ROMA (ITALPRESS) – The National Health System after the pandemic is still marked by strong territorial unevenness and management criticality, although it has started towards a phase of consolidation. The Court of Auditors affirms this in the Report to Parliament on the management of Regional Health Services, approved by the Autonomous Section with Resolution No 21/SEZAUT/FRG/2025, from which the increase from 131,3 to 138,3 billion of public health expenditure reported to the three-year period 2022-2024, with an increase of 4.9% compared to 2023 (5.4% on 2022) and the maintenance of a stable.
The increase, specifies the accounting judiciary, is driven by the expenditure items relative to staff (+5.6%) and intermediate consumption (+7.5%), but reduced to a real increase of just over 1% due to inflation, highlighting a more defensive spending dynamic that expanded. Private expenditure and territorial differences weaken the equity of access and universal service. In 2024 the total health expenditure was 185 billion, of which 74% were borne by PA and compulsory insurance, 22% were paid by households and 3% were paid by voluntary schemes, with an increase in the share of the private component which places the latter among the highest in comparison with the European average.
There are significant differences in the delivery of the Essential Levels of Assistance (LEA) and a clear North-South misalignment. Regions in return plan (Calabria, Molise, Sicily, Campania, Lazio, Abruzzo, Puglia) continue to show structural difficulties despite some improvements in the accounts. The increase in interregional health mobility also marks differences in attractiveness and capacity to provide services. On the PNRR investment front of Mission 6 (Salute), in which 15.6 billion are planned to strengthen proximity, digitization and health infrastructure, at the end of 2024 41% of the objectives were completed, with the remaining 59% to be concluded in the two years 2025-2026.
The proximity network (with 1,038 Community houses and 307 Community hospitals) represents the strategic axis for the new SSN, but the monitoring carried out has evidenced delays in the start of the work and difficulty in covering the holidays of staff, with shortcomings of health profiles and technicians able to limit the full operation of the new structures. On the pharmaceutical side, the total spending 2024 exceeded the planned roof of 15.3% of the FSN. The introduction of new spending roofs and the payback mechanism guarantee a financial balance which, however, presents considerable margins of uncertainty related to litigation with enterprises. It grows the use of generics and biosimilars.
On staff, there is a significant use of flexible contracts and, in some regions, the so-called “gettonists”, an institution which entails greater costs and requires constant monitoring. In general, the shortage of public resources is reflected in the difficulty of recruiting and maintaining staff. The Court recalled the need to strengthen governance, accelerate investment, stabilize staff and correct the differences between regions. The future of the SSN will depend, in fact, on the ability to transform resources into qualitatively better services, increasing management efficiency and strengthening territorial equity.
– Photo of repertoire IPA Agency –
(ITALPRESS).
