The Salute Zdravstvo project, a cross-border story

Autism, cross-border CUP, services for pregnant women: healthcare between Italy and Slovenia. An interview

The five-year period that laid the foundations for a healthcare collaboration between Italy and Slovenia ended at the end of November 2022 and, despite many bureaucratic and language barriers, the project achieved remarkable results in an area where the border is hardly perceived by citizens anymore. We started by asking Maja Radovanovic, project manager of the Salute Zdravstvo project managed by the European Grouping of Territorial Cooperation EGTC (a consortium established more than ten years ago between the municipalities of Gorizia in Italy and Nova Gorica and the municipality Sempeter-Vrtojba in Slovenia) what the greatest satisfaction was.

“We managed the project without too many hitches, except for the onset of the pandemic which blocked many activities such as gymnastics for pregnant women in the pool and other face-to-face meetings. But it was a very long and substantial project, with a budget of 5 million Euros and numerous public bodies involved on both sides of the border. Yet the results have been tangible, and above all they have given life to a path that is continuing and will continue. For my part, the greatest satisfaction was to see good concrete results of putting Italian and Slovenian experts and doctors in dialogue. By taking them to visit other contexts such as Denmark and Great Britain for example, we were able to introduce on the territory new practices, which have improved the quality of life of users and the offer of healthcare systems".

The project had five lines of work: cross-border single reservation centre (CUP), maternity, autism, mental health, and social inclusion. Can you give some concrete examples?

The meeting of the best practices of the two countries and the dialogue with the outside have produced great results, not only in human terms but also in terms of infrastructure. What struck me the most was a result obtained on the path of physiological pregnancy, where we introduced the practice of small group meetings with midwives. In Slovenia the term "midwife" corresponds to the Italian "grandmother", and this also affects the mindset: one always thinks of an older lady, while the professional profile of the midwife, who can also be a man, is little known and valued. Thanks to a practice imported from Denmark, we have introduced the habit of pregnant women to get involved in meetings before giving birth, where they can ask questions, ask for advice, exchange ideas, participate in a path that accompanies the birth. Well, this is one of our most concrete results.

How did the doctors and experts you involved in the cross-border working groups respond?

The goal was to be able to bring the two healthcare systems closer without wanting to draw up any rankings, but seeking dialogue and promoting collaborations, exchanges, synergies. And as outsiders we have tried to facilitate dialogue above all. All doctors, midwives, psychiatrists, social workers have focused on patients, who in our territory crossed by the border often move themselves from one side to the other. The dialogue took place on concrete, scientific, and medical bases, taking into consideration the needs of the patients. The territorial area is limited, everything is nearby, but before, none of the experts knew what was happening on the other side, even if perhaps the patients were already used to looking in Nova Gorica for what they didn't find in Gorizia.

Can we say that the project took note of an existing situation?

Sure. Mobility was already there, and we have done nothing but give it official recognition, and also make it clear to institutions, doctors, and hospitals. Those working groups have kicked off an exchange that will continue, and we hope that others will follow the example and set up facilities like the social tailor's shop, the room equipped for meetings with autistic children, and the two info points on social inclusion. The frontier is truly a line that no longer seems to exist in the three municipalities.

 

Is there, however, something that didn't work out the way you wanted?

Sure. Paradoxically, activities involving people have proved easier to manage, and the results more concrete. For the CUP, instead, there was some difficulty. This is the single reservation centre, which we wanted to integrate between Italy and Slovenia, developing a platform capable of managing reservations and tickets of the two national healthcare systems, but with different local and regional regulations and therefore too complex to be integrated. Unfortunately we haven't succeeded entirely: while bookings work, there are some hitches on tickets and welfare coverage, as the Slovenian healthcare system is still unable to communicate with the Italian one, which moreover works on a regional basis.

Does this confirm that people respond better to change than bureaucratic structures?

Exactly. To succeed, we would probably have needed a few more years... In any case, in the final report, which also identifies gaps and failures, we indicated this point as a stimulus for future work. It is true that there is a European regulation which would impose the uniformity of some practices, but unfortunately it is not being implemented. Another need would be the translation of the reports, there is still a lack of funds.

By working on such a delicate area as that of healthcare needs at a cross-border level, has your idea of borders perhaps changed?

In the end we had the confirmation that, in the perception of the people who live here, the border almost disappears: it is something invisible, and if anything, we realise it when there is some hitch, mostly bureaucratic. As far as I'm concerned, however, I think that living on the border is a privilege: you can experience the best things of both nationalities, for me it's something beautiful. A bit like for this project: the path was difficult, but the results are rewarding.