduate working "a bit in France, a bit in Dubai"; those who
work half the year; those planning to buy a Porsche. But often, those
who turn their backs on the SSN's safe harbor carry frustration, the
urge for redemption or revenge - an expression of a wider distrust
toward institutions. The "Great Resignation" phenomenon is so
far-reaching that it demands serious reflection.
Not infrequently, the gettonista combines profit maximization -
presenting as a perfect homo oeconomicus, a true child of neoliberalism
- with union grievances and a drive to sabotage a system perceived
(often rightly) as unjust, unequal, estranged from its universalist
ideals, and incapable of valuing competence.
It's not for us to judge whether these impulses are sincere or merely
mask a latent guilt - the stigma inevitably weighing on the gettonista:
being little more than a mercenary or, worse, a vulture feeding on the
carcass of a dying SSN.
You might ask: why are ASL willing to pay these exorbitant rates instead
of hiring stable, qualified staff?
First, because many jobs have truly become unattractive; competitions
are announced but go unfilled. And this is true not only for emergency
care, as one might expect, but also for specialties. Today it's not rare
to find gynecology, neurology, internal medicine, and orthopedics
staffed by gettonisti.
But above all, it's about the spending cap mentioned earlier. Often ASL
can't hire new staff because they'd exceed their personnel budget
limits. So how do they pay for gettonisti? Simple: by categorizing them
under "Goods and Services" - like a canteen, an electrical contractor,
or any other outsourced service needed to run a hospital.
It's clear, then, that the issue isn't purely financial. If ASL have the
money to pay gettonisti, they'd also have it to hire directly. This
proves it's a political choice: the move from a public to a de facto
private system.
Several ASL, now dependent on gettonisti, are already asking to delay
the decree's application. Whatever path the government takes, it's easy
to imagine the only way to keep many emergency rooms open will once
again involve tricks. These are already on the horizon: direct hiring of
doctors as freelancers (essentially gettonisti without the cooperative
middleman) or temporary hiring of trainees, underpaid and often unqualified.
Thus, the sudden halt to new contracts - without a serious policy to
assess and meet healthcare staffing needs - seems just another
(pseudo)muscular move by the government: a blend of false pragmatism,
anti-bureaucratic rhetoric, and anti-scientific populism. A propaganda
strategy to calm public anger while hiding the decades-long agenda:
dismantling public healthcare to protect the interests of industrial and
mafia consortia.
Riccardo
https://www.sicilialibertaria.it/
_________________________________________
A - I N F O S N E W S S E R V I C E
By, For, and About Anarchists
Send news reports to A-infos-en mailing list
A-infos-en@ainfos.ca
nurses hired by private cooperatives to work shift by shift - was
halted: Italy's local health authorities (ASL) are now forbidden to sign
new contracts with the cooperatives employing these professionals.
Existing contracts, however, remain valid until their natural
expiration. ---- This is a measure long hoped for, but its sudden
implementation inevitably sparks concern and uncertainty, given how
deeply embedded the gettonisti have become in Italy's National Health
Service (SSN). Today it's estimated that doctors on these temporary
contracts cover 20-30% of Italian emergency rooms - in some cases up to
80% of shifts.
The shortage of healthcare personnel is often framed as an emergency,
but in reality it's the predictable outcome of a deliberate strategy to
dismantle the SSN.
Austerity policies have hit healthcare with some of the harshest cuts.
Since 2004, no fewer than seven measures have limited new hires by
imposing spending caps on staff; none of the governments over the past
20 years have tried to reverse course, even while hypocritically
lamenting the SSN crisis and claiming urgent structural reforms were needed.
Symbolic is Law 191/2009 of Berlusconi's third government, which decrees
that "personnel expenses[...]shall not exceed for each of the years
2010, 2011 and 2012 the corresponding amount of 2004, reduced by 1.4%."
As with this measure, other restrictions were initially temporary but
then renewed and entrenched by successive governments - the classic
script where the normalization of an "exceptional state" paves the way
for a new paradigm. And the paradigm is precisely the shift from public
to private healthcare, from a universal system to an exclusionary and
unequal one. As in many other sectors, health services are being
forcibly outsourced, with strategies that, in the case of the
gettonisti, border on the absurd.
Gettonisti are paid by the ASL (through cooperatives) salaries up to
five times higher than those of permanent employees, often working
beyond the hours allowed by national contracts and sometimes providing
mediocre service: understandable, as they don't live the daily life of a
ward and often lack the right qualification or the psychophysical
stamina needed (it's not uncommon to see doctors over 70 years old in ERs).
A brief "anthropology" of the gettonista is worth sketching: the
category contains impulses not always to be condemned, from a spirit of
protest to the desire for greater economic and social mobility. There's
the fresh graduate working "a bit in France, a bit in Dubai"; those who
work half the year; those planning to buy a Porsche. But often, those
who turn their backs on the SSN's safe harbor carry frustration, the
urge for redemption or revenge - an expression of a wider distrust
toward institutions. The "Great Resignation" phenomenon is so
far-reaching that it demands serious reflection.
Not infrequently, the gettonista combines profit maximization -
presenting as a perfect homo oeconomicus, a true child of neoliberalism
- with union grievances and a drive to sabotage a system perceived
(often rightly) as unjust, unequal, estranged from its universalist
ideals, and incapable of valuing competence.
It's not for us to judge whether these impulses are sincere or merely
mask a latent guilt - the stigma inevitably weighing on the gettonista:
being little more than a mercenary or, worse, a vulture feeding on the
carcass of a dying SSN.
You might ask: why are ASL willing to pay these exorbitant rates instead
of hiring stable, qualified staff?
First, because many jobs have truly become unattractive; competitions
are announced but go unfilled. And this is true not only for emergency
care, as one might expect, but also for specialties. Today it's not rare
to find gynecology, neurology, internal medicine, and orthopedics
staffed by gettonisti.
But above all, it's about the spending cap mentioned earlier. Often ASL
can't hire new staff because they'd exceed their personnel budget
limits. So how do they pay for gettonisti? Simple: by categorizing them
under "Goods and Services" - like a canteen, an electrical contractor,
or any other outsourced service needed to run a hospital.
It's clear, then, that the issue isn't purely financial. If ASL have the
money to pay gettonisti, they'd also have it to hire directly. This
proves it's a political choice: the move from a public to a de facto
private system.
Several ASL, now dependent on gettonisti, are already asking to delay
the decree's application. Whatever path the government takes, it's easy
to imagine the only way to keep many emergency rooms open will once
again involve tricks. These are already on the horizon: direct hiring of
doctors as freelancers (essentially gettonisti without the cooperative
middleman) or temporary hiring of trainees, underpaid and often unqualified.
Thus, the sudden halt to new contracts - without a serious policy to
assess and meet healthcare staffing needs - seems just another
(pseudo)muscular move by the government: a blend of false pragmatism,
anti-bureaucratic rhetoric, and anti-scientific populism. A propaganda
strategy to calm public anger while hiding the decades-long agenda:
dismantling public healthcare to protect the interests of industrial and
mafia consortia.
Riccardo
https://www.sicilialibertaria.it/
_________________________________________
A - I N F O S N E W S S E R V I C E
By, For, and About Anarchists
Send news reports to A-infos-en mailing list
A-infos-en@ainfos.ca
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