Recruitment, hospitals and medicines: the healthcare package of the Pnrr decree

Recruitment may not exceed 30 per cent of the planned needs over the three-year period and must be carried out without new burdens on public finance. Moreover, the measure has a precise deadline, as it can only be used until 31 December 2026.

The decree, which has a function on the use of the NRP, intervenes significantly on the investments destined for territorial and hospital healthcare. It also allows the regions to use healthcare construction resources - those historically provided for in Article 20 of the 1988 law - to cover increases in the cost of materials. The procedure is simplified and made more flexible, eliminating certain constraints that hitherto limited access to these resources, thus favouring the overcoming of the stalemate of strategic works such as Community Homes, Community Hospitals, and hospital safety interventions.

The increase in the retirement age for general practitioners and paediatricians is maintained. It is, in fact, extended until 31 December 2027 the possibility for general practitioners and paediatricians to ask to extend until 'one year later' the attainment of the age limit, already set at 72 years. And therefore to remain in service until the age of 73.

A measure already introduced on an emergency basis to address the shortage of professionals in the area.

The decree also intervenes on the disability reform and towards the new system of non-self-sufficiency assessment, postponing some deadlines to avoid operational gaps during the transition from the old to the new model.

In order to avoid delays in the purchase of medicines covered by the Regions will be able to resort more easily to negotiated procedures without a call for tenders, overcoming the limitations of traditional tenders where there is no competition. The aim is to ensure therapeutic continuity especially for chronically ill patients and patients suffering from rare diseases.

Finally, the decree intervenes in two structural areas of the system: on the one hand, the revision of the rules for the accreditation of healthcare facilities, with the introduction of public procedures that will, however, have to safeguard continuity of care and employment levels, and on the other, the transparency of supplementary healthcare funds, for which more stringent obligations are introduced to publish balance sheets and information

The provision introduced amends the discipline that provided for the definition - on the basis of an agreement, at the Permanent Conference for Relations between the State, the Regions and the Autonomous Provinces, following the outcome of the activities of a Working Table - of a revision of the rules relating to the accreditation of healthcare or sociomedical facilities, public or private, issued by the regions or Autonomous Provinces, and to the contractual agreements of the aforesaid accredited facilities with the same territorial entities, or with the entities and companies of the National Health Service. Some of them are defined, providing for the holding of a public evidence procedure that in any case allows employment levels and continuity of care to be safeguarded .

It is understood that the agreement must be concluded by 31 December 2026.