Sardinia: the employment of retired family doctors in the local health authorities is legitimate
The Consulta promotes the regional law that responds to established critical situations in the use of essential levels of primary care
It falls within the organisational responsibility of the region 'to adopt measures aimed at responding to situations of ascertained criticality in the fruition of the essential levels of primary care, in order to ensure the effective enjoyment of the right to health'. In these terms, the Constitutional Court (sentence No. 177 of 2025) deemed in line with the Constitution Article 1, paragraph 1, of the Sardinian Regional Law No. 2 of 31 January 2025, which extended to 30 June 2025 the effectiveness of Regional Law No. 5 of 2023, which allowed retired general practitioners to join, also with free-professional contracts, the primary care and continuity of care projects activated by the local health authorities to ensure primary care in disadvantaged areas. This law had been censured by the Government, with an appeal that the Constitutional Court had rejected (sentence no. 84 of 2025).
The terms of the judgment
The Avvocatura Generale dello Stato had challenged Article 1(1) of Regional Law No. 2 of 2025 arguing that the region had invaded the exclusive legislative competence of the State in the matter of "civil law" in relation to Article 21(1)(j) of the National Collective Agreement governing relations with general practitioners of 4 April 2024, which precludes the return to service of doctors already retired. While the region had objected that:
- the shortage of general practitioners, which the aforementioned provision would have sought to remedy, was allegedly attested by the GIMBE Foundation's report of 4 March 2025 on the National Health Service;
- this situation would have been aggravated due to the 'negative' impact on the attractiveness of the medical profession caused by the epidemiological emergency from COVID-19 and the early retirement introduced by Decree-Law No. 4 of 2019 (Urgent provisions on citizenship income and pensions), converted, with amendments, into Law No. 26 of 2019.
Regional legislative competence over health
This thesis hit the nail on the head. The Constitutional Court ruled that the regional provision, in extending the terms of the previous discipline, '[responds] to the impossibility of having recourse to general practitioners who are regularly in agreement to ensure the essential services attributable to these areas of assistance necessary to guarantee the quality and indefectibility of the service, whenever an individual living in the region finds himself in a condition of need with respect to health'. Hence, the judgment in narrative, according to which the contested provision "must be brought under the legislative competence of the Autonomous Region of Sardinia in the field of health protection", since it is an "extraordinary organisational measure that attempts to respond to the contingent situation of the lack of primary care and continuity of care in the Region".
