Health: recruitment plan skipped, doctors and nurses strike on 20 November

The manoeuvre on healthcare renounces the maxi recruitment plan for doctors and nurses: there was talk of around 30,000 new recruits over three years, but the measure does not appear in the budget law sent to Parliament despite the announcements made on the eve of the meeting, including by the Minister of Health himself Orazio Schillaci. On the other hand, other measures that had been talked about in recent days have been confirmed: from incentives for young specialising doctors to the refinancing of hospital tariffs (the so-called Drg) and the raising of the ceiling on purchases from private healthcare. The increase in doctors' and nurses' allowances passes, but it will be limited and gradual. This is also the reason for the protests of doctors and nurses who will be on the streets on 20 November to strike against the manoeuvre.

As had been anticipated by the government immediately after the manoeuvre was first passed, the healthcare requirement in 2025 will increase by 1.302 billion (to which must be added the billion allocated by last year's budget manoeuvre), and will then rise to 5.078 billion for 2026, 5.780 billion for 2027, 6.663 billion for 2028, 7.725 billion for 2029, and 8.898 billion. All funds, part of which, as explained by the manoeuvre itself, will be used for the contractual renewal of health personnel and part will also be reserved for the 'pursuit of health objectives of a priority nature and national importance'. The remaining funds will be used to finance all the other measures of the manoeuvre. Among these, however, one of the most eagerly awaited is missing, as mentioned, namely the maxi three-year recruitment plan that was supposed to be worth about 30,000 new entries among doctors, nurses, and other personnel.

In all, there are 20 articles dedicated to healthcare in the new budget law. Among the priorities of the manoeuvre in healthcare is putting more money in the pockets of healthcare personnel. First of all, the allowance for those working in emergency rooms is increased: both doctors and nurses by allocating 50 million in 2025 and 2026. Then an item in the pay envelope of all health workers is increased, namely the specificity allowance: for doctors it will increase by 50 million in 2025 and 327 million from 2026, while for nurses it will increase by 35 million in 2025 and 285 million from 2026, and finally for other social and health workers by 15 million in 2025 and 150 million from 2026. Incentives also arrive for young doctors: the contract for trainees will increase by 5 per cent (about 100 euro) while the variable part will increase by 50 per cent for a number of specialisations that are currently chosen less: from Emergency Medicine (the one in the emergency room) to Radiotherapy up to General Surgery and Nephrology.

There are a number of other measures that distribute the funds a little. First of all, there are 'bonuses' - 50 million in 2025 and 100 million from 2026 onwards - to reward the Regions that will be more compliant on waiting list obligations. incentives for the First of all, there is the increase in the expenditure ceiling for the purchase of healthcare services from private accredited facilities, which grows by 0.5 points in 2025 (61.5 million) and one point from 2026 (123 million). The price list of hospital services is updated after twenty years (the so-called Drg) by allocating 77 million in 2025 and one billion from 2026 (350 million for rehabilitation and 650 million for the hospital part). 50 million is earmarked for updating the essential levels of care and the 2025-2028 pandemic plan is also financed: 50 million in 2025, 150 million for 2026 and 300 million from 2027.

The trade unions Anaao Assomed, Cimo-Fesmed and Nursing Up, confirming the demonstration of 20 November, proclaim a national strike of 24 hours on the same day of doctors, health managers, nurses and health professions ex law 43/2006. "The text of the Budget Law for 2025 - explains a joint note of the unions - confirms the reduction in funding for health care compared to what was announced in recent weeks and changes the cards on the table compared to what has been proclaimed for months". The manoeuvre - according to the trade unions' calculations - envisages an increase in the medical health specificity allowance of EUR 17 net for doctors and EUR 14 net for health executives for 2025, EUR 115 in 2026 for doctors and zero for health executives, while in the pockets of nurses would arrive about EUR 7 in 2025 and about EUR 80 in 2026, and it is no better for the other health professions. "Moreover, we are talking about resources linked, for the most part, to a contract whose discussion will only begin in at least two years, and which will arrive in the pockets of those concerned who knows when. In short,' the unions explain, 'basically crumbs that offend the entire category'.