It is an evergreen issue of the NHS tariff prosthetics and assistive technology. But it is a classic for nothing loved that leads to a nostalgia junk. Launched by the Ministerial Decree 332 of 27 August 1999 with the intent to be updated every three years at most, contains the classification of what the health care system in terms of grants and aids related. And now here first Italian curiosity: while the nomenclature awaited its lawful update accompanied by proclamations, battles and attempts disregarded, the very definition of aid has changed, adapting to the new criteria proposed by the ICF (International Classification of Functioning , Disability and health). The world has moved on, the approach to disability has changed, and the products made available to persons with disabilities by technological development have increased remaining closed off by a cataloging obsolete still in use. Health Minister Lorenzin recently illustrated the imminent launch of the new nomenclature. There are many new features, some controversy and doubt recurring: will be the right time?
That’s nomenclature is a story that sees the experts, associations and all those who follow the fortunes of the legislation on the rights of disabled people in our country engaged in a campaign that lasts for exhaustion. Trench warfare with the aim of expanding the range of products classified to allow everyone access to the best available principals that the market proposes eliminating those superseded by time, or rationalizing the offer. But the verb update from us goes hand in hand with the verb redo. And the verb remake with that wait. Which so far has come to coincide with the adjective vain. So nothing has changed since that ’99.
The nomenclature is divided into three lists, one health benefits prosthetic , another series of technical aids and third of the equipment purchased directly by USL and assign in use to disabled . The first concerns the devices made to measure and those of series whose application requires changes made by a qualified engineer, the second relates to serial devices whose application or delivery does not require the intervention of the technician and the third contains devices purchased directly by local health authorities. Anything that does not fit into this classification is granted in exceptional circumstances only for people with serious disabilities, or only if it is a device that can be traced to the most similar content in the nomenclature, but delivering a cover expenses not exceeding the aforementioned akin.
In 1999, there were standing in energy return, sophisticated mobile lifts and stationary, digital hearing aids, communicators to-speech and a thousand other tricks useful to reduce the disabling condition that there are today. All aids that the Minister of Health Lorenzin ensures that they will be covered in the new catalog. As part of the rationalization disappear self-propelling wheelchairs on the front wheels, the motocarrozzine three-wheeled footwear coating for implants … A great leap towards democracy of AT, which becomes a garrison more widely accessible. Announcements are illustrated by Lorenzin hearing in the Senate of Wednesday, February 4 that provides an update “continuous and systematic” in the nomenclature. However the coveted news does not get support from the plebiscite.
The new nomenclature provides that aids series that are provided by local health authorities are purchased through calls for which the ministry is committed to providing the regions tools that the tenders are made in a reasoned way, that is not the race to the minimum price but encourage maximum personalization . This, however, does not reassure those who see in this method the risk of not get to have the support most appropriate. And so Marco Gentile, co-chairman Luca Coscioni and prepared a petition addressed to Renzi and hopes Lorenzin where the application of a European model consists of a repertoire all models available with costs to the national health service, so that the choice can be clear and agreed between prescriber and assisted .
To learn more, I asked Renzo Andrich which I think is one of the leading experts on aids and also hopes a repertoire of aids, referring to the European Position Paper published in 2012 dall’Aaate (now European scientific assistive technologies) that recommends a medical model only to principals that have a clinical risk and a social model for aids that do not have.
However, the same Andrich argues that “the top priority at the moment is that the new nomenclature to be launched soon. Every although well intentioned improvement initiative, if it were to lead to postponement of the times, it would be absolutely detrimental at this time. We could rightly say that “the best is the enemy of the good.” History repeats itself: in 2008 a new nomenclature was about to see the light at the last moment he was held back by regional officials with the good intention to calibrate some imperfections, arrived at the last minute on the table of the minister, was signed at a time when the falling Government and never came into force because the government later withdrew for further clarification. “
The war of position continues. A good law seems a goal unconquerable. And the ranks of the troops meanders a thought: rather than anything that is better than?
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