Health: 27,000 recruitment plan ready in the manoeuvre, priority for nurses

A three-year recruitment plan in the manoeuvre that, when fully implemented, will open the doors of National Health Service hospitals and clinics to almost 30 thousand health workers and doctors. But with a top priority: nurses, who are the number one emergency in the NHS, given that there is a shortage of at least 70,000. The ambitious plan devised by the Ministry of Health's technicians does not stray too far from the one attempted last year, again with the budget law, but then wrecked due to the Mef's stop. This time, however, healthcare should not be sacrificed on the altar of public accounts because the objective shared by the government is to try to remain with healthcare funds at 6.4% of GDP so as to be less attackable by the oppositions that have built part of the narrative on healthcare cuts on that bar. That is why unless there are any surprises the extra funding for healthcare in 2026 should eventually be around 2-2.5 billion, a necessary endowment precisely to stay on that red line of spending on GDP. Compared to last year, the other change is the prioritisation of nurses and other staff: of the 27,000 recruitments, only about 2,000 will be doctors, the other 25,000 will be the health workers who are most in need.

The funds to finance the plan are expected to be around 420 million in 2026, 845 in 2027 and then around 1.6 billion from 2028, and recruitment will follow this same pace. The objective is to grow the entire health personnel of the SSN by 1.5 per cent in 2026, 3 per cent in 2027 and 6 per cent in 2028 (for doctors the growth will be from 0.5 per cent to 1.5 per cent in 2028). A small breath of fresh air, but certainly - if it succeeds - a significant first step to try to save the SSN struggling with a haemorrhage of personnel, as the Minister of Health Orazio Schillaci also knows, who has put this at the top of his priorities: in addition to recruitment, the idea is to include incentives for personnel. If the defiscalisation of the specificity allowance - envisaged for both nurses and doctors - seems difficult due to the doubts of the Mef, it is instead more likely that they could be increased. For nurses another important innovation could come from the end of the exclusivity constraint: in this way those who work for the SSN will be able to add - without prior authorisation from the ASL - even freelance activities and intramoenia (i.e. within public hospitals), in line with what doctors are already doing today (in 2025, among other things, the experimentation of freelance activities of nurses, which never really took off, will end).

Another of the cornerstones of the manoeuvre on the health front should be the increase in investments in prevention, which, by the way, always have economic returns as well, transforming themselves into avoided hospitalisations and fewer therapies: here the objective is to raise the bar of dedicated funds - currently 5% of the health fund - to 6%. Among the interventions in the pipeline on this front is, for example, the extension of oncology screening by widening it to a wider age range in order to intercept possible sufferers earlier, but also the funding for the mental health plan (at least 80 million) and for the national health plan (300 million). The list of the desired could be lengthened even more, but there is no shortage of important unknowns that could absorb at least a substantial part of the extra endowment foreseen in the Financial Bill for healthcare. The first is linked to the recent Tar (Regional Administrative Tribunal) rulings that rejected the new fee schedule with which the SSN reimburses visits and examinations to private facilities that have signed agreements. In the crosshairs are some reimbursement rates judged by operators to be too low and unsustainable. For this reason, economic intervention may be necessary to raise them: at the moment nothing is decided, but the figure should start at least at 200 million. The second uncertainty, almost a certainty, is related to the refinancing of home care, which is financed until 2025 by the NRP and which will now need at least EUR 600-700 million to be able to continue.