Revitalizing the Italian NHS: remarks on the 2021–2026 national recovery plan (next generation EU)

Abstract

The first cases of coronavirus disease (COVID-19) were recorded in China in late 2019. By February 2020 the disease had begun to spread to other Asian countries and then throughout Europe, where Italy was the first country to be hit by the pandemic. Overall, the country’s national health service is reputed to provide quality health services. Indeed, nearly all Italian residents are registered with the NHS, which covers most of the medical costs in hospitals and physician consultations (OECD 2019), and hospitals are described as providing high-quality treatment for patients requiring acute care. As Morciano and Caredda (1) state, “Italian prevention services are largely public and free at point of delivery. Immunisation and screening programmes represent priorities in the public health area, although with differences in services between regions”. Yet there remain wider issues that hinder NHS performance. Italy has a decentralized healthcare system organized by region and a weak governance structure that generates inequalities, with poor national coordination between the country’s 20 regions (2). There is also the problem that the pandemic response plan appeared to be outdated when the crisis emerged (The Guardian, 13 August 2020 https://www.theguardian.com/world/2020/ aug/13/italy-pandemic-plan-was-old-and-inadequatecovid-report-finds). The infection rate rose rapidly after the first recorded case of COVID-19 (23 February 2020), with nearly 3,000 new infections and 100 deaths occurring in less than two weeks. The Italian government issued a Decree of the President of the Council of Ministers (DPCM) announcing a national lockdown shortly thereafter (11 March through 3 May 2020), followed suit by other European countries over the subsequent weeks. The pandemic had gone global, escaping the control of many countries. And it continues to spread by variants. Presently, the number of COVID-19 cases has begun to increase again in Italy, and localized lockdowns were issued between October 2020 and the first half of 2021. While the situation had stabilized during the second half of 2021, the emergence of the new omicron variant aroused renewed alarm in early 2022. The pandemic has created numerous challenges for the Italian NHS. The national recovery plan will need to address several, among which the following are of particular importance.