Reorganizing Italy’s Territorial Healthcare: the Ministerial Decree No. 77/2022 and its Comparative Significance
Keywords:
Public law, public health, comparative law, national health systems, NHSAbstract
As approved by the European Commission in 2021, Italy’s National Recovery and Resilience Plan encompasses a far-reaching reform in the governance and structure of the national health service (NHS) that should shift the focus of assistance from large, centralized hospitals to a tight network of numerous smaller health centers dislocated in the country. In this respect, the adoption of the Ministerial Decree no. 77 on May 23, 2022, represented a key step in the execution of the intended reform, to the extent that the Decree set forth the main terms of the primary care reorganization process. This review summarizes the key elements of the Decree, foreshadows its legal and public health implications, acknowledges the uncertainties about the economic feasibility of the reform, and highlights its possible comparative significance for health systems facing similar challenges, especially those — such as the UK NHS — that share a comparable type of funding system and organizational framework.
References
1. Filippini T, Vinceti SR. Italian National Recovery and Resilience Plan: a Healthcare Renaissance after the COVID-19 crisis? Acta Biomed. 2021 Nov 17; 92(S6): e2021463. doi: 10.23750/abm. v92iS6.12339.
2. Council of the Europan Union. REVISED Annex to the COUNCIL IMPLEMENTING
DECISION on the approval of the assessment of the recovery and resilience plan for Italy. 2021 Available on: https://data.consilium.europa.eu/ doc/document/ST-10160-2021-ADD-1-REV-1/ en/pdf. [Last accessed: 2023 January 25].
3. Ministero della Salute. Decreto 23 maggio 2022
n.77. Regolamento recante la definizione di modelli e standard per lo sviluppo dell’assistenza territoriale nel Servizio sanitario nazionale. Gazzetta Ufficiale - Serie Generale 2022 n. 144 del 22 giugno 2022.
4. Vinceti SR. La costituzionalità della psicologia di base: Una pronuncia “regionalista” con interessanti profili di diritto comparato. Giurisprudenza costituzionale 2021; 6: 2688-97.
5. Vinceti SR. The Legal Status of General Practitioners at the dawn of the New Primary Care in Italy. Ann Ig. 2022 Sep-Oct; 34: 431-8. doi: 10.7416/ai.2021.2492. Epub 2021 Nov 30.
6. Vinceti SR. La mobilità sanitaria interregionale in Italia alla luce della teoria federalista e delle esperienze comparate. Corti Supreme Salute 2022; 3.
7. CERGAS – Bocconi. Rapporto OASI 2022: Osservatorio sulle Aziende e sul Sistema sanitario Italiano. Egea Editore.; 2022.
8. OECD Health Policy Studies. Realising the Potential of Primary Health Care. 2020. Available on: https://www.oecd.org/health/realising-thepotential-of-primary-health-care-a92adee4-en. htm [Last accessed: 2023 January 25].
9. Toth F. La sanità in Italia. Bologna: Il Mulino; 2014.
10. UK Parliament. Health and Care Act 2022 - Government Bill 2022. Available on: https:// bills.parliament.uk/bills/3022/publications [Last accessed: 2022 January 25].
11. Clarkson P, Brand C, Hughes J, Challis D, Tucker S, Abendstern M. Cost effectiveness of pilot self-assessment sites in community care services in England. Aust Health Rev. 2013 Nov; 37(5): 666-74. doi: 10.1071/AH13056.
12. Henderson C, Knapp M, Fernandez JL, et al. Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. BMJ. 2013 Mar 20; 346: f1035. doi: 10.1136/bmj.f1035.
13. Roderick P, Pollock AM. Dismantling the National Health Service in England. Int J Health Serv. 2022 Oct; 52(4): 470-9. doi: 10.1177/00207314221114540. Epub 2022 Jul 25.
14. Street A. For-profit health care might be damaging population health. Lancet Public Health. 2022 Jul; 7(7): e576-e7. doi: 10.1016/S24682667(22)00142-6.
15. Bach-Mortensen AM, Goodair B, Barlow J. Outsourcing and children’s social care: A longitudinal analysis of inspection outcomes among English children’s homes and local authorities. Soc Sci Med. 2022 Nov; 313: 115323. doi: 10.1016/j.socscimed.2022.115323. Epub 2022 Aug 30.
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.