Healthcare, recruitment and staff incentives in the manoeuvre. And intramoenia for nurses

At least 3 billion would be needed to ground all the measures that the technicians at the Ministry of Health are working on for the upcoming budget law, but already reaching 2 billion - the bar indicated by Minister Schillaci to his colleague at the Mef Giorgetti this summer - would be a 'good result'. In short, the hunt for resources has begun, but the outcome is still unknown. All that is certain is that the bulk of the resources that will be available for this item, which is so sensitive for citizens, will be dedicated to health personnel in order to attract new doctors and nurses or to prevent those who already work there from fleeing from public hospitals.

The priorities - to which 1-1.5 billion will be allocated if there is at least a 2 billion dowry - are first of all recruitment and then incentives, including tax incentives, to make health workers' payrolls heavier. On the first front, two paths are being studied: the first, the ideal one, envisages finally overcoming the expenditure ceiling on recruitment with the implementation of the mechanism of personnel requirements calculated with an algorithm on which Agenas (the health agency for regional services) had worked for a long time and so far remained in the drawers, or else the expenditure ceiling would be touched again (the hypothesis is 5%). On the incentives front, there is a range of possible interventions: for doctors, after last year's unsuccessful attempt, there will be a new attempt to propose the defiscalisation of the specificity allowance (worth about 800 euro) at 15 per cent or, alternatively, a possible increase. For nurses, who are the number one emergency (there are at least 70,000 missing), the aim is to increase the specificity allowance by at least doubling it (today it is worth about 80 euros), but among the incentives aimed at there is also that of finally making freelance work simple and accessible also for SSN nurses, as in the case of intramoenia for doctors. Welfare benefits are also being studied to make a profession from which young people are fleeing more attractive (at the last admission test there were more places than candidates) with the aim of ensuring that a nurse with a 3+2 degree - soon three new master's degrees will be launched - comes close to earning almost as much as a young doctor. In the future - after the manoeuvre - the goal, which is not easy, is to make the bargaining of health personnel separate from that of the rest of the civil service precisely in order to give them more flexible tools.

In addition to health personnel, Minister Schillaci is also aiming to put another 500 million on the plate for the Drg (after last year's billion), i.e. the reimbursement rates for hospital admissions that are no longer updated to current costs. Also on the track is 80-100 million to finance the latest national plan on mental health, while the aim is to find 300 million to finance the new National Health Plan, which has been missing for over 16 years. The technicians would also like to find as many resources as possible to refinance the reimbursement rates for outpatient specialisation (visits and examinations) that have seen the raising of shields by laboratories and private facilities. Infrastructural resources (ex Article 20) are also needed to do the work in the hospitals to enable the 3100 new pieces of equipment (CT scans, MRIs, etc.) financed by the NRP to be installed.

In the meantime, the Gimbe Foundation has underlined how, with public health spending standing at 6.3% of GDP in 2024, Italy will rank 14th among the 27 European countries of the OECD area and last among the G7 countries. A critical picture against which the hospital doctors of Anaao Assomed are calling for 'immediate measures' and the Italian Democratic Party is announcing 'tough opposition' in view of the Budget Law 2026.