Health contracts: here are the outstanding negotiation issues

The contract round for the three-year period 2021-2024 seems to be really over for all NHS employees. For the two collective contracts of the Executive Areas, the Pre-agreements have just been signed (on 11 November for PTASS executives and on 18 November for health executives), but essentially the negotiations are over. Both texts are a bridge-contract closed with a thousand perplexities that have been hastily overcome in order not to lose further time and purchasing power. The one for the Health Area has only 22 articles, the one for the Local Functions Area has 26 (there are 40, but 14 articles concern the RAL and municipal and provincial secretaries sections). They could be called 'contratticchi', as Sciascia would have said. So be it: at least such pragmatism has allowed the 137,000 health executives and the 5,000 PTASS executives to benefit from the increases, inexorably armoured by the rules of the contract renewals - the HICP at 5.78% - and to immediately start thinking about the 2025-2027 contracts, which, by the counterparts' shared admission, will have to deal with many aspects left open, starting, for the health executives, with many aspects of work organisation. And, in this last regard, a shopping list can be drawn up for both tables, based on the indications of the respective unimplemented Guidelines and on the claims of the unions that could not be negotiated in recent months, supplemented by some personal considerations of the writer that are reported objectively for the sole purpose of making the contracts more straightforward and usable.

Let us begin with the unfulfilled sector committee guidelines. In practice, only the supervision by superordinate managers of monthly work schedules (paragraph 4), remote readiness (paragraph 5) and hourly leave (paragraph 6) remain unimplemented. On the other hand, the regional indications concerning the exemption from the probationary period for those who have specialised (paragraph 3, second clause), the taking of holidays during the notice period (paragraph 6), the elimination of the restriction of the same discipline in the calculation of the required experience (paragraph 3, fourth clause) have been implemented, the substantial increase in the fixed position, even though the Guideline Act had specifically mentioned the position of senior professionals (paragraph 3, third clause), the increase in the financial ceilings for additional services (paragraph 7) and the reconstitution of the employment relationship not necessarily in the 'last' company (paragraph 8). Perhaps the most important issue of all - that of working time - was by mutual agreement postponed to the next contract. A planning list for the three-year period 2025-2027 can be found in the five joint declarations at the end of the text.

The contents of the Guideline Act of 17 September 2025 are all present in the Pre-agreement of 11 November minus the maintenance assumed in paragraph 7. Contractual welfare has been rewritten, although it does not seem that the 'customised welfare' indicated in paragraph 8 can be discerned from the new draft. In the future, a connecting or coordinating rule should be deepened for those administrations that apply this CCNL even though they are not part of the SSN and have application difficulties in certain institutions (disciplinary procedure, Committee of Guarantors).

There are also rules that were absent in the three previous contracts (2020, 2024 and 2025) to be provided for in the new contract. These are the institutes governing mobility, fixed-term employment, secondment and, finally, the parameters used to identify simple and complex structures.

Previous regulations are still in force and could be supplemented or amended to improve their application: