Italy’s Healthcare Reform Gets Green Light: New Hospital Models, Stronger Community Care, and Greater Flexibility for Doctors

Healthcare, green light for enabling law: new referral hospitals and greater integration with the local community. More flexibility for doctors and openness to EU and non-EU professionals.

The Council of Ministers has approved, upon a proposal from Health Minister Orazio Schillaci, the enabling law for the reorganization and strengthening of the National Health Service (SSN). This structural intervention aims to make the healthcare system more efficient, modern, and responsive to citizens’ needs, strengthening integration between hospitals and the local community and introducing new organizational models.

“We want a National Health Service better able to meet citizens’ healthcare needs,” stated Minister Schillaci, “ensuring greater uniformity in the provision of services, in compliance with the principles of equity, continuity of care, and humanization of treatment.”

Third-Level Hospitals and Reducing Healthcare Mobility

Among the main innovations of the reform is the updating of the classification of hospital facilities, with the introduction of third-level hospitals, centers of excellence with a national or supranational catchment area, designed to reduce healthcare mobility and ensure high standards throughout the country.

Alongside these, the measure provides for the identification of elective hospitals, acute care facilities without emergency rooms, intended to accommodate non-urgent patients transferred from higher-level hospitals. The goal is to improve the appropriateness of care and optimize the use of hospital resources.

Community and Care of Fragile Patients

The enabling law devotes considerable space to strengthening community care, with particular attention to dependent individuals, continuity of care, and the promotion of home care. Staffing standards and new care models for patients with complex and advanced chronic conditions are envisaged, in addition to strengthening palliative care.

The reform also aims to promote good clinical, healthcare, and organizational practices, strengthen the integration of healthcare and social care, reorganize mental health services, and promote clinical bioethics as a tool for humanizing care. This context also includes the reorganization of the regulations governing general practitioners and pediatricians, who are called upon to play an increasingly central role in community healthcare.

More flexibility for doctors and a fight against waiting lists

In parallel with the reform, Forza Italia has presented an amendment to overcome the incompatibility regime that, since 1991, has limited the ability of NHS doctors to perform additional activities in other public or private facilities. This proposal aims to reduce waiting lists by allowing professionals, on a voluntary and paid basis, to offer additional hours.

Minister Schillaci has described the 38-hour fixed-term contract model as “anachronistic,” paving the way for greater organizational and contractual flexibility. According to the proponents, even partial participation by doctors could generate millions of additional services each year, without requiring new hires.

An opportunity for struggling regions, like Calabria

The new measures could also represent a concrete opportunity for regions experiencing a severe shortage of healthcare personnel, like Calabria. This is the context for the recent request by the regional president, Roberto Occhiuto, to facilitate the recruitment of doctors from European Union and non-EU countries, to address the structural challenges of the Calabrian healthcare system.

The introduction of more flexible organizational models, the review of incompatibilities, and the strengthening of the ministry’s role in the governance of the National Health Service could facilitate the inclusion of foreign professionals, making the public system more attractive and helping to fill staffing gaps in hospitals and local services. This strategy, if accompanied by integration and skills recognition processes, could positively impact the quality of care and reduce healthcare mobility to other regions.

Discussion with professionals

Signs of openness are coming from the medical community and trade unions, but also requests for involvement. Cimo-Fesmed has welcomed the idea of ​​greater liberalization of the medical profession, while Anaao has reiterated that no reform can be effective without the full involvement of healthcare professionals.

The legislative process is only just beginning: the implementing decrees must be adopted by December 31, 2026. The government’s challenge is to transform these reforms into concrete tools to reduce the risks.