Dr. Andrea Valdré, Director CHP

Dr. LAURA ZECCHI

Development and strategic planning CHP

EUROSOCIALNETWORKTHE NATIONAL HEALTH SERVICEThe territorial Healthcare Unit of

FlorenceThe social services in the municipalities

The interaction among services

Project approved by the Tuscan District with Italian Decree No. 1975 of 22/04/2010 Regional Operational Programme ob. 2 Axis V “Transnationality and interregionality. Transnational projects submitted by Tuscan Provinces/Districts”.

Implementing body: temporary association for a special purpose between the Province of Florence (leader) and Irecoop Toscana cooperative company (partner).

Healthcare in Italy is based on Art. 32 of the Italian Constitution, which officially recognizes health as a fundamental right of the individual.

Italian Consitution- Article 32The Republic of Italy safeguards health as a fundamental right of the individual and as a collective interest, and guarantees free medical care to the indigent.

No one may be obliged to undergo a particular health treatment except under the provisions of the law. The law cannot under any circumstances violate the limits imposed by respect for the human person.

The health reform in 1978(the same year of the WHO Conference in Alma-Ata)

Principle of universality: according to which health benefits are guaranteed to every one without distinction of individual, social or income conditions;

Principle of equality: according to which every one has the right to the same benefits, their needs being equal;

Principle of globality: according to which it is not the disease which is taken into consideration, but the person in general, this necessarily infers a connection among all health services of prevention, treatment and rehabilitation.

Population

Area

Density

Fiscal burden/GDP

Over 65

60 millions

301,225 sq. km

163.1

43.2 %

21 %

9 millions

449,964 sq. km

21.9

47.8 %

17 %

The National Health Service (NHS)Since 2011 regional districts

administrate public health.

Through the Local Health Units (Italian: ASL) the regional districts provide hospital services, healthcare in the districts and prevention.

Every Local Health Unit organizes, provides and purchases services from the private sector and from voluntary associations in Tuscany.

Tuscany3,7 millions population287 Municipalities9 Provinces12 Local Health Units

Our territorial Health Unit

6.500 employees5 hospitals4 zones33 municipalities

Population

Over 65

Resident migrants

Life expectancy at birth

217,000

48,201 (20.18)

20,208 (9.4 %)

80.49 - 85.33

365,000

94,664 (21.82)

46,268 (12.4%)

79.95 – 84.96

Area North-Western Florence Area Florence

Healthcare services

Area: North-Western Florence

Primary care 200 General Pratictioners. nursing services

Adult mental health Child mental health Addiction care centres (Addiction to drugs, alcohol, smoke, etc.)

Social services Prevention

Social services – (Law 328/2000) The Italian Republic assures to people and to

families an integrated system of social interventions and services, promotes interventions in order to guarantee the quality of life, equal opportunities, non-discrimination and rights to citizenship; it prevents, cancels or reduces the conditions of disability, need and individual or family deprivation rising from the inadequacy of income, social difficulties or non-autonomous situations.

The role of municipalities (Law 328/2000)

The municipalities are responsible for the administrative functions concerning the social interventions at local level and contribute to the regional planning.

The planning and carrying out of the local system of social services.

Areas of expertise of the municipalities

Information to the citizens for the access to the services. Professional social services, counselling and contract of

undertaking Foster care and international adoption. Cultural mediation and social integration. Job placement. Home care. Aid grants, meal tickets, tuition fees for day care centres… Fees for adult day care centres and day carers for elderly

people or disabled, etc. ………………………

The Community Health Partnership of the north-west zone of Florence is a public consortium that includes the eight municipalities of Calenzano, Campi Bisenzio, Fiesole, Lastra a Signa, Scandicci, Sesto Fiorentino, Signa and Vaglia. It was created in 2004, in response to the 2002 Tuscany Regional Health Plan, to better integrate social and health services and improve services for the disadvantaged population, including socially excluded immigrants. Since then, 17 other communityhealth partnerships have been created within the Tuscany Region.

Plus Municipalities and the Territorial Health Unit join together in a single BODY and develop complex projects which involve different private entities in order to cope with the needs of a wide area.New feature: the project salvages the previous little plans and everything is carried out together.

ADVANTAGES

The private entities share common working methods and good practices, rationalize the resources and reduce the managing costs The public body offers more opportunities to less wealthy citizens. It develops a role of strong coordinator of the territorial policies.

WEAKNESSES: this system works only if the public body can wield a strong coordination also on the activities of common planning.

A few projects examples:

Social exclusion (reception shelter for women with children, adult shelter, job search, housing search, Food Bank….)

Disability (job placement, professional training workshops, recreational and free time workshops, holidays, school-home daycare,

rehabilitation…)

Minors (recovery programmes for failing students, day care centres, sport, school/work counselling, social hardship aid…)

Services with social purposes provided

by single or joint municipalities:

Interventions and services: (directly provided: interventions of professional social services, counselling, information, contracts of undertaking: home

care, school or after school assistance, others...)

Money transfers: (directly provided: low income grants, rental and aid grants, tax breaks, exemption from fees payment)

Admission in residential or semi-residential care home managed directly or indirectly

Intervention areas: toward following subjects

-Family-Minors-Young people-Elderly people-Disabled-Addictions-Mental health-Immigrants-Adult exclusion and hardship

But the interventions of the municipalities and the Local Health Units are not sufficient to cover the entire demand; this is why the role of volunteering and of the third sector becomes of great importance.

Exemples of interaction: DISABILITY

Undertaking Social worker and neuropsychiatrist

School and after-school care

Rehabilitation therapy speech therapy, physiotherapy etc.

Day care centres

Socio-therapeutic placement

Job placement

Residential care

Holidays,Free time,Sport,Theatre wksps, etc.,Professional training wksps,Home-school centres,“Dopo di Noi”

External actors3rd sector

Thank you very much for your attention.