Demand-responsive buses and community nurses: the government's plan against the depopulation of inland areas

After a long wait, there is a government plan in black and white for the country's inland areas. The 164-page document plus annexes, which was formally approved in April by the steering committee at Palazzo Chigi but has now become available, outlines a series of guidelines that the administrations will have to follow in order to deploy the available public resources from various financial sources. Interventions will have to focus on three major sectors: transport, health and education.

The NRP - which is a source of funding in addition to the national dowry - describes inland areas as 'small centres, identified as areas distant from centres of supply of the essential services of education, health and mobility, very diversified within themselves and with strong potential for attraction'.

In particular, the 'National Strategic Plan for Inland Areas' recalls that to the 72 inland areas already defined in the 2014-2020 programming period, 43 new ones have been added, financed with national and regional resources (plus a further 13, identified directly by the regions and financed only by them). In total, considering only national resources, EUR 281.2 million were made available for the old programming period. For the period 2021-2027, however, we are at 310 million, of which 172 million for the new areas. The municipalities concerned are classified as intermediate, peripheral, and ultra-peripheral on the basis of their distance from the Poles, i.e. the centres capable of simultaneously offering the most advanced school, hospital, and railway services. In all, 3,834 municipalities. With the Mezzogiorno most directly affected, since inland areas account for 67% of the total number of municipalities and 36% of the population.

More than 13.3 million people live in this portion of Italy that lives on the margins of an adequate supply of essential citizenship services, about a quarter of the resident population in Italy. And it is here that the highest rates of demographic decline are concentrated, with over 90% of southern municipalities having fewer inhabitants in 10 years' time than today. The government document, following a public consultation launched in July 2024, provides guidelines for implementing targeted interventions for the specificities of each territory. In practice, it is a list of actions from which to choose to deploy resources. It is divided into three large chapters. For transport, the priorities include more efficient local public transport modes, e.g. with on-demand services or smaller buses, the financing of infrastructure maintenance and the implementation of infomobility platforms, the creation of interchange car parks and cycle networks. Among the guidelines for schools, five stand out: aligning school curricula to the needs of the territory with vocational courses, entrepreneurship education and prevention of dropping out of school; enhancing technical skills through extracurricular courses; teacher training; use of technology to reduce the isolation of schools; improvement of infrastructure; canteens, gyms, kindergartens and building safety. Lastly, health, for which possible interventions include community houses and outpatient clinics; community hospitals with facilities of up to 20 beds; training and contractualisation on an experimental basis of the figure of the 'family or community nurse' for personalised assistance to the elderly; continuity of care units (district medical teams for the management of complex patients); advanced emergency vehicles; telemedicine services.

Each inland area - which at the end of the day has EUR 2.3 million from the Development and Cohesion Fund and EUR 1.7 million from the Rotation Fund for Community Policies - must formulate an action strategy through the lead agency and with the support of the reference Region or Autonomous Province. The Cabina di Regia (Steering Committee) envisaged by the 2023 South Decree and chaired by the Minister for European Affairs, the South, Cohesion Policies, and the NRP is responsible for approving the strategies within 60 days of their receipt, after which the framework programme agreements will be signed with the various administrations involved.