Environment and health. Yes to the “One Health” and “Planetary Health” approach. The Government reviews and approves the decree establishing the National Health Prevention System from environmental and climate risks. Here’s how it will work

This is the decree that contains a series of measures for the implementation of the NRP, already approved by the government on 13 April, but yesterday reviewed under the lens of the CDM which made some additions. For health, the establishment of this new body stands out, which absorbs all the functions on the subject, surpassing the organization envisaged by Legislative Decree 502 of 1992. Here is how it will work and how much it will cost. THE DRAFT OF THE DECREE.

22 APR

Last night’s Council of Ministers reviewed and definitively approved the decree law that introduces further urgent measures for the implementation of the National Recovery and Resilience Plan already examined and approved at first reading on 13 April.

In particular, the text has been supplemented with regulations that envisage new rules for initial and continuing training and for the recruitment of secondary school teachers; certain paths for those who want to teach; a clearer definition of the objectives and methods of training teachers throughout their career and annual competitions to constantly recruit staff, opening the doors to young people more quickly.

For health few detailed changes for article 27 (in the previous version 23) which introduces a new body into the health system with the “aim of improving and harmonizing the policies and strategies implemented by the National Health Service for prevention, control and the treatment of acute and chronic, communicable and non-communicable diseases associated with environmental and climatic risks “.

To do this, the decree establishes the “National Health Prevention System from environmental and climatic risks“(SNPS) which will replace the structures and methods of intervention on the subject contemplated by Legislative Decree 502 of 1992.

In fact, paragraphs 1 and 2 of article 7 quinquies of that provision which provided for a framework agreement between the Ministries of Health and the Environment and the Regions for the coordination and integration of interventions for the protection of health and the environment are repealed. then delegating to the Regions the identification of the methods and levels of integration between health and environmental policies with specific program agreements and conventions between Local Health Authorities, hospitals and regional environmental agencies.

With the decree approved yesterday all this disappears in a logic of integrated “one health” approach in the further “planetary health” evolution and through, according to the decree, “the adequate interaction with the National Network System for Environmental Protection (SNPA)”.

It will therefore be the new SNPS and the existing SNPA that will contribute “to the pursuit of primary prevention objectives related in particular to health promotion, prevention and control of health risks associated directly and indirectly with environmental and climatic determinants, also deriving from changes socio-economic, enhancing the protection needs of communities and vulnerable people or in situations of vulnerability, in line with the principles of equity and proximity “.

In particular, the following functions are entrusted to the SNPS:

a) identifies and evaluates the health problems associated with environmental and climate risks, to contribute to the definition and implementation of prevention policies through integration with other sectors;

b) favors the inclusion of health in decision-making processes involving other sectors, also through institutional communication and training activities;

c) contributes, for the profiles of competence, to the definition and implementation of planning acts on prevention and the essential levels of assistance associated with primary prevention priorities, ensuring consistency with the actions on essential levels of performance environmental techniques (LEPTA), referred to in article 9 of law no. 132;

d) contributes to the identification and development of criteria, methods and integrated monitoring systems, also making use of information systems functional to the acquisition, analysis, integration and interpretation of models and data;

e) ensures support to the competent authorities in the environmental sector for the implementation of the Health Impact Assessment (VIS) in the context of the Strategic Environmental Assessment (SEA), the Environmental Impact Assessment (EIA) and the Integrated Environmental Authorization ( AIA).

The following are part of the SNPS, operating in coordination with each other, in a network logic:
a) the prevention departments of the local health authorities;

b) the regions and autonomous provinces of Trento and Bolzano, also with network coordination functions of the Prevention Departments, among themselves and with other health and socio-health structures, as well as with other bodies in the area of ​​competence, that contribute to the achievement of the objectives of the SNPS;

c) the Experimental Zooprophylactic Institutes;

d) the Higher Institute of Health, with tasks of coordination and technical-scientific support;

e) the Ministry of Health, with tasks of direction, planning, monitoring, institutional communication, also through the adoption of specific directives.

In order to ensure the interaction of the SNPS with the SNPA, it is envisaged the next establishment at the Presidency of the Council of Ministers of a Control room, which includes:
a) a representative of the Presidency of the Council of Ministers, who chairs it;

b) two representatives of the SNPS, designated by the Minister of Health from among the managers of the Ministry and the Higher Institute of Health, with proven skills in the sector of health prevention;

c) two representatives of the SNPA, designated by the Minister of Ecological Transition, from among the managers of the Ministry or among the members of the SNPA with proven skills in the sector;

d) a representative of the regions and autonomous provinces of Trento and Bolzano, designated by the Conference of the regions and autonomous provinces.

Financing of new activities we proceed with the interventions indicated in the project “Health, Environment, Biodiversity and Climate“Of the Pnrr, within the limit of the resources referred to in article 1, paragraph 2, letter e) to n.1 of Legislative Decree 6 May 2021, n. 59, equal to 51.49 million euros for the year 2021, 128.09 million euros for the year 2022, 150.88 million euros for the year 2023, 120.56 million euros for the year 2024, € 46.54 million for the year 2025 and € 2.45 million for the year 2026.

Furthermore, starting from the year 2023, the total expenditure of 50,190,000 euros per year is authorized, out of the ordinary resources provided for by the legislation in force for the financing of the National Health Service, to be allocated to the recruitment with permanent contracts of two health professionals. every 200,000 inhabitants, of which one with managerial qualification and one in category D, also in derogation of the personnel expense constraints established by the provisions in force.

All the regions and autonomous provinces of Trento and Bolzano have access to this funding, notwithstanding the legislative provisions on the sharing of special autonomies in the financing of the related health needs.

April 22, 2022
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