500 million requested for elderly people who are not self-sufficient, and Schillaci promises to pay ‘close attention’ to the vulnerable

A boost – though it remains to be seen what resources will actually be available – has just come from the Health Minister himself in an interview given during the ‘Welfare, Italia’ Forum organised by Unipol in collaboration with the TEHA Group: in the forthcoming budget, in addition to the recruitment of healthcare staff, prevention and mental health – as he announced – “greater attention will be paid to the elderly and to those suffering from neurodegenerative diseases, which represent a real social scourge”. The announcement comes on the day that the Pact for a New Welfare System on Dependency – which brings together over 60 associations – has put forward its request to allocate at least 500 million in the budget for the 4 million frail elderly people, but the total number rises to 10 million people when carers are included.
The ‘Pact’s’ request – which was among the promoters of the 2023 Reform on Non-Self-Sufficiency (Law 33) – has been scaled back compared to what was presented last July: at that time, the associations were aiming for one billion, but given that healthcare resources in the draft budget are now halved compared to the 5.5 billion requested by Schillaci from the Minister for the Economy and Finance, Giorgetti, a dose of reality was needed. A request “tailored to public finance constraints, which maintains the objective of initiating change and developing it over time”. The fact remains that “the forthcoming Budget Bill is an opportunity not to be missed to provide concrete solutions for elderly people who are not self-sufficient and their families,” the Pact warns. “Resources are limited, but it is possible to identify the priority measures from which to begin tackling one of the country’s main social challenges.”

The Pact proposes to simplify the process of accessing services and support, by reducing the number of assessments and the need to move between departments; to establish a continuous home-based service that integrates healthcare with support for daily living; to improve the quality and accessibility of residential care facilities; and to trial the new Universal Benefit, with graduated payment levels and a top-up for those who opt for specialist services.

The difficulties within the system are very real: to access services and support, an elderly person must undergo an average of 5–6 assessments; home care provides 16 hours per year per person; around 270,000 people are on the waiting list for a place in a care home, a figure similar to the number of older people currently in care.
When a parent loses their independence, families often find themselves having to organise care on their own, navigate a fragmented system of services and bear the costs. If the elderly person can remain at home, ongoing support is needed; when they require a care home, there must be available places, adequate staff and affordable fees. Home care and residential care homes are different responses to different needs, both of which are necessary. When support is insufficient, care does not disappear – as the Pact emphasises – but falls on the time, labour and savings of family members.

The proposed measures form part of the recent series of systemic actions. Following the 2023 reform, in early October the Government approved the first National Plan dedicated to frailty and lack of self-sufficiency amongst the elderly population. This is an important step: it provides a common framework for planning and prioritises objectives such as home care, access to services and the strengthening of the social and healthcare workforce. We must now continue along this path: the Public Finance Policy Document does not yet include any specific allocations for the Pact’s proposals, “but the budget is still being finalised”, as the 60 organisations – and, above all, the families awaiting these resources – hope.