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Doctors: a contract that never came into being already expired, the corporate welfare option

Fringe benefits are among the main resources available to employers, including public employers, to incentivise the productivity of their employees

by Claudio Testuzza

2 May 2025

3' min read

Key points

Contracts increasingly delayed
Integrating contracts with corporate welfare
Benefits for company and employee

3' min read

The delayed contract renewal significantly reduces the purchasing power of medical and healthcare executives, which already fell by 6.2 per cent over the period 2015-2022, consolidating their position at the bottom of Europe, and further worsens prohibitive working conditions that reduce their attractiveness.

Contracts increasingly delayed

The contract for the three-year period 2022/2024 of the Medical, Veterinary and Healthcare Executives was never born but expired in December, without negotiations for its conclusion ever even starting. The contract still in force is for the three-year period 2019-2021. While doctors leave hospitals for private practice, which is much more rewarding and remunerative, and often seek work abroad. If public health contracts are not renewed on appropriate terms, the National Health Service will be emptied of needed professionalism. Hospital doctors have suffered a loss of purchasing power in their salaries, which varies according to professional category and length of service. In general, the loss is between 8% and 10%. The Budget Law has provided for derisory increases for doctors in 2025, which translates into about EUR 17 net per month, with an increase to EUR 115 net per month from 2026.

Complementing contracts with corporate welfare

In such a context, one element that should be brought to the attention of the contracting parties is the so-called corporate welfare. Contractual welfare, also known as negotiated welfare, refers to the welfare benefits that the company must provide according to the provisions of the collective agreement applied. In fact, contractual welfare originates from a contract, whether individual or collective, national, territorial or company.

Participating companies make welfare goods and services available to employees and the quotas and deadlines are identified by each CCNL. The proposed arrangements may consist of reimbursed amounts, direct provision of services or both.

For example, in the CCNL for employees of nursing homes and care and social services, corporate welfare was introduced in March 2018. Companies applying that CCNL must provide each employee with EUR 200 per year in the form of welfare goods and services. Employees can spend this sum on supplementary pensions, supplementary healthcare in its various forms, parenting support and child education services, care services for elderly family members, insurance policies, public transport services, shopping vouchers and vouchers

Various measures have been planned to incentivise corporate welfare with the idea that these benefits and services provided by companies, instead of productivity, profitability, quality and so on, can be applied thanks to tax exemption.

Benefits to company and employee

In this way, companies are able to save on labour costs, including taxes and contributions related to the various bonuses, while at the same time benefiting their employees and their satisfaction, who find themselves enjoying benefits worth more than a monetary bonus in their pay packet.

Article 51(2)(f) of the Consolidated Income Tax Act (TUIR) provided for IRPEF exemption for services and benefits for the purposes of education, instruction, recreation, social and health care, and religious worship, which may be included in company agreements as forms of payment in kind with full tax and social security contribution exemption. The rewrite of letter f-bis), paragraph 2 of Article 51 of the TUIR also extends the IRPEF exemption for sums, services and benefits paid by the employer to the generality of employees (or categories of employees) for the use and attendance by family members indicated in Article 12 of the TUIR, even if not tax dependent, of education and instruction services, including pre-school age, including supplementary services and canteen services related thereto; toy libraries, places of entertainment for children for educational purposes and summer and winter centres; scholarships. Also important is letter f-ter) of paragraph 2 of Article 51 of the Consolidated Income Tax Act, which states that 'sums and services provided for the use of care services for elderly or non-self-sufficient family members are also exempt.

In a situation of pay restraints, fringe benefits may be among the main resources available to employers, including public employers, to create corporate welfare and incentivise their employees' productivity and satisfaction.

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