Imitations will always lack the quality of the original. Following
elections the United States' Constitutional Law gives the elected
president the authority to assign his trusted people to leading
positions to form a staff that clearly numbers skilled managers
and expert professionals who will implement the government's political
specifications in various sectors. This rotation is called 'Spool
System'. In Italy the Spool System is applied according to the
card game rule "the Ace wins all". Both before and after
elections, wherever there is a chair, whether it is for an errand
boy or a general manager, the person occupying it will suffer
the tension and uncertainty resulting from the awareness that
he must leave his place to newcomers, to people in the winner's
coalition who must be "given jobs". The following is
what occurs in the Health sector. Let us for example consider
the Lazio region where Local Health Administration directors,
general managers of hospital units, directors of departments and
so on have been replaced straight away in record time and where
programmes that were previously approved by the former administration
have been blocked for the only too obvious purpose of making room
for aspirants already appointed by the new president. The President
of the Lazio Regional Administration, former defender of society's
rights Marrazzo, who owes his fame to the television programme
Mi manda Rai 3, is the typical example of how one may not practice
what he preaches. In the NHS the Spool System is also applied
to highly specialised posts, which envisage assignments through
competitive examinations. Hence a Spool System designed to find
jobs for friends, wife, children, and why not the lover? Today
the latter is called 'partner', but we prefer the term 'lover'
because it calls to mind feelings, even if they are outside the
rules, while the term 'partner' instead recalls memories of outings,
childhood games and similar experiences… that are not always
pleasant for all. However it requires a special talent to apply
the Italian Spool System and a "school of thought",
otherwise it is impossible to understand why Francesco Storace,
the current Minister of Health, has never succeeded in replacing
at least one commissioner in Pavia! The real problem is: what
will be the cost of all this in economic terms? How much will
such a shameless politicisation of the National Health Service
cost the Italians' health? The best go abroad and those who cannot
do so live a life of frustration void of all enthusiasm,…
scraping a living while intellectual stimulus is crushed by the
uncertainty of a future - Waiting for Godot - one who will change
the written rules once again and especially apply them as he wishes
to suit his interests and to further his political career. Funds
allocated for research will not suffice to compensate for the
loss of so much potential and the topic of NHS faults will be
discussed more and more often. And as Cronin wrote: The Stars
Look Down
Genina Iacobone
Direttore di Leadership Medica