Doctors and nurses: more attractive competitions if there is service accommodation

It is well known to all insiders that healthcare companies have great difficulties in recruiting healthcare personnel, with particular - if not exclusive - regard to nurses and doctors in four or five particular disciplines. Competitions are either deserted or receive an insufficient number of applications to guarantee a reliable and long-lasting ranking list. There are basically two reasons for this: a general one - the inability of the current regulations to meet the needs of companies - and a subjective and conjunctural one, i.e. the low attractiveness that the nursing profession and the medical profession have reached by now, limited to the disciplines of pathological anatomy, anaesthesia resuscitation, emergency medicine, geriatrics and radiotherapy, just to mention the most critical among the twenty for which the Budget Law 2025 has increased the scholarship. Some attempts have been made in the recent past, such as the case of the Region of Tuscany, which - while applying the infamous Presidential Decree 483/1997 - with the operation 'Start-smart competition - water/land' attempted to direct the procedure towards specific company needs, providing a targeted addendum to the notice.

A number of press reports have recently emerged concerning two measures that may make the recruitment of the above-mentioned medical staff more attractive to the NHS. The first, reported in the 'Stampa' of 22 June, refers to the initiative of the Verbania municipality, which, as part of its property disposal plan, will no longer put up for auction the last unsold flat. The three-room apartment will be proposed to the ASL VCO for its healthcare reception plan (PAS). These are initiatives that the healthcare company is trying to implement with the help of mayors to offer incentives for the transfer of healthcare professionals, at a time when there is a shortage of doctors and nurses throughout the country. Other municipalities in the area have also approved the possibility of reserving a portion of municipally-owned housing in their calls for tenders for healthcare professionals. Moreover, the regional law on social housing includes a specific provision on the allocation of housing to the police and fire brigades, and the emergency in hospitals would certainly justify the assimilation of healthcare workers to these categories.

But the initiative mentioned above is certainly not a complete novelty, because the problem of providing service quarters is not at all new, since already 21 years ago, the CCNL of the former Area IV of 10.2.2004 provided in Article 22, paragraph 4, this clause: "The company, at its own expense, may regulate the use of service quarters for special needs related to the particular type of duties performed by previously identified categories of managers. An identical rule had already been provided for the sector by Article 27, paragraph 4, of the National Collective Labour Agreement of 20.9.2001, when the health sector was in a serious crisis of finding nurses. In the same way that university housing exists, a corresponding hospital housing should be implemented: the internal spaces in the company structures exist and with a little foresight it would have been possible to use the funds of the PNRR or, before that, those of the ESM, with respect to which, however, someone said that "we do not need them".

The second piece of news comes from the Veneto Region (Region Portal, press release no. 1148 of 1 July) and it is the new measure put in place by the Zaia Council, the first Region to propose it in order to respond to the staffing emergency in local hospitals. It consists of an allowance of 1,000 euro per year for each of the three years of the course for new entrants to the Padua and Verona Faculties of Nursing who pass the annual internship exam. The incentive will be disbursed for each year of the degree course in the form of vouchers, through the Job Centres, for a total investment of 9 million euro. As one might have imagined, even an initiative of this kind has generated dissent, considering it an electoral manoeuvre and, in any case, not a structural one: but the underlying idea is absolutely legitimate and aimed at recruiting more nurses than those who now apply in competitions.

Nevertheless, also out of a dutiful debt to the historical memory of our public health, I would like to recall that many and many years ago the Pio Istituto di S. Spirito in Rome - the largest hospital organisation in Europe - in its numerous nursing schools not only provided books, uniforms, lessons, and a canteen for its students but also provided a "presalarium" that increased over the three years of the course, not to mention that the school was completely free of charge without the regional DSU fees of today. If we then add that the students who graduated within one or two months were hired directly by the hospital where they had studied and which had invested considerable resources in them, we can find a possible answer to the nursing staff crisis: the training and employment contract, to be stipulated in the second year of the three-year degree, a solution that would make it possible to avoid the public competition, to increase the loyalty of nurses and not to disperse the investments made. The solution, with due differentiation, can also apply to doctors.