In addition to the economic resources to ensure the services, there is a lack of doctors, nurses and, in general, all the social and health workers who should take care of the revitalization of the territory but also of the reorientation of hospital services, starting from the emergency rooms. Here is a Eurostat analysis of OECD data showing Italy’s gap to other EU countries.
22 JAN –
The problem of human resources is the first piece of the puzzle to be put together for the implementation of the PNRR and it is the alerting of the regions: in addition to the economic resources to ensure the services, there is a lack of doctors, nurses and other In general, there is a lack of everything social and Health workers who should deal with the revitalization of the territory, but also with the reorientation of hospital services, starting with the emergency rooms.
The analysis of the Italian situation in terms of the European panorama (not only in the EU countries and in any case also in comparison – for the professions of doctor and nurse, for which data are available in the OECD report Health at a Glance 2022 – with the partners of the G7 as more industrialized countries and therefore with greater development opportunities, also from a technological point of view, as the PNRR itself indicates in many of its “missions”), results from the focus of the statistical office Eurostat of the European Union, recently carried out, also in light of the latest data provided in the 2022 edition of the OECD’s Health at a Glance.
Going beyond the general data already presented at that time and the economic differences among doctors and nurses, Eurostat compares the situation of workers in the various European systems for professions and assistance activities and provides a general framework for its assessment of keeping main professions “under observation”, both in terms of the distribution in the population as well as based on the functions performed: doctors, nurses, but also midwives and, for the first time, the support staff ( This chapter takes into account both staff similar to Italian social and health workers and home care workers, including those who are not adequately trained in health care, but definitely support the most vulnerable groups in carrying out daily activities).
Eurostat’s focus is not limited to the human resources situation, but also analyzes possible future developments based on the training of the professionals considered, since training is one of the cornerstones to gradually fill the gaps and in any case to rebalance the care functions bring based on the development of skills and specializations.
As far as Italy is concerned, the overall picture that has been emphasized is that there is no shortage of doctors, but some numbers and specializations are missing. But even if they don’t appear to be lacking on paper today, we do know that public health is suffering from a severe shortage instead. And another alarming number: Italian doctors are the oldest in Europe. On the other hand, very critical figures regarding the number of nurses whose number is “in reserve”, both in terms of consistency and in terms of future prospects, for training and possible alignment with the rest of Europe (but also with many OECD countries) of responsibilities and competencies.
Obviously, the numbers of bottlenecks cannot be derived from comparisons between countries, since the structure of the different health systems is different and therefore the needs are also different, as also emphasized by Eurostat. For example, no one can say that there are “too many” doctors in Italy, because their ratio per thousand inhabitants is higher than the international average, also because, as Eurostat points out, there are sectors where this type of comparison highlights important weaknesses in the comparison to other countries.
For example that of general medicine, where Italy is not entirely absent, but has lost about 5,000 doctors in ten years, which theoretically would have to be regained in order to bring the number of Italian general practitioners per 100,000 inhabitants to the European average. And the current ones often do not do justice to their role as filters on the territory because there is a lack of multi-professional organization of assistance.
Or even, as Eurostat points out, the balance of some specializations (the Eurostat analysis takes into account those that, on average, are similar in the largest number of countries) in relation to emerging pathologies or treatment needs.
Just as little can one speak of a shortage similar to that which would arise in the case of nursing staff, for example, if their rate per 100,000 inhabitants were to be raised to the values of the OECD average: around 150,000 more than today would be needed and not the 65,000 that was also required by the Court of Auditors in its recent report on NADEF (October 2022) and by the Italian Nursing Federation, aware of the impossibility of finding such a workforce in anyone in a short time, proposed another aid organization that focuses on greater responsibility towards its professionals of the social and health care chain (in relation to the training and management of support staff in the structures and also to the training of home care workers). , analyzed by Eurostat in the chapter “Support staff”), with a development of roles and responsibilities, which Eurostat also describes in the description of the Prof. Dr Nursing deployment in the analyzed countries.
And for midwives another example: Eurostat data show a shortage in Italy of about 8,300 units, but also in this case the structure of the services, the demographic evolution (with sharply declining births), the epidemiological evolution (with some perinatal pathologies on the increase that may require support and continuous monitoring) and the multiprofessional organization of care.
However, the coherence based on the relationship with the population is in any case an indication of the responsiveness of the services and of the possibility that, as the PNRR shows, they can evolve primarily towards helping the person at home.
Julius Nisi
January 22, 2023
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