Le reti in Sanità

Il presente lavoro di ricerca intende analizzare l’importanza dei modelli organizzativi a reti per rispondere alla sfida della complessità del momento storico, politico, sociologico, economico; in modo particolare in Sanità per rispondere all’esigenza di mettere al centro la persona nel percorso di cura ed ottenere una migliore integrazione delle cure. Sebbene i vantaggi delle reti siano bene descritti in letteratura sono ancora pochi gli studi nell’ambito della valutazione. Il caso di studio ha riguardato la rete oncologica romagnola così come percepita dagli informatori chiave, dagli operatori (medici, infermieri, amministrativi) e dalle persone con esperienza di tumore. Dall’analisi degli informatori chiave emerge forte che la rete nasce per dare risposte di qualità ai bisogni dei pazienti, mentre per gli operatori quanto sia importante la dimensione delle relazioni umane e avere valori condivisi per raggiungere obiettivi di efficacia e qualità delle cure. Per quanto riguarda invece la percezione delle persone con esperienza di tumore si rileva quanto sia importante l’appropriatezza della traiettoria di cura nonché l’avere continuità in un percorso, già di per sé difficile, oltre all’importanza dell’umanizzazione dei servizi e della corretta comunicazione medico paziente.

La protezione dei diritti sociali nell'ordinamento dell'Unione Europea

This study deals with the protection of social rights in Europe and aims to outline the position currently held by these rights in the EU law. The first two chapters provide an overview of the regulatory framework in which the social rights lie, through the reorganisation of international sources. In particular the international instruments of protection of social rights are taken into account, both at the universal level, due to the activity of the United Nations Organisation and of its specialized agency, the International Labour Organization, and at a regional level, related to the activity of the Council of Europe. Finally an analysis of sources concludes with the reconstruction of the stages of the recognition of social rights in the EU. The second chapter describes the path followed by social rights in the EU: it examines the founding Treaties and subsequent amendments, the Charter of Fundamental Social Rights of Workers of 1989 and, in particularly, the Charter of Fundamental Rights of the European Union, the legal status of which was recently treated as the primary law by the Treaty of Lisbon signed in December 2007. The third chapter is, then, focused on the analysis of the substantive aspects of the recognition of the rights made by the EU: it provides a framework of the content and scope of the rights accepted in the Community law by the Charter of Fundamental Rights, which is an important contribution to the location of the social rights among the fundamental and indivisible rights of the person. In the last section of the work, attention is focused on the two profiles of effectiveness and justiciability of social rights, in order to understand the practical implications of the gradual creation of a system of protection of these rights at Community level. Under the first profile, the discussion is focused on the effectiveness in the general context of the mechanisms of implementation of the “second generation” rights, with particular attention to the new instruments and actors of social Europe and the effect of the procedures of soft law. Second part of chapter four, finally, deals with the judicial protection of rights in question. The limits of the jurisprudence of the European Union Court of Justice are more obvious exactly in the field of social rights, due to the gap between social rights and other fundamental rights. While, in fact, the Community Court ensures the maximum level of protection to human rights and fundamental freedoms, social rights are often degraded into mere aspirations of EU institutions and its Member States. That is, the sources in the social field (European Social Charter and Community Charter) represent only the base for interpretation and application of social provisions of secondary legislation, unlike the ECHR, which is considered by the Court part of Community law. Moreover, the Court of Justice is in the middle of the difficult comparison between social values and market rules, of which it considers the need to make a balance: despite hesitancy to recognise the juridical character of social rights, the need of protection of social interests has justified, indeed, certain restrictions to the free movement of goods, freedom to provide services or to Community competition law. The road towards the recognition and the full protection of social rights in the European Union law appears, however, still long and hard, as shown by the recent judgments Laval and Viking, in which the Community court, while enhancing the Nice Charter, has not given priority to fundamental social rights, giving them the role of limits (proportionate and justified) of economic freedoms.