Aran data

Healthcare, salaries in local health authorities: here are the average salaries and territorial differences

Salaries vary mainly by variable part, almost all of which is linked to production incentives

by Lorenzo Pace

29 December 2025

3' min read

Translated by AI

Versione italiana

Key points

The sample
Most-paid
Differences
Where the differences come from
Few territorial differences
Policy choices

3' min read

Translated by AI

Versione italiana

From the salaries within the Local Health Agencies, which reach up to 36 thousand euro for the health professions, to the salary differences between the regions of Italy, which thanks to collective agreements are not high. An issue, the latter, that intersects with the question of 'differentiated federalism, which finds precisely in the health sector one of the areas where the need for greater managerial autonomy is most keenly felt'.

This is what emerges from the half-yearly report of Aran, i.e. the Agency for the Negotiation Representation of Public Administrations, on public employees' salaries. Which focuses, in particular, on healthcare.

The champion

The premise concerns the number of National Collective Labour Agreements (Ccnl) applied to non-managerial personnel in the health sector. There are 542 thousand of them, employed in the roles - health, social, administrative and technical - of the Local Health Authorities (485 thousand people), University Polyclinics (43 thousand) and other entities (13 thousand).

The highest paid

The highest average remuneration is associated with the health professions, i.e. civil servants and health professionals, with a level of just under 36,000 euro, while the prevailing professional groups of the sociomedical and administrative roles, i.e. operators and assistants, are at average levels of around 28,100 and 29,500 euro respectively

The differences

These are averages, however. For each professional group, the analysis proposes the absolute difference between the lowest and highest salary level. The difference is less than EUR 5,000 for the health and administrative professions and less than EUR 4,000 for the social and health professions.

For Aran, thus, a first important element is highlighted: 'In the health sector,' it says, 'once the professions are circumscribed, the effect of a collective agreement characterised by strong central regulation allows individual administrations a margin of differentiation in remuneration policies that is not particularly high

Where the differences come from

Each average salary consists of a fixed part and a variable part. The latter is around 6,500 euro in the health professions, just above 4,700 euro in the social health professions and around 3,200 euro in the administrative professions.

For all three cases, the differences are due to 'pay choices on the variable part'. Specifically, at69%, 76% and 61%. For the health professions, it is almost entirely the incentive part, i.e. productivity compensation, that explains the gaps.

Few territorial differences

Finally, the analysis focuses on territorial gaps, explaining that 'no differentials attributable to regional geography emerge, but rather patterns of territorial contiguity. In fact, local health authorities and hospitals, which are contiguous from a territorial point of view, tend to be aligned in the de facto salary levels recognised for the same roles'.

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High values are recorded among the Lombardy and Veneto provinces, while lower values emerge in the Po Valley area, often extended towards the Marche. The special statute regions differ from one another: on the one hand, Sardinia presents lower average wages; on the other, Sicily and the autonomous provinces of Trento and Bolzano with decidedly high values.

Salary policy choices

Each province, moreover, can be distinguished according to the pay policy choices that local health authorities and hospitals have implemented with respect to the health and administrative profiles. "It should be remembered that on average, health professionals in the health role (mostly, nursing professions) are paid about 22% more than assistants in the administrative role."

The central grades are those where there is greater uniformity in the treatment of the two roles. That is, they are provinces in which the authorities remunerate the health profile on average between 21% and 24% more than the administrative role, in line with the national average deviation. These are, for example, some provinces in Western Lombardy and Upper Emilia-Romagna (Piacenza and Parma).

The extreme gradations denote, on the other hand, provinces that are characterised by health care institutions that differentiate more according to profile. That is, provinces in which the institutions use the remuneration institutions either to make the remuneration of the two profiles more distant, paying on average a higher remuneration to the health care (over 24%), or to close the difference between the two roles, remunerating on average more the administrative role (under 21%)

The provinces in which companies chose on average to recognise a higher remuneration for health professions include, for example, some provinces in Lombardy (Bergamo, Brescia, Mantova), in central-western Italy (Roma, Frosinone, Caserta, Benevento) and on the Islands.

On the contrary, the provinces in which healthcare companies favoured higher salaries for administrative professions are to be found in Veneto, Trentino, Piedmont, Valle d'Aosta and Tuscany

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