I thank Nicola Magnavita and colleagues for raising important points regarding my Correspondence.1
I agree that the process of analysing the pandemic through a commission is slow, but citizens deserve to know the results of an audit. Some structural problems within health management existed before this pandemic; COVID-19 only emphasised them. Citizens now also fully understand that their regional vote affects their lives. Criticising decentralisation is valid, but the implementation of any law should be analysed before changing the law.
Within decentralisation, Italy foresaw central and regional quinquennial sociosanitary plans. The plans define and prospectively update the organisation of the health system. The most recent national plan was produced in 2006 and the regional plan for Lombardy, Italy, was produced in 2010. Plans for pandemic preparedness are out of date and have not been implemented.
Stress, grievance, and suffering can lead to conflict at every level. In Lombardy, hospital managers have penalised some doctors who stood up and spoke openly about mismanagements. Accountability, ownership, transparency, humility, and admission of mistakes by politicians and managers can powerfully de-escalate conflicts and are the first steps towards improvement.
I am regional councillor of Lombardy, president of +Europa/Radicali, and a member of the Regional Council of Lombardy's COVID-19 investigative commission.
Reference
- 1.Usuelli M. The Lombardy region of Italy launches the first investigative COVID-19 commission. Lancet. 2020;396:e86–e87. doi: 10.1016/S0140-6736(20)32154-1. [DOI] [PMC free article] [PubMed] [Google Scholar]