Manoeuvre, flat tax on civil servants is the only immediate benefit for health workers' salaries

The budget law for 2026 does not contain any particular or effective interventions in favour of the personnel of the National Health Service, especially for the health component that suffers the most critical problems. There are a hundred or so paragraphs that concern healthcare in general and some deal with the salary component. But these regulations - in particular paragraphs 357-360 - have the characteristic of being a generic application framework and not having immediate enforceability.

In fact, the provisions that increase some allowances for health personnel will come into force only with the 2025-2027 contractual renewals, which are still far from arriving, while other rules are random and uncertain in their application because they are left to the discretion of the individual regions (paragraphs 361 and 364). For these reasons, the judgement of the medical unions on the 2026 manoeuvre is entirely negative because they were expecting much other interventions, especially of immediate applicability, such as the de-taxation of performance pay and that of increases for contract renewals.

In essence, the only provision that can be considered already in force for all purposes is paragraph 237, which, in any case, does not target healthcare employees but the entire civil service and, moreover, excludes executives. It provides, in fact, that for the year 2026 only, the accessory remuneration, both fixed and variable, paid to non-managerial personnel of all public administrations is subject - but only within the limit of EUR 800 per year - to a substitute tax (yet another form of flat tax) of 15%.

The provision applies to holders of employment income not exceeding EUR 50,000 per year. It should be noted that almost all the personnel in the sector do not reach this amount. In any case, for the staff of the sector employed by the companies and entities of the SSN, the benefit is in addition to, but in fact absorbs, the flat tax on the additional services of healthcare personnel, while, of course, the specific 5% tax on nurses' overtime remains.

Reiterating that for medical and health executives there is nothing certain and quick to implement, it must be concluded that the measure will be able to generate a lower tax rate of 18% on ancillary remuneration and, in any case, within the limit of just over EUR 60 per month. In detail, it concerns bonuses, overtime and allowances related to working conditions (shift, ward, night and holiday and other specific emoluments).