Who Will Be Left to Care for Us? The Italian Health Service Between Aging and Competencies
The smooth functioning of the national health system is increasingly affected by the high incidence of restrictions on duties. The study " The unsuitability and working limitations of Italian NHS staff (by Carlo De Pietro, William Pacileo, Agnes and Marco Pirazzoli Sartirana CERGAS of Bocconi), presented today at the University, calculates that the unsuitability (total, partial, permanent or temporary ) recognized only in the last decade affects 11.8% of the staff, or about 82,600 of 700,000 workers employed by the NHS.
"Considering that the analysis could not go further back in time due to the difficulty of finding documentation," says De Pietro, "and that, even within the period in question, we have lost track of many limitations recorded in the early years, 'the effective rate of unfitness is higher. To say that the phenomenon affects one in five workers can be considered a conservative estimate. "
In addition, employee unsuitability increases significantly with age, and the employees of the NHS are aging rapidly. The unsuitable are less than 4% in the age group between 25 and 29 years, but 24% between 60 and 64. The average age of employees is now approaching 50 years and increases at the rate of one year every 24 months. So, if the latest data available, which date from the end of 2011, totaled an average age of 47.3 years, we can expect that it is now a couple of years higher and continuing to grow.
The unsuitable are mainly concentrated in roles involving social welfare. The unfit among social health workers and technical workers reaches 24.1%, and among those who perform the professions of nursing and midwifery, 15.1%.
The majority of the limitations (62.1%) relate to the handling of heavy loads and patients with awkward postures, and ultimately detracts functioning of the wards in particular.
The problem is more prevalent among women than among men: 79.6% of employees with limitations are female and 20.4% male, especially because of the feminization of many professional profiles of healthcare. In all age groups the percentage of women with limitations is much higher than that of men, up to, for workers between 60 and 64 years, 31.8% for females, compared with 15.8% of males.
A thorough analysis of the phenomenon in nine health care structures employing more than 28,000 employees has moved the CERGAS working group to advance some suggestions on policy and management to mitigate the effects of the phenomenon. "First," says Carlo De Pietro, "companies must be able to perceive the extent of the problem, through the collection of organized and useful information. Currently, in order to conduct our research, we had to create our own taxonomy and compare information recorded on all types of media - often only on paper. "
Secondly, qualified doctors, who must evaluate employees, should be supported in developing a professional community with benchmarks that make assessment more homogeneous. The third suggestion is to promote a more active role of health structures in the management of limitations, for example, a system of professional dialogue, the involvement of labor representatives in safety issues and the definition of rules of personnel management that explicitly consider age.
The last, but probably most crucial suggestion, is the change of certain rules of the system, with a reorganization of the legislation on the subject that would make changes of qualification possible.