National Report Italy, May 2019 

  • Macroeconomic Outlook

In the last year, Italian economic recovery continued, albeit at a slower pace than it was in 2017. Real GDP for 2018 was 1.2%, with respect to 1.5% as expected in the Stability Program. The main measures envisaged by the 2019 Budget include the total sterilization of the safeguard clauses (VAT increases) for 2019 and the reduction of those expected for 2020 and 2021, the relaunch of public and private investments, the introduction of a flat tax for small businesses and for self-employed workers, the reform of the pension system in order to support youth employment, and the establishment of the Citizens basic Income.

  • 2019 Healthcare Funds & Economy

Healthcare expenditure -as percentage of national GDP- averages on 6.7% in the five-year period 2014-2018 (6.5% under unchanged legislation in 2019). In 2019 Italian healthcare budget is 111.2 billion euros with respect to a fund of 113 billion euros in 2018. This is because healthcare fund is strictly connected to the GDP. In our country, we are still facing prolonged austerity measures at the expense of public servants in the public sector. As a consequence, people are not taking care anymore of their health condition, especially in the some of the southern regions, because of economic constraints with consequent reduction of their life expectancy. It’s interesting to highlight -on more time again- an OECD analysis, about Italian healthcare system, showing a significant increase of out-of-pocket expense (36 billions in 2016), the need of improving long term care as well as to increase prevention’s activities.

  • Medical Specialists’ Shortage

In Italy, the shortage of Specialists is related to different causes: a large number of them is reaching the retirement age, as well as too few new doctors are currently being trained. Because of the lack of candidates with the necessary qualification, recently in two Italian regions (Veneto and Molise) doctors who had previously retired have been put again into hospital service.

  • National Collective Labour Agreement

After 10 years’ time waiting, it is likely that, in the next weeks, we will finally discuss a new collective agreement (related to the period 2016-2018!!!): our goals still include new possibilities of careers, increased meritocracy, clinical safety, and guarantee of contract rules’ application without interpretation.

  • Medical Malpractice in Italy

We are facing the consequences of law n. 24/2017, on liability of healthcare professionals. Indeed, according to the new law, in case of medical malpractice following imperfection, the healthcare professionals will avoid liability if the plaintiffs will not be able to demonstrate that the physicians didn't act in accordance with the recommended guidelines published under law; in the absence of these guidelines the professional should adhere to principles of good practice. Moreover, law n. 24/2017 states that the healthcare facility will be liable in contract for the doctor’s negligent or fraudulent behaviour. Conversely, the reform makes clear that practitioners can be sued as to civil liability, with the ensuing consequences regarding burden of proof and statutes of limitation. As regards limitation, a contractual action must be brought within 10 years, while an action under tort must be brought within 5 years. Another significant innovation contained in Law n. 24/2017 is represented by the creation of an Ombudsman for Health, to whom recipients of medical care can address their complaints. It is also expected that new regional Authorities -aimed to manage healthcare risks and patient safety- will be created to collect data about medical malpractice and related litigation, to identify appropriate measures to prevent and manage healthcare risks and to train healthcare professionals.