‘Without us, the health service grinds to a halt’: nurses are calling for more resources and better working conditions

‘Without nurses, community care centres cannot function, home care cannot get off the ground, waiting lists cannot be reduced, and chronic conditions cannot be managed.’ Barbara Mangiacavalli, president of the National Federation of Nurses (Fnopi), is unequivocal in her assessment of Italy’s healthcare situation and in justifying the profession’s demands for the 2027 budget.

Meanwhile, there is agreement with the concerns expressed by the regional presidents: “In line with the support already expressed at the Conference of Regions and Autonomous Provinces for the sustainability of the National Health Service, the Federation shares the view, put forward by many quarters, that the resources currently allocated to healthcare do not meet the country’s needs”. With regard to staffing, in particular, “there is a lack of funds to recruit staff beyond the constraints of historical spending levels and to bring salaries closer to European standards”.

‘The Federation has always carried out “its role as a subsidiary body of the State with the utmost integrity, and for this reason it is called upon to act with a sense of realism”’, reads the introduction. ‘We know that public finance constraints are tight and we are not asking for miracles,’ adds Mangiacavalli. ‘The National Health Service today relies on the dedication of those who work there. The dedication of healthcare professionals is not an infinite budget item. Ensuring the system’s sustainability means, first and foremost, valuing the country’s human and professional capital through concrete actions.’ In the background lies the Constitution, which was also highlighted on the occasion of the most recent International Nurses’ Day: health is a right enshrined in Article 32 and is, for this reason, an inalienable right: it cannot be the variable that adapts to whatever remains after other budgetary decisions have been made, as the Fnopi is keen to emphasise.

Among the specific demands is a 15 per cent flat-rate tax on allowances for night and public holiday shifts, to ease the tax burden on those providing round-the-clock care in hospitals and across the region, and to make a career in the public health service more attractive. An increase in the specific professional allowance to provide stable recognition of nurses’ skills and responsibilities.
“Sare just some of the concrete measures to ensure that the Essential Levels of Care are met in the face of growing needs linked to an ageing population and chronic conditions”, explains Fnopi. Furthermore, certain regulatory and legislative reforms do not entail direct costs for the public purse. “There is scope for manoeuvre on these issues, and the Federation calls for them to be pursued decisively and within a clear timeframe”. A few examples: organisational models consistent with the country’s reality, involving a mix of skills, the sharing of expertise across professions, the full operational role of family and community nurses within the local area, and new models of professional practice, including under agreements with the National Health Service: “These are organisational and governance choices, rather than simply matters of expenditure, and they can unlock value even today,” is the argument.

Another demand is for a definitive end to the derogation allowing professionals with foreign qualifications to practise. The extension until 31 December 2029 of the temporary authorisation to practise without recognition of qualifications and without registration with the professional bodies – provided for in the last Budget Act – must, according to Fnopi, ‘be abolished’. This is not a stance against foreign professionals, who are a valuable resource – as the statement clarifies – but rather it means establishing the principle that anyone providing care to citizens in Italia must do so under the same rules, with their training and language proficiency verified, and under the supervision of the professional bodies. A solution that began as an emergency measure, extended time and again, is becoming a permanent feature. It is time to return to a standard, swift and reliable process for recognition.