The Government announces a relaunch of public health, with new investments and hiring, but the picture that emerges from the data is still uncertain. The Budget Law provides additional funds and incentives for staff, in an attempt to strengthen a system put to the test by years of underfunding and an increasing reliance on the private sector.
Alongside the resources allocated to the public service, however, a significant part continues to flow towards private structures and supplementary healthcare, with agreements, spending caps and new contracts.
According to the Gimbe Foundation and Cnel, family healthcare spending is increasing, while staffing in hospitals is decreasing.
The maneuver provides for interventions for nurses, doctors and service pharmacies, but the issue of a still unstable balance between public and private remains and how much the new funds will be able to impact on the stability of the national health network.
Healthcare funds: new resources but doubts about their destination
Economy Minister Giancarlo Giorgetti announced that the new budget law will include an additional 2.4 billion, in addition to the four billion already foreseen for healthcare. A significant figure, but still far from making up the 13 billion cut in the last three years, according to estimates by the Gimbe Foundation.
Behind the announcement, however, there are signs of a more prudent strategy involving the entire welfare system. Of course, while healthcare receives new resources, other sectors such as schools and pensions are shortened and suffer cuts. And the doubt remains as to how much of these additional funds will translate into a real improvement for citizens.
More space for private individuals in health management
The Minister of Health Orazio Schillaci has assured several times that the maneuver will help reduce waiting lists. But, in fact, a substantial part of the new resources will once again go to the private sector. Of the funds allocated, 246 million euros will be used to purchase services from affiliated structures, i.e. clinics and external professionals who will be reimbursed by the National Health Service.
Added to these are another 100 million intended to cover the increase in tariffs requested by the same structures, in addition to the billion already foreseen last year for the same purpose.
Even the 90 million planned for mental health will follow a similar approach: instead of strengthening public services, for example by hiring more psychologists in local health authorities, a large part of the resources will be used to finance the psychologist bonus, which reimburses sessions carried out by private professionals.
Pharmaceutical spending, ceilings increase but not services
Another delicate issue concerns spending on drugs and medical devices. From 2026, the maximum amount that the State can spend on medicines each year will increase by 350 million euros. But this does not mean that there will be more medicines available for patients.
The objective, in fact, is another: to reduce the budget overrun, which today exceeds four billion. Half of this amount is currently covered by pharmaceutical companies through the so-called paybacka mechanism that obliges them to return part of the money spent in excess.
With the increase in the ceiling, companies will have to repay less and the State will bear a higher share. In practice, the distribution of economic weight changes, but not the services for citizens.
A similar dynamic also concerns medical devices, such as prostheses and equipment. After protests from companies, the government decided to waive 75% of the sums due with the payback and raised the spending limit by another 280 million. Even in this case, the main benefit will be for suppliers, while the impact on the services offered by the public remains limited.
What the CNEL says: fewer public services and more direct spending by families
The CNEL annual report on the services provided by the public administration does nothing but confirm the trend. Health spending directly borne by citizens has reached 42.6 billion euros per year, equal to approximately a quarter of the national health needs.
Between 2018 and 2023 there was an average drop of 2% in diagnostic services and 1.7% in specialist visits provided by the public health service, against a constant increase in the use of the private sector.
