The pandemic has highlighted the fragility and disparities of a National Health Service already hard put to confront the combination of an ageing population and the growing incidence of chronic pathologies. As a result, the political agenda is now focused on striking a new balance between macro assistance levels (moreover, previously indicated in “fiscal federalism” reforms) and the proportioning of related standard costs. Offering people care and assistance continuity are fundamental criteria in a functioning healthcare system that are going to require a substantial boost in the quality and quantity of local “territorial” socio-medical and assistance alternatives to hospitals, with a view to making services as homogeneous as possible across the various regions.
With regard to the healthcare sector, the National Recovery and Resilience Plan (PNRR), on the one hand, correctly sets a series of objectives designed to point the national system in the direction of local level reorganization and reinforcement, not least by means of digital infrastructures.
Such a reform process will necessarily have to depart not from a reorganization of demand but rather from the urgent need to resolve the issue of fragmentation and lack of regional homogeneity. In brief, an innovative model finally suited to fostering the development of national health services, outlining standards (particularly for IT systems), reducing asymmetries and promoting efficiency, adequacy and appropriateness across the nation.
This in turn calls for a rethinking of the supply side that starts with an accurate analysis and understanding of a shifting health services demand increasingly influenced by the incidence of chronic pathologies and the ageing of the population.
The combination of digital technologies, new models for providing care, local level facilities organized in function of that changing demand, and renewed consideration of the home as the prime location for prevention and treatment, are all elements contributing to the radical evolution of the National Health Service. Aims include a new role for the family physician, a holistic approach to health that also involves the private sector and a stronger focus on prevention underpinned by continual data monitoring through the use of Electronic Health Records, which could well be the key to the organization and provision of healthcare and social assistance services to citizens.
Italy’s public and private institutions are in a position today to seize the opportunities offered by the pandemic to make bold innovative decisions involving public facilities, intermediate agencies, private enterprise, professionals and citizens in forging a new alliance dedicated to improving collective and individual well-being and to the long-range stamina of the National Health Service.