Annual accounts

Doctors and nurses: still too few for community care homes and waiting lists; salaries are nothing to write home about

In 2024, the number of healthcare workers increased by 6,750 compared with 2023, but the number of doctors fell in the South (-434) and the number of nurses in the Centre-North (-565)

by Paolo Del Bufalo

7 July 2026

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3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

Waiting lists, community hospitals, home care: the main issue that needs to be resolved if these services are to function properly is the staff shortage, which prevents any reform from becoming truly effective.

The hiring freeze

Minister Schillaci identifies the shortage of healthcare staff as one of the most critical problems facing the National Health Service, and points the finger at the more than ten-year freeze on staff turnover and at policies that have favoured the use of external locum doctors rather than promoting in-house staff, Many doctors and nurses are leaving the public sector partly due to excessive red tape, slow career progression and poor financial rewards.

The regions are trying to take remedial action on certain issues. For example, 30 June marked the last day of service for contract doctors in Sardinian A&E departments. Other regions, such as Lombardy, have suspended new recruitment drives and are moving towards a single regional register, whilst in Sicily and elsewhere, efforts to make the transition are underway.

Against this backdrop, the 2024 Annual Accounts of the State General Accounting Office, which have just been published, do not really bring any good news.

In 2024, the number of NHS staff in the healthcare sector increased by 6,750 compared with 2023, but this is really not enough.

Doctors and nurses account for the lion’s share, numbering 382,921 out of a total of 488,463 healthcare staff employed by the National Health Service (SSN) – 78.4 per cent of all healthcare staff.

The shortage of nurses

There is a shortfall of at least 60–65,000 nurses in the National Health Service (SSN), for example, and in the Community Care Homes alone the shortfall reaches as many as 9,000, yet even with nearly 12,000 graduates a year, by 2024 there will be a total of just 3,615 more than in 2023.

The number of doctors, moreover, is actually falling: in 2024, there were 781 fewer than in 2023, whilst trade unions estimate that there is a shortfall of around 20,000 staff members.

Temporary staff, retirees, brain drain abroad and outdated, slow recruitment processes are leading to the depletion of the healthcare workforce, with the situation varying from region to region and across different geographical areas.

As far as doctors are concerned, it is quicker to say – paradoxically – that their numbers have risen in only five regions (Lazio, Umbria, Friuli-Venezia Giulia, Trentino-Alto Adige and Lombardy) and by around 170 in total (without which the overall decline would have been even greater, approaching the thousand mark); in any case, the figures are negative across all geographical areas, with the sharpest decline (-434) in the South.

The number of nurses, on the other hand, has fallen in Umbria, Emilia-Romagna, Friuli-Venezia Giulia, Bolzano, Veneto, Liguria, Lombardy and Valle d’Aosta; and, in terms of geographical areas, the north-east has seen the sharpest decline (-565).

PERSONALE DIPENDENTE DEL SSN

Salaries are not particularly impressive

As regards pay, too, the figures emerging from the 2024 Annual Report for National Health Service staff – again compared with 2023 – are not encouraging, confirming the minister’s view that staff are not adequately rewarded.

Between 2023 and 2024, inflation did not rise; on the contrary, it fell by around 4.7 per cent over the two years, the new contracts were expected to lead to an average pay rise of around 3.8 per cent, whilst at the top of the scale are healthcare executives with a +3.47 per cent increase, doctors saw an increase of just 1.63 per cent, whilst ‘healthcare professionals’ – including nurses, midwives, and staff working in prevention, rehabilitation and so on – recorded an increase of only 0.68 per cent.

There are also those who are seeing a decline: amongst healthcare staff, chemists have seen a fall of 1.08 per cent, whilst ‘highly qualified staff’ have seen a drop of as much as 7.65 per cent.

Certain allowances, overtime and payments linked, for example, to schemes such as doctors’ private practice are not included in the items taken into account when calculating average pay, but earnings are limited in any case.