When the Minister of Economy Giancarlo Giorgetti announced that 2 billion euros would be allocated in the maneuver 2026 additional to health, many have breathed a sigh of relief. With a National Health Service in evident suffering, the promise appeared as a reverse signal signal. However, by analyzing the accounts in detail, it is clear that this money will not end up in the paychecks of doctors and nurses, nor will they be used for new hires or to strengthen the organic equipment of the hospitals.
The reality is more complex, since in fact these are resources that risk being entirely absorbed by other items of bound expenditure.
What the extra funds for the health of the maneuver 2026 will really be for
According to the first estimates developed by the Regions, the destination of these resources is already largely marked. Between 700 and 900 million they will have to cover activities already started with the PNRR, which from 2026 will no longer receive European funding. This is the case, for example, of home care.
Another half billion will be absorbed by specific chapters such as prevention, “services pharmacy” and other measures already planned. Also in this case these are not discretionary investments: they are bound funds, mandatory, which do not leave margins of choice.
Therefore, only the residual part, estimated at around 500 million, could reach health personnel. But not for structural increases: since it is insufficient funds to affect national contracts, the solution identified is that already tested in past years, that is, the increase in rates for “additional activity”.
To make the picture even more critical is the management of funds. Despite the debate on differentiated autonomy, if all funds are bound to specific destinations and decided centrally, this means that the regions do not have the freedom to use resources for their specific needs, such as the opening of new departments or the hiring of extra personnel, if these do not fall within the default categories. An approach that further limits the response capacity of the local health system.
Because the money promised by the government is not enough
As underlined by numerous experts, the relationship between health expenditure and the gross domestic product (GDP) in Italy is around 6.4%, a low and insufficient percentage if compared with the real needs and with the investments of other advanced European countries.
France and Germany permanently exceed 7%, some countries even reach 8%. This gap means that, in per capita terms, Italy invests less for every citizen. And this deficit translates into a constant lack of funds for the hiring of staff, the purchase of new technologies and the modernization of the structures.
Such an expense does not allow the system to work efficiently. Problems that citizens live every day, such as long waiting lists for visits and exams, the lack of medical and nursing staff and the progressive aging of healthcare facilities are achieve. The low investment makes it difficult to guarantee timely and high quality service to everyone, and the most authoritative observers agree that without reaching at least 7% it is not possible to guarantee a competitive and sustainable public system.
The problem is therefore structural. The additional 4 billion already foreseen by the previous maneuver and the 2 billion announced today do not change the overall frame, since with this move the national health fund will reach 140 billion, a figure that may seem imposing but which, if related to the real needs, is not enough to cover the current expenses, let alone relaunch the sector.
According to a recent report by the Observatory on companies and on the Italian health system (Oasis) of the SDA Bocconi, for example, to reach the levels of investment of other European countries, at least 40 billion euros would be needed to Italy. This figure, which seems enormous, would serve to cover the gap accumulated over time and finance the necessary structural investments.
What remains for doctors and nurses
The approximately 500 million euros intended for doctors and nurses, at national level, not only are equivalent to just over a drop in the sea, but will not be used to structurally increase salaries or for new hires. What we know is that they will be used for extraordinary paid at 100 euros per hour for doctors and 50 for nurses.
The trade associations and the unions have severely criticized this approach, claiming that an extra compensation for extraordinary cannot solve the problem of insufficient staff or adapt the basic salaries, which remain among the lowest in Europe.
This strategy is based on the idea of asking those who are already exhausted to work more, instead of solving the lack of professionals at the root and making the sector more attractive and competitive at European level.
