Due to the cuts in the National Health Service (SSN), Italian public health is facing a period of serious difficulty, marked by a under chronic loan who had a direct impact on investments in healthcare personnel, both employee and agreement.
According to Nino Cartabellotta, president of the Gimbe Foundationthe blocks in hiring, the non -contractual renewals and the insufficient number of scholarships for specialists and family doctors are feeding a crisis in Italy that has lasted for years.
For this reason, there is a risk Access to increasingly limited essential servicesespecially if we consider that in recent years – on the other hand – the health expenditure of families has recorded an increase of 26.8%.
Italian public health expenditure below the OECD average
As explained by Nino Cartabellotta, president of the Gimbe Foundation, during his speech at the conference ‘Investing in health professionals to guarantee the health of the person’, held in Bari on February 22, 2025, The data that emerge are worrying.
First of all because public health expenditure in Italy in 2023 stopped at 6.2% of GDP, well below the OECD average, which stands at 6.9%. In fact, this means that our country is not investing enough in the National Health Service, with direct consequences for families who, in fact, spent more for the care, turning to the private individual (in 2023 the expenditure of Italian families To access the private health services has increased to 40.6 billion euros, with a Increase of 26.8% Between 2012 and 2022).
Another alarming figure is that in 2023 private expenditure for health has reached 23% of total health expenditurewell above 15% indicated by the World Health Organization (WHO), a limit beyond which accessibility to health services risks compromising.
These are percentages that return a single framework, namely: the private expenditure of families becomes an indicator of the growing difficulties in accessing public services, both because of the long waiting listsboth for the renunciation of necessary services, especially in the weakest social groups.
The economic load for families grows
To confirm a crisis that risks worsening The data of the report of the Gimbe Observatory on private health expenditure in Italy in 2023, commissioned by the National Welfare & Health Observatory (ONWS) and presented on February 18, 2025 at the CNEL.
In detail, what it actually is that in 2023 total health expenditure in Italy has reached 176.1 billion eurosdivided into public spending (130.3 billion euros, equal to 74%), private expenditure directly paid by families (40.6 billion euros, equal to 23%) and private expenditure intermediated by health and insurance funds (5 , 2 billion euros, equal to 3%).
However, even if the main share of health expenditure in Italy comes from public spending (which represents 74% of the total), the same is placed well below international standards.
In addition, private expenditure intermediated by health funds and insurance represents only 3% of total health expenditure, with 88.6% of the private expenditure on the direct dependent of families, while according to the World Health Organization it should not exceed 15% of total health expenditure to guarantee a fair and accessible health system.
Crisis accentuated by the lack of staff
Together with the sub -analyzing and the growing private expenditure, another fundamental element is accentuating the Healthcare crisis in Italy, or the lack of staff. The lack of doctors, nurses, and other health professionals is undermining the sustainability and efficiency of the system, with devastating effects on working conditions and access to treatments for citizens.
One of the main causes of the lack of health personnel is the stagnation in hiring. In recent years, the blocking of hiring, combined with the lack of contract renewals, has reduced the new drains drastically, compromising everything else.
Furthermore, he was able to create a situation where it is increasingly difficult to guarantee optimal working conditions also to professionals in the sector are increasingly also Doctors and nurses who leave the NHS To migrate to the private sector or, in some cases, abroad. According to the data of the Gimbe Foundation, this phenomenon is particularly acute in less attractive specializations, such as emergency-urgency, and among general practitioners, whose number is insufficient to cover the needs of the country.
The consequences In fact, of this personnel bleeding are evident: the waiting lists are increasingly longer, the emergency rooms are collapsing and many citizens are found without a general practitioner.
