The Government has allocated 4 billion euros for the next three years in order to strengthen the national healthcare system. Of these, 2.4 billion should be spent as early as 2026. The goal is an increase in hospital staff: doctors, nurses and healthcare technicians.
The aim is to reduce waiting lists and allow hospitals to deal with the constant increase in hospitalizations and operations due to the aging of the population. For doctors, the focus is above all on new hires, higher salaries and incentives to dedicate themselves exclusively to the public sector, abandoning the freelance profession.
For nurses, the reasoning is paradoxically the opposite. To attract them to the national healthcare system, we want to implement the rule that would allow them to work as freelancers at the same time.
What does the healthcare package provide?
The Minister of Economy Giancarlo Giorgetti presented a report on the budget planning document to the Council of Ministers, which explains in broad terms the interventions of the Budget. For healthcare, the Government has allocated 4 billion euros until 2028, of which 2.4 billion will be used as early as next year.
The objective is to reduce waiting lists by acting on healthcare personnel. According to what the newspaper reports The Pressthe Government wants to hire within the next year:
- 2,300 doctors;
- 9,700 nurses and healthcare technicians.
Furthermore, the executive wants to increase the salaries of healthcare professionals, to make the Italian public healthcare service more competitive both compared to the private sector and to foreign public hospitals. The increases, anticipated by Health Ministers Orazio Schillaci, should be:
- 220 euros gross per month for doctors;
- 110 euros gross per month for nurses.
Furthermore, doctors should receive an allowance of between 246 and 1,825 euros gross per month if they renounce the profession, agreeing to work only in the public sector. For nurses, however, the operation will be the opposite. The Government aims to give them the opportunity to work as freelancers too, so that the public job does not exclude them from all the other job opportunities that the market offers.
This rule has already been approved in the so-called Bill Decree of 2023, but has remained de facto unapplied also due to the opposition of many local health authorities. The law expires at the end of 2025, but could be extended to allow its application also next year, with a greater push from the Executive to ensure that nurses’ initiatives are not hindered.
How many doctors does the NHS need?
In the latest report from the Gimbe foundation, the shortcomings of the Italian national healthcare system are highlighted, especially with regards to staff. The doctors to whom the Ccnl applies are 109,024 or 1.85 per 1,000 inhabitants. The OECD average, which is taken as a reference point in this report, is 3.9 doctors per 1,000 inhabitants.
Italy, however, has a peculiarity. If you count all the doctors, even those who work in the private sector, it is one of the best OECD states, with 5.4 doctors per 1,000 inhabitants. It is clear that the NHS has an attractiveness problem compared to the private sector, but not only that.
Gimbe also underlines that new medical students do not choose the specializations necessary for the functioning of the NHS, such as:
- emergency medicine;
- general medicine;
- general surgery.
The scholarships in this regard, in fact, are only awarded for just over half of those available each year.
To reach the OECD average with only the public, the State would therefore have to double the number of doctors present in hospitals. The presence of so many doctors in the private sector also explains why spending in the private healthcare sector in Italy continues to grow and has reached 25% of the total.
The problem of nurses
However, the data from the Gimbe foundation highlight another problem, even more complex than that of doctors: the shortage of nurses. There are approximately 277 thousand operating in Italian public hospitals, 4.7 per 1,000 inhabitants. Even including those who work in the private sector, the figure comes to 6.9 nurses per 1,000 inhabitants. The OECD average is 9.5. This means that in Italy there is a shortage of around 150,000 nurses.
The problem is different than that of doctors. It is not a question of the attractiveness of the NHS, but of a lack of personnel. In Italy there are simply not enough people who are professional nurses. And they’re not coming. In 2023, there were 17.3 nursing graduates per 100,000 inhabitants compared to an OECD average of 45.3. In 2025, for the first time in years, nursing faculties had fewer enrollments than available places.
The only solution, in this case, is to draw from abroad while waiting for investments in the quality of working life and the salaries of nurses in the public sector to attract more students to universities. It was Minister Schillaci himself who admitted this need. Some Regions are already starting to move in this direction, contacting staff from India, Argentina, Paraguay, Albania and Indonesia.
Mental health and pharmacy plan, the other measures of the Maneuver
The hiring project for the National Health System is the main one, both in terms of expenses and importance, within the chapter of the Health Budget, but it is not the only one. Other expense items include:
- 80 million for the mental health plan and the family psychologist;
- 60 million for the Rare Diseases Plan;
- 150 million for local and home care, which will rise to 280 million in the following two years;
- 70 million per year for the stabilization of the pharmacy services;
- 36 million for Experimental Zooprophylactic Institutes;
- 20 million for testing the third level hospital network;
- 10 million for the palliative care fund.
There is also a plan to increase pharmaceutical spending by 0.5%, while hospital care rates will be updated by 2027, with an investment of 550 million euros. Finally, around 400 million euros will be allocated for research between funding for current research and new hires.
