Waiting lists: the decree does not take off and 4 million people forego treatment (+51%)

"Despite announcements and official declarations, the Law Decree on waiting lists (DL 73/2024) has not yet produced concrete benefits for citizens". This is what Nino Cartabellotta, president of the Gimbe Foundation, says, pointing out that exactly one year after its publication, "the implementation of the measures has first been blocked by the long gestation of the implementing decree on the national platform, then held hostage by the institutional conflict between the Government and the Regions on the decree on substitute powers". In the meantime, reality returns alarming numbers: according to ISTAT, in 2024 one in ten people gave up at least one healthcare service, 6.8% because of long waiting lists and 5.3% for economic reasons. And the reason for waiting lists increased by 51% compared to 2023.

According to an independent analysis conducted by Gimbe, as of 10 June 2025, of the six implementing decrees envisaged by the DL Liste d'attesa, only three had been published in the Official Gazette last April. Of the remainder, one has been out of date for more than nine months and two have no defined deadline. "As already highlighted at the hearing by the Gimbe Foundation," Cartabellotta continued, "the urgent nature of the measure has proved incompatible with such a large number of implementing decrees, some technically complex, others politically burning.

In the question time of 5 November 2024, explains the Gimbe report, Minister Schillaci had announced that from February 2025 the national 'dashboard' with the indicators for monitoring waiting lists would be available, complete with data from all the Regions and Autonomous Provinces. In actual fact, however, the decree on the platform only reached the State-Regions Conference on 18 December 2024, the agreement was not signed until 13 February 2025, and publication in the Official Gazette inexplicably slipped to 11 April. Since that date, the regions have had 60 days (doubled from the 30 initially envisaged) to present the projects necessary to ensure 'communication' between their own platforms and the national one. 'Precisely on 10 June,' Cartabellotta concludes, 'the 60 days expired, but the timeframe for making the data of all the regions publicly accessible on the national platform remains totally unpredictable.

The 'thorniest' implementing decree, the one on the exercise of substitutive powers, has ignited a bitter institutional clash between the government and the regions, which has lasted two months of official missives with crossed accusations and claims. The climate seems to have calmed down after the 22 May confrontation between Prime Minister Meloni and the President of the Conference of Regions Fedriga, who met Minister Schillaci on 28 May to finalise the text of the decree. 'Beyond the public declarations of rediscovered institutional harmony,' Cartabellotta comments, 'as of 10 June, there is still no agreement between the government and the regions on the implementing decree. But above all, according to Cartabellotta, 'it is bitter to note that, on an issue that affects a constitutional right, the head-on clash has taken over from the loyal cooperation between the State and the Regions, making the supreme principle of the 'Republic that protects health' evanescent. Meanwhile, millions of people continue to wait. Or worse, they give up health services'.

"The expression 'renunciation of treatment'," Cartabellotta explains, "has now entered the common language of politicians and the media, but it should be abandoned because it is misleading: in fact, renunciation concerns diagnostic tests and specialist visits, not therapies". In 2024 the phenomenon recorded an alarming surge: according to Gimbe's elaborations on Istat data, 9.9% of the population - about 5.8 million people - gave up at least one health service, compared to 7.6% in 2023 (4.5 million people) and 7% in 2022 (4.1 million people). The figure is substantially homogeneous across the country, with no significant differences: 9.2% in the North, 10.7% in the Centre and 10.3% in the South. "The real problem," Cartabellotta observes, "is no longer, or at least is not only, the wallet of citizens, but the ability of the SSN to guarantee services in times compatible with health needs. It should also be remembered that the ISTAT questionnaire allows multiple answers: citizens can indicate both economic reasons and long waiting times among the causes of withdrawal. "It is precisely the intertwining of these two factors," Cartabellotta comments, "that makes the phenomenon even more alarming: when public healthcare times become unacceptable, many people are forced to turn to the private sector; but if the costs exceed their spending capacity, the service becomes a luxury. And in the end, for one person in 10, the forced choice is to give up'.