The Polyclinic is one of the hottest topics in the race to vote for the election of the next rector of the University of Messina and the three candidates – the director of Economics Michele Limosanithe former vice-rector Giovanni Moschella and the former vice-chancellor Giovanna Spatari – they dedicate more or less large chapters of their respective programs to the university hospital. There is no shortage of common points, despite the fact that the candidates are the expression of different “political” areas within the University: for example, the question of the working hours of university teaching staff engaged in welfare activities, the issue of EP professionals (but it should be remembered also category D, biologists, physicists and other professional figures on which equally many unknowns hang), compliance with the memoranda of understanding. And above all the return of the Polyclinic to the center of university life.
Michele Limosani’s debut is tough, one of many attacks on Cuzzocrea management: according to the “opposition” candidate, the university hospital company “has suffered a constant and systematic regression from 2019 onwards”. There are four main reasons, according to Limosani: «The transformation of the Aou into a Covid hospital during the pandemic; the useless and fruitless pursuit of the transformation of the Aou into Irccs; centralized management without any shared development of objectives and strategies with the institutional bodies of the Aou envisaged by the memorandum of understanding and the university bodies envisaged by the University Statute; the unreasonable and too prolonged commissioner leadership of the company”. For Limosani there is only one recipe: «Let’s allow the University to finally return to being a protagonist in its Polyclinic. We need much more universities in the Aou than there have been in recent years, to the detriment of what was wanted by those who should have defended it and, instead, have inexplicably opposed it.” There are two main objectives. First: «To fully recognize the university departments and the School of Medicine and Surgery as having a significant role in the health planning of the Polyclinic which, I remind you, is characterized by the inseparability between teaching, research and assistance. This is a role which unfortunately has been widely ignored in the recent past.” Second: «Build a team made up of more than one pro-rector, starting from the one with the specific delegation to relations with the Aou and the scientific director who constantly assists the rector in defining all the political and management choices, both current and programmatic nature, inherent to university healthcare”. Limosani also announces that «I will fight to ensure that the name “Policlinico”, unexpectedly removed, returns to all official documents and deeds of the Aou». Another delicate point: «While waiting for a rule from the national legislator, I intend to put a decisive word on the matter that has unexpectedly damaged the Ep (High professionalism, ed.) doctors who work at the Polyclinic, through a modification of the memorandum of understanding between the Region and the University of Messina currently in force”, recognizing, in fact, “the right to the conferral of the managerial role”. Courses chapter (also with reference to the agreement with Papardo): «The structural resources currently available in the University and the number of teaching staff do not seem to be sufficient to meet the needs of the increase in the student population» which has occurred in recent years. «Interventions aimed at strengthening and enhancing the University’s structures are necessary, with the consequent technological adaptation, and the development of a recruitment plan to hire new teachers». And “every course” should return to the Polyclinic.
Among the other key points: «Reorganization of the emergency room activity; rationalization of the logistical distribution of post-operative intensive care places; request for a new evaluation of the requirements necessary for the reactivation of the breast unit; implementation of IT services for bookings and collection of reports”.
Moschella, in the introduction, also speaks of «tensions and divisions» created in recent years, after which «I consider it necessary to have a phase of serenity that allows us to work with confidence and tranquility on scientific research and healthcare activities. The objective to be pursued is to start a shared path between all the parties involved, which makes the university hospital a truly attractive center for Southern Italy. The University, in particular, must return to playing a leading role in the management of the university hospital, considering the essential contribution that can and must be provided by university doctors, due to their multiple skills and professionalism”. Moschella dedicates a paragraph to the topic of “relations with the regional health system”. And here too, «it is necessary, first of all, to note that there are already institutional offices and channels which, in recent years, have not been adequately valorised and whose full effectiveness, however, must be guaranteed. I am referring, in particular, to the Interdisciplinary Linking Structure (Sr) of the medical area, to the Steering Body and to the Management Board of the AOU”. In summary, «the institutional offices and tools exist. There is no need to create new ones. All it takes is to abandon the dirigiste logic and adopt a participatory and authentically democratic vision.” As regards staff, «the growth of the Aou must pass through renewed attention paid to all university staff assigned to the Company, both teaching and non-teaching, rethinking with a shared method the problems that characterize working space and time. The reference is also to the category of EP staff, who deserve to have a role suited to the work commitment they put into the care facilities on a daily basis.” Moschella explains that he wants to «create a specific University structure which, with the help of dedicated administrative staff, facilitates participation in national and international competitive tenders, assisting researchers not only in the eligibility assessment and planning phases, but also in the drafting of progress reports, management of technical-financial documentation and project reporting. Particular attention will obviously be dedicated to European and international projects in the medical field, especially if they are interdisciplinary and transdisciplinary”. Therefore, for the former vicar «measures are necessary and urgent aimed at increasing the attractiveness of specialization schools in the health area, through: the establishment of teaching courses, optional and transversal to the different specialist branches, aimed at the acquisition of skills methodologies functional to scientific research; the promotion of the research activity of postgraduates, by reserving an annual quota of the operating funds of the specialization schools”. And finally «the facilitation of the inclusion of new residents away from home, providing general logistical information and facilitating their search for housing solutions both in the medium term and for short periods».
The former vice-rector starts from the most delicate period in the history of the Polyclinic: «Certainly the emergency phase due to the pandemic did not help, although it is necessary to highlight how our Polyclinic, in that historical phase, played a fundamental role for the entire provincial territory ». Having closed (more or less) the Covid chapter, «today, however, some problematic issues remain on the table such as, by way of example, the age of the pavilions and the systems, the overall reorganization of the services and above all the question relating to the headquarters and the role of our emergency room”. Looking to the future, according to Spatari «the separation of the medical areas from the surgical ones will reduce interference and overlaps» and, from this perspective, «the separation of the various pavilions based on specializations will also favor interprofessional communication». As far as students are concerned, “the provision of quality teaching in the medical field also and above all involves adequate infrastructure” and “the same need is also recognized with reference to the research profile”.
Another chapter: «In terms of the full valorization of medical-health personnel, a crucial profile is certainly that represented by the promotion of the careers of health professionals». One of the key words is “clinicalisation”: «An absolutely priority intervention direction that tends to reduce costs deriving from excessive use of hospital resources and to promote more efficient management of nosocomial problems». But “to ensure that the initiatives to be undertaken do not remain mere statements of principle, I am convinced that it is necessary to launch every appropriate initiative aimed at adapting the spending ceiling, currently among the lowest in Sicily”.
Spatari admits that «the field of relations between the University and the hospital is the one in which, given the cohabitation of staff belonging to different roles and institutions, the elements of possible conflict are most marked. To overcome the difficulties encountered in this area, it is necessary that the points envisaged in the memorandum of understanding between the Region and the University be fully implemented, through constructive and constant discussion with all interested parties”.
The former vice-rector announces that «I will promote a targeted policy dedicated to the identification of sources of funding for research with simultaneous full support for experimental research activities in the bio-medical-health field also at an interdisciplinary level». And «with specific reference to the sustainability of degree courses in Medicine and health professions, it will be necessary to guarantee the highest quality in terms of the provision of the training offer, while being fully aware that these activities are particularly burdensome both with reference to the financial profile and to the technical-organisational one”. Furthermore “it is intended to provide for the offer of suitable support initiatives for students who wish to carry out the internship activity”. On the case of the EPs, “I believe that it is a priority to start a fruitful consultation at regional level, and if necessary at ministerial level, to resolve an issue in a certain and definitive manner”.