The regions are calling for more funding in the budget, but the key issues remain access to healthcare and how the funds should be spent

In 2025, over 5.6 million people went without a necessary consultation or test. Meanwhile, the regions are calling for more funding in the 2027 budget. One question remains: how much of those billions will actually translate into available treatment when it is needed? On 30 October, six regional presidents asked Massimiliano Fedriga to urgently convene the Conference of Regions to ensure the continuity of services. The regions’ request was for an additional 6.8 billion in 2027 and 18 billion over the three-year period; the draft bill adds 2.365 billion in the first year, on top of the one billion already earmarked. Healthcare funding would thus reach 146.3 billion: the nominal maximum, but less than what was requested. On 25 October, the Conference had pointed out that, prior to the new budget, funding was set to fall from 6.14 per cent of GDP in 2026 to 5.86 per cent in 2028, whilst expected expenditure was set to rise more sharply. The regions are also calling for fewer restrictions on staffing and are requesting advance payments for care for the non-self-sufficient amounting to up to one billion per year.

Istat’s 2026 BES report, which focuses on equitable and sustainable well-being, highlights the difficulties in accessing services. In 2025, 9.6 per cent of the population went without a necessary service, a figure that remained essentially stable compared with 2024. 6.5 per cent cited long waiting times and 5.2 per cent cited financial reasons: the reasons may overlap and the percentages should not be added together.

In the North, 8.7 per cent are giving up; in the Centre, 10.7 per cent; and in the South, 10.3 per cent. In Sardinia, the figure has risen from 17.2 per cent to 19.5 per cent – almost one in five people; in the Marche region, it has risen from 10.6 per cent to 12 per cent. Among women, the proportion reaches 11.2 per cent, compared with 8.1 per cent among men. Among older people in the South, the figure stands at 14.1 per cent for those with lower levels of education, compared with 8.7 per cent for those with higher qualifications.

The AGENAS report as at 30 September 2026 indicates an improvement in waiting lists. In the first nine months, bookings for consultations and tests rose from 19.7 to 21.8 million. The proportion of appointments within the maximum waiting times rose from 76.9 per cent to 78.6 per cent for initial consultations and from 83.3 per cent to 85 per cent for diagnostic tests. However, there remain over 3.19 million appointments exceeding the time limits: 2.11 million initial consultations and 1.084 million tests. Regional disparities and differences across priority categories persist. Only 69.3 per cent of colonoscopies and 69.9 per cent of dermatology appointments meet the maximum waiting times. BES and AGENAS observe different phenomena, so the results do not contradict one another. AGENAS measures appointments and waiting times; Istat also counts those who give up due to waiting times, costs or distance from services. Those who are unable to book an appointment may be left off the waiting lists, but not exempt from the need for care. Greater activity, therefore, does not automatically equate to fewer unmet needs: to assess this, data on dropouts and actual accessibility are also required.

To explain these disparities, it is necessary to cross-reference various indicators. Current expenditure by the Regional Health Services (SSR), regional GDP, mobility and Essential Levels of Care (LEA) are comparable on a 2024 basis; the Istat BES report of 26 October updates figures on out-of-pocket expenditure and home care to 2025. The ratio of SSR expenditure to local GDP does not correspond to the share of the National Health Fund in national GDP and does not include private expenditure. In 2024, SSR expenditure accounts for approximately 4.7 per cent of Lombardy’s GDP, compared with 10.4 per cent of Calabria’s. Per capita, however, the figures are much closer: €2,427 in Lombardy and €2,243 in Calabria. This disparity is explained by GDP per capita: €50,400 in the former and €21,700 in the latter. A twofold share of GDP does not mean having twice the resources per citizen, nor does it measure the efficiency of the service.