Adnkronos (Adnkronos) – "The 9th Gimbe Report highlights critical issues that the National Health Service must address. Alongside these, the measures promoted by the Ministry of Health to strengthen prevention, staffing, and services must be enhanced. The priority is to translate these into concrete responses for citizens, with accessible, timely, and appropriate care." Thus, in a statement, Fism, the Federation of Italian Medical-Scientific Societies, positively assesses the interventions launched to strengthen the NHS and highlights four operational proposals for the three-year period 2027-2029.
"In four years, something unprecedented," Fism details, "we have gone from €125,4 billion to €142,9 billion in 2026: an increase of €17,5 billion, the highest growth ever. In the latest budget law alone, €3,5 billion in structural funds were allocated for prevention and personnel, and the updating of the Essential Levels of Care. The ministerial budget provides €238 million annually for prevention and early diagnosis programs and €450 million annually for the hiring of healthcare workers."
These interventions – the scientific society observes – must be measured by their ability to reduce waiting times, ensure care for people with chronic conditions, and make services effective in the community.
Scientific societies can support institutions with clinical expertise, training, evidence-based recommendations, and tools to evaluate quality and outcomes. Italy continues to achieve "internationally significant health outcomes," including high life expectancy and low preventable mortality. However, public healthcare spending remains "lower than the OECD average: 6,2% of GDP versus 7,1% and $3.952 per capita versus $4.861."
Total per capita health spending is $5.337 compared to $6.097. Families have out-of-pocket spending that is 12,3% higher than the average, while spending through funds and insurance is 43,7% lower.
Increasing resources and updating the Essential Levels of Assistance (LEA) are important steps. To make the new services truly affordable, "they must be accompanied by planning based on health needs, actual costs, and service delivery capacity. Needs," FISM highlights, "are growing with the aging population and the spread of chronic diseases, which affect approximately 24 million people." Regarding personnel, "Italy has 5,8 doctors per thousand inhabitants, compared to the OECD average of 4," the statement continues. "The greatest challenges concern nursing and care: 6,9 nurses per thousand inhabitants versus 9,7; 1,2 nurses per doctor versus 2,4; 19,5 nursing graduates per 100 inhabitants versus 43,6. Hospital nurses' wages are 27% lower at purchasing power parity. The gap in long-term care is also significant: 1,5 workers per 100 elderly people versus the OECD average of 5."
General practice, whose share of expenditure has increased from 6,2% to 5,1%, "supports a key part of the management of chronic conditions. Its effectiveness must also be assessed based on continuity of care and the ability to monitor patients, in coordination with local and hospital services," Fism points out. Regarding equity, 18 regions and autonomous provinces are compliant with the Essential Levels of Assistance (LEA) in 2024, five more than the previous year. However, 5,8 million people still report having forgone visits or tests, and interregional healthcare mobility amounts to €5,15 billion. The gaps also depend on the organization of services, the distribution of professional resources, and the social determinants of health. Spending for accredited private practitioners represents 20,8% of public healthcare spending, the lowest figure since 2012. The use of paid professionals accounts for approximately 0,4% of spending: an indicator to be monitored along with staffing stability and continuity. of assistance”.
Fism puts forward four operational proposals for the three-year period 2027-2029: 1) Strengthen nursing and community care. Alongside staff interventions, implement a plan for training, professional development, and salary enhancement; also invest in long-term care, where the gap with the OECD average is widest. 2) Plan the real cost of the new LEA (Lea). Determine the needs required to provide the new services in each region, supporting the updating of essential levels with adequate resources, personnel, and organizational capacity. 3) Measure access to and performance of services. Develop a public national dashboard, updated at least every six months, to track compliance with deadlines for prescribed services, unanswered requests, and the effective operation of community homes and hospitals and healthcare technologies. Finally, 4) Promote appropriateness and prevention. Implement the recommendations of scientific societies on low-value services and link accreditation, quality, and outcomes. Strengthen screening, information, and counseling, including through initiatives such as 'Fism for People'.
"The analyses," concludes Loreto Gesualdo, president of Fism, "help identify priorities. The measures promoted by the ministry offer concrete tools to address them. Fism is making available the expertise of its 250 scientific societies to support this process and help translate decisions into services that are more relevant to the individual. The National Health Service must continue to guarantee health outcomes and strengthen timelines, access, and proximity."
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