Empty wards: every day, 10 doctors leave before retirement and 5 go abroad

Every day, ten doctors leave the public health service before reaching retirement age, and five choose to move abroad; seven are subjected to physical and verbal abuse, and a further seven are the subject of criminal complaints, with the result that 68 per cent of doctors and healthcare managers working in hospitals are experiencing burnout, that is, physical and psychological exhaustion. The figures presented by Pierino Di Silverio, outgoing president of the Anaao Assomed trade union – the leading union for hospital doctors – in his report to the 26th National Congress currently taking place in Rome, describe a sense of unease that spreads from hospital wards to the everyday lives of the public.

“The courage to speak the truth is the foremost duty of those who have the honour of representing others,” warned Di Silverio, recalling the focus of the entire congress: to place the future of the National Health Service and the role of the professionals called upon every day to ensure its functioning at the centre of the debate, in the face of ‘years of underfunding, staff shortages, rising demand for care and increasing organisational complexity’. According to Anaao Assomed, the crisis in public healthcare is not an inevitable fate, but the result of specific political and administrative choices that can and must be rectified. At stake is the sustainability of the NHS: “It represents one of the country’s most important civil achievements, and its future will depend on the decisions taken today,” warned Di Silverio. “We are willing to contribute to this process of change, whilst reiterating that safeguarding public healthcare inevitably depends on the recognition, respect and appreciation of those who ensure its smooth running every day,” he added.

The trade union’s proposal sets out three structural reforms: moving away from the corporate model introduced by Legislative Decree 502 of 1992; redefining the relationship between the National Health Service and universities; a review of the hospital/local area organisational framework outlined in Decrees 70 and 77. On this last point, the trade union – which has opened the door to ‘hospital staff working in community care homes’ – is, however, calling for a ‘hands-on’ approach to structural investment in staff; genuine integration between hospitals and the local community; the development of telemedicine; the strengthening of community-based healthcare; continuity of care between hospitals and the local community; the revitalisation of home care; and genuine integration between health and social services.

Among the priorities identified is the renewal of the collective agreement. Anaao Assomed is calling for a structural review of the current collective agreement framework, with remuneration commensurate with the level of responsibility required of medical and healthcare management, merit-based career paths, clear limits on workloads and effective measures against all forms of job insecurity. It was emphasised that financial recognition for professionals is not a corporate demand but an essential condition for ensuring the quality and continuity of care. The Minister for the Public Administration, Paolo Zangrillo, responded to these remarks in his video address: ‘We have concluded the 2019–2021 round of negotiations – which we had inherited from previous governments – in record time, and thanks to an allocation of 20 billion for the three-year periods 2022–2024 and 2025–2027, we are now on a positive trajectory. Your sector is one of the most sensitive, and we have paid close attention to healthcare. The agreement includes a series of new measures that offer improved conditions for staff, such as the introduction of legal representation, psychological support and the possibility for the employer to bring a civil action in the event of assaults. So it is not just about pay; the regulatory aspects have also played an important role. And that is not all, because we have also launched the 2025–2027 round of negotiations in the healthcare sector, and we are confident that we will soon be able to do the same in your sector. It would be an extraordinary achievement because we would be able to ensure that our staff can carry out their work in suitable conditions and with the right level of motivation.’

In his report, Di Silverio paid particular attention to the issue of professional autonomy, reiterating “the need to defend the role of the doctor as a professional capable of integrating scientific knowledge, clinical experience and the therapeutic relationship into their decisions”.