The analysis

Record exodus of doctors from the public health service: more resignations than retirements, and the South is being drained of staff

Exhausting shifts, low pay, burnout, red tape and verbal abuse: according to the Anaao Assomed trade union, these are the causes of the mass exodus from the NHS, which saw a 150 per cent increase in 2025 alone

by Health Editorial Team

2 October 2026

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4' min read

Translated by AI

Versione italiana

4' min read

Translated by AI

Versione italiana

In as many as 12 out of 20 regions, during 2025, doctors who have chosen to leave the National Health Service before retirement outnumber those who have reached the retirement age. This is a widespread phenomenon, reflecting the exodus from the NHS that doctors have been denouncing for years, with peaks in Lazio, Trentino-Alto Adige, Friuli-Venezia Giulia and Sardinia, where the number of doctors resigning is between 2.4 and 3.3 times higher than the number retiring.

The data

An analysis by the Anaao Assomed Research Centre – the leading trade union for hospital doctors – based on data from Onaosi, the State Annual Accounts and the Ministry of Economy and Finance (MEF), reveals a veritable surge in resignations: for the first time in the decade 2015–2025, in a single year (namely 2025) resignations have “soared” by 150 per cent compared with the 1,503 recorded in 2024, reaching 3.5 per cent of all doctors in post – a threshold never before recorded, not even during the most critical months of the pandemic (3 doctors per 100). “2025 is sending us a warning signal that no one can afford to ignore,” concludes Di Silverio.

Looking at the overall picture of human resources, the figures reveal significant pressure on staffing levels: for every 100 doctors recruited on permanent contracts during 2025, as many as 43 resigned and a total of 77 left the public sector, including those who retired and others who left for other reasons.

With regard to internal mobility, analysis of staff transfers between healthcare organisations shows that these are not driven solely by individual career choices, but reflect the far-reaching reorganisation processes that took place between 2016 and 2017, as well as the lingering effects of the extraordinary events linked to the pandemic emergency. Excluding these exceptional variables, the time series reveals an overall stable trend, with a slight downward trend in recent years.

The generational change

Despite the exodus from hospital wards, the long-awaited generational change has begun. Between 2015 and 2024, the average age of hospital doctors fell significantly: by 2 years and 7 months for male doctors and by 2 years and 4 months for female doctors. Over the same period, the total number of staff increased by 2.7 per cent, rising from 105,380 to 108,243.

A key contribution to this rejuvenation came from the Calabria Decree, strongly supported by Anaao Assomed, which between 2019 and 2025 enabled nearly 10,000 young doctors to enter the system, accounting for up to 43 per cent of fixed-term appointments.

But the South is being depopulated

However, the long-standing divide in a country of two speeds remains unresolved. Over the last decade, the Centre-North has recorded a net increase of 4,029 doctors (+5.9 per cent), whilst the South has continued to see its numbers dwindle, losing 1,166 doctors (-3.1 per cent). The regions paying the highest price in terms of staff reductions are Basilicata (-24.6 per cent), Molise (-17.2 per cent), Valle d’Aosta (-14.2 per cent) and Calabria (-12.6 per cent), confirming the need for targeted measures to rebalance the provision of healthcare across the regions.

“This is not a matter of normal career mobility,” comments Pierino Di Silverio, National Secretary of Anaao Assomed, “but a full-blown exodus, driven by gruelling shifts, salaries that are not in line with European standards, working conditions bordering on burnout, unsustainable bureaucratic burdens and assaults on wards. It is not doctors nearing the end of their careers who are leaving, but professionals at the height of their clinical expertise, with an average age of around 48. The paradox is clear: whilst a generational renewal has been successfully initiated thanks to the Calabria Decree, there is now a risk of undoing all that has been achieved. In 2025, for every 100 doctors hired on permanent contracts, as many as 43 have resigned, effectively filling a ‘bathtub with no plug’.

A possible recipe

To halt the decline and defend Article 32 of the Constitution, Anaao Assomed is calling on the Government, Parliament and the Regions to turn words into action through a 10-point emergency plan:

1. Make the Calabria Decree a permanent feature, transforming specialist training into a work-based training contract to enable young people to take on leading roles.

2. Put an end once and for all to the staff expenditure cap, an anachronistic constraint that stifles recruitment.

3. To ensure European-level pay through the tax exemption of ancillary pay, the increase in the job-specific allowance and the timely renewal of collective agreements.

4. Reform professional liability, limiting criminal liability to cases of wilful misconduct and gross negligence alone, in order to curb defensive medicine.

5. Safe hospitals, with security measures in A&E departments, strict enforcement of anti-assault regulations and the reorganisation of spaces.

6. Life balance and welfare: safeguarding rest periods, parenthood and services for a National Health Service with an increasingly female workforce, whilst recognising the value of time, which has now become an asset of inestimable worth.

7. Regional equalisation, with financial and career incentives for disadvantaged areas and the South.

8. A permanent national observatory on staff resignations, to monitor the reasons for and future career paths of professionals.

9. Reform of the profession, balancing flexibility with professional recognition, to modernise the work and adapt it to rapid economic, technological and market changes.

10. Health and safety at work, understood not only as physical protection against accidents, but also as a guarantee of mental and physical wellbeing, contractual stability and career development for professionals.

‘2026 will tell us whether this was a mere hiccup or the start of a downward spiral. We have shown that, when we invest in young people, the system responds. Now we need the courage to invest in those who stay.’