-32,500 in two years. 95 hospitals closed, over 10 thousand doctors missing

The health of the National Health Service (NHS) continues to worsen, starting from the situation of hospitals public: in just two years, from 2020 to 2022, they were 32,500 beds cut. In all, at least 100 thousand have been missing for years beds of ordinary hospitalization and 12 thousand of intensive care. Furthermore, between 2019 and 2022, over 11,000 doctors left public facilities. The number of hospitals is also decreasing: in 10 years 95 (9%) have been closed. And the resources are increasingly fewer: “in 2024, the financing of the Health Fund increased in absolute terms compared to 2021 but decreased compared to the GDP and is strongly eroded by inflation”.

The alarm

This is the picture drawn today by the Forum of the 75 Scientific Societies of Italian hospital and university clinicians (Fossc) who, in a press conference at the headquarters of the representation in Italy of the Parliament and the European Commission, launched an appeal to the government asking for a «major structural reform and urgent measures to save the universalistic NHS. Treatments for everyone – they warn – are at risk”. Also due to the lack of doctors: «By 2025 – states the Fossc coordinator, Francesco Cognetti – 29,000 white coats and 21 thousand nurses will retire, without sufficient inclusion of new and increasingly younger professionals, trained at the expense of the State (approximately 150 thousand euros each) go abroad, where they receive salaries even three times higher.” Not only. In 2024, he notes, “the financing of the National Health Fund increased in absolute terms compared to 2021, but decreased compared to the GDP, and these resources were largely used for negligible contractual increases for staff”. Furthermore, «the essential levels of LEA assistance, i.e. the treatments considered fundamental, are not respected in 12 out of 21 Regions. And these – he specifies – are the LEAs currently in force which date back to the Prime Ministerial Decree of 29 November 2001, updated with the Prime Ministerial Decree 12 January 2017, but never implemented”.

Waiting lists, the plan to reduce waiting times: more doctors, clinics open in the evening, visits also on weekends and holidays

The numbers

But the “more seriously ill” is represented precisely by hospitals: Italy, underlines the Forum, occupies 22nd place in the European ranking of the number of beds. The Italian average is 314 ordinary hospital beds per 100 thousand inhabitants compared to the European average of 550 and 8-10 intensive care beds per 100 thousand inhabitants compared to 30 in Germany and more than 20 in France. A “very serious” situation – states Fabio de Iaco, president of the Italian Society of Emergency Medicine Simeu – which causes serious distortions in the care system. In fact, patients who require intensive or semi-intensive care often, due to lack of beds, risk remaining in the emergency room for days, despite having more serious conditions. This is alarming and for this reason we urgently ask that semi-intensive care facilities be encouraged.”

Staff

Even the Pnrr, states the Forum, “plans to reserve only 8.3% of the funds provided for healthcare, but only for technological updating and research in hospitals, nothing for structural and personnel strengthening”. It is precisely the lack of personnel and services that risks creating phenomena of “health desertification in some areas of the country” is also the alarm raised by Cittadinanzattiva. In these conditions, the Scientific Societies ask “how it is possible to even think about passing the law on Differentiated Autonomy”. The largest hospital doctors’ union, Anaao Assomed, is of the same opinion: «The profound differences between North and South in health matters put the country’s social cohesion at risk. And the bill on Differentiated Autonomy being examined by Parliament, instead of bridging this gap, risks widening it further, dividing Italy in two: one in the North, with first class healthcare and citizens, and one in the South, with healthcare and second-class citizens.” What we risk, warns Anaao secretary Pierino Di Silverio, is “social disintegration”.