Health contract: after bridge agreement spotlight on welfare and working hours

The contract round for the three-year period 2022/2024 is, therefore, finally complete. With the signature of the Local Functions Area on 23 February and that of the Health Area on 27 February, the employment contracts for all NHS personnel were renewed. The two aforementioned ones join the CCNL of 27.10.2025 to regulate the legal and economic treatment of 723,000 workers (137,370 healthcare executives, 5,218 PTA executives, 581,148 employees of the sector).

The two recent contracts completed the integration phase of the effectiveness without any particular obstacles by reaching the conclusion, respectively, after 103 and 100 days from the Preintesa. The texts are exactly those of 11 and 18 November, including the attached joint declarations, with the sole exception of a trivial material error that was corrected with regard to the numbering of the articles.

The overall judgement on the renewals is rather easy, because they are to be considered as bridge-contracts closed in a hurry and in an agreed manner by the counterparts, especially in order not to make wage increases lose further purchasing power. In fact, they are almost non-contracts, in the sense that they grant armoured and non-negotiable wage increases and on the regulatory level they provide for minor changes, but do not resolve many critical aspects, which are postponed to the next contract covering the three-year period 2025/2027, which has already been in progress for 15 months anyway.

Therefore, it is much more interesting to examine the Guideline Act of the Sector Committee issued on 26 February in the immediate aftermath of the signing; for PTA management, the document is still being drafted. Browsing through the Guideline Act, an immediate aspect of political significance concerns the fact that for the first time the contractual renewals for management and the sector will proceed in a temporally aligned manner, and the timeliness of bargaining will in itself represent a significant achievement; let us be clear, the unacceptable delays are not overcome because, although negotiations will begin immediately, it can be assumed that they will be concluded more or less two-thirds of the way through the contract.

Paragraph 2 deals with the Financial Framework, which indicates a 5.4 per cent increase of the 2023 payroll when fully implemented. But the contract renewal will also have to ground the extra-contractual increases earmarked by the budget laws of 2024 and 2025. Paragraph 3 provides guidelines on six specific issues. The one under a) postulates increasing the attractiveness of the employment relationship in the NHS and takes up the issue of working time, with particular reference to critical and never resolved aspects such as work schedules, surpluses, and unrecognised overtime. Next, the document mentions contractual and corporate welfare, falling for the umpteenth time into the same misunderstanding as always: if dedicated resources are not provided, welfare will remain an empty box and to think that it can be financed with portions of the funds or contractual increases themselves is pure utopia. More concrete appears the following paragraph, where it is stated for the first time ever that shift workers after six hours are entitled to meal vouchers. Evidently after dozens of rulings in favour of nurses, it was realised that to insist on denying it would be a form of reckless resistance. However, there is an incision in the text that suggests that the negotiation will be anything but simple, because the right will be exercised 'compatibly with financial resources', which could mean that it will be financed as a 5.4 %.