Elderly people who are not self-sufficient: ‘1 billion immediately’ for the reform awaited by 10 million people

To relaunch, through the forthcoming Budget Bill, the reform of care for the frail elderly (Law 33 of 2023), which is intended to support 4 million frail elderly people, by allocating an initial one billion euros – in addition to existing funds – to give substance to four priorities: simplified access to procedures; home care tailored to patients and carers; strengthening care provision in residential care homes – which currently has 270,000 people on waiting lists compared with 300,000 active beds; and a reworking of the Universal Benefit scheme. These are the proposals put forward by the Pact for a New Welfare System on Long-Term Care, which brings together 61 organisations and was the leading promoter of the reform in 2021.

“With 10 million people in Italia involved every day in care – including the elderly, family members, carers and care workers,” explain Cristiano Gori and Eleonora Vanni, coordinators of the Pact, “we are facing a social emergency that runs deep within the fabric of our country. That is why we are calling on political parties to come together, in the same bipartisan spirit that led to the passing of the 2023 enabling act, and to respond to civil society’s appeal to implement a programme of progressive yet concrete measures through the 2027 budget.”
Today, the figures paint a very different picture: 5–6 bureaucratic steps to obtain disability recognition and benefits; a mere sixteen hours a year of home care for the elderly (in Denmark, for example, the figure is 150); a severe shortfall in the regional distribution of residential care homes (RSAs), with the south of the country at a disadvantage; the carer’s allowance, which has been awaiting comprehensive reform for 45 years and for which the pilot scheme launched by the Reform itself has effectively failed, involving 25,000 very frail elderly people with the lowest ISEE score.

The priority is to get started, albeit gradually, because the mountain to be climbed is high and rugged, as one in six Italians is well aware – a country that risks being overwhelmed by the ageing and disability crisis. This is an increasingly pressing issue, much like the sweltering heat that in recent months has been taking its toll, first and foremost, on the elderly, who are overwhelmed by precarious physical and mental health, multiple chronic conditions, isolation and energy poverty. The future does not currently look bright: over the next 10 years, the number of people aged over 85 – the section of the population with the greatest care needs – is set to rise by 30 per cent. Whilst “we are not starting from scratch”, as the Pact’s experts are keen to emphasise, after three years of virtual standstill, the implementation of what is “a sound reform” can no longer be delayed.

“The Pact proposes a phased approach to implementing the reform,” emphasises Gori, “based on two aspects of sustainability: economic and operational. The one billion we have earmarked to get things off the ground in 2027 is fresh funding, distinct from the various funds already in place: we are not asking for ‘pre-election handouts’ but for a concrete commitment from the entire political establishment, to whom we will present our proposal in detail in September.”

Judging by the initial figures, the Pact’s recovery programme for the three-year period 2027–2029 provides for just over 6 billion euros, which is broadly in line with what was announced when the reform was first launched.