Italy’s plan to reshape its national health system has run into strong resistance, with regional authorities calling for the government to withdraw the draft law and restart negotiations on how the system should be managed.
The proposed reform aims to redesign the Servizio Sanitario Nazionale (SSN), Italy’s public healthcare system. It includes changes to hospital organisation, territorial care networks and the creation of high-level centres of excellence with national and international roles. However, the Regions, which play a key role in managing healthcare, say they were not properly consulted during the process.
Speaking before a Senate committee, Massimo Fabi, coordinator of the Health Commission of the Conference of Regions, criticised the government’s approach, arguing that regional administrations should have been involved from the very beginning rather than being consulted only after the draft had already been prepared.
The Regions are now preparing an official document requesting the withdrawal of the bill. Their concern is that the reform risks upsetting the balance between national and regional responsibilities and could weaken the powers guaranteed to regional governments under Italy’s Constitution.
According to Fabi, the proposal “undermines the foundations” of the national health system and interferes with areas where Regions hold shared legislative authority. The Conference of Regions is expected to formally request a complete reset of the reform process and a new phase of negotiations with the government.
At the same time, a second source of tension is emerging over the future role of general practitioners, or family doctors. A separate draft reform promoted by Health Minister Orazio Schillaci focuses on how these doctors are organised and whether they should be more closely integrated into community healthcare centres known as Case della Comunità.
The proposal has triggered strong opposition from the Italian Federation of General Practitioners (FIMMG). The union argues that the reform could weaken the trusted relationship between family doctors and patients. It insists that general practitioners should remain independent contractors within the public system rather than becoming salaried state employees.
