A recent chorus of criticism echoed against the announced cuts to the SNS. And rightly so, no one believes that it is possible to cut hundreds of millions without harming patients. The State Budget proposal envisages removing around 800 million euros from SNS purchases, which is equivalent to reducing 10% of the current expenditure of hospitals and health centers. Government officials avoid the word “cut”, preferring “improve efficiency”. But, regardless of the euphemism, the reality is simple: less money available will mean less care, at a time when the system is already experiencing enormous difficulties.
The SNS exists to defend patients. It was created to ensure access to quality healthcare for all. This mission is not compatible with measures that delay diagnoses or limit treatments. At the end of June, almost one million users were waiting for a first consultation, and more than half had already exceeded the maximum guaranteed response times. How, then, can we accept guidelines to “slow down” consultations and surgeries? It is unthinkable to betray the duty of care.
Financial rigor is necessary, and the budget is not elastic. But choosing to cut spending on Health is a political decision that reflects questionable priorities, especially when there are other areas to look for savings. Even admitting the need to optimize costs, we cannot start at the end, cutting back on patient care. Asking hospitals to reduce activity, as was reported this week, knowing the negative impact on patients, is unacceptable. No matter how much there is talk about “improving efficiency” or cutting “fat”, wanting to reduce expenses and, at the same time, improve the NHS is an impossible equation. Anyone who truly knows the sector knows the growing and inevitable weight of the costs of innovation, technology and human resources.
There are, however, ways to save. Combating fraud and abuse of resources, estimated at 800 million euros, is essential. Improving management and purchasing, renegotiating contracts and reducing bureaucracy can free up funds without compromising quality. But the real leap may be in the digital transformation of the NHS, with a single e-health process, interoperable platforms and telemedicine, which can reduce waste, avoid duplication and shorten waiting lists. Artificial intelligence, applied in an ethical and supervised way, can help with management and care, allowing doctors to focus on what is irreplaceable: human contact. In short, efficient and rigorous management.
Financial sustainability is essential, but never at the expense of patients. Health is not a budget variable, it is a fundamental right. “Optimizing resources” cannot mean denying care or postponing surgeries. Rigor, yes; blunt cuts, no. Patients are not a waste, the NHS only fulfills its mission if it is modern, efficient and, above all, faithful to its mission of caring.
Chairman of the Order of Doctors