The investments of the Pnrr in Health could help to "smooth out" some of the problems of the Italian system, in particular in terms of territorial health care, "but other aspects will have to be tackled differently". The Parliamentary Budget Office writes it in a focus entitled "The PNRR and health care: aims, resources and first goals achieved".
The infrastructural rebalancing between the Regions
As regards, for example, infrastructural rebalancing, considering the great heterogeneity among the regional health services, "the criteria for allocating and allocating funding appear rigid - writes the Upb - while aiming to support the weak areas with the constraint of minimum spending aimed at the South (40 per cent), which, however, has been respected so far. A fixed percentage for all the interventions appears to be hardly compatible with the results of the surveys on the starting conditions and the needs in the various territories”.
An example is the case of big machinery: from the comparison between the percentages of allocation of the relative loans and the distribution of the requirement for investments in high and medium-tech electro-medical equipment resulting from a survey carried out in 2020, differences emerge, with two regions of the South (Campania and Puglia) obtaining an advantage significant with the allotment and two of the Center (Umbria and Lazio) which are disadvantaged.
Shortages of personnel and emergency services
Furthermore, the Pnrr does not solve the question of staff shortages, "not representing the right instrument to finance ongoing current expenses", which should instead be addressed with the budget law. Other critical issues, such as those concerning the services of first aid, are addressed by the Pnrr mainly relying on technological improvements and on the lightening that would be ensured by the preparation of an efficient treatment system in the area.
However, "the problems of the emergency room appear relevant and urgent, and therefore they will probably also have to be tackled with tools of a different nature, overcoming personnel shortages as soon as possible".
Uncertainty about future resources
Furthermore, the UBP points out that there is “uncertainty about the current resources available to manage health services enhanced thanks to planned investments, above all once the funding secured by the PNRR is exhausted and the new facilities will be operational.”
Estimates of the burdens "often appear to be elaborated mainly on the basis of available resources - continues the focus - and part of the costs would be covered within the context of the NHS funding, thanks to the cost savings allowed by the reorganization of the system and by technological innovation and digital".
However, "even if it is not implausible that the reforms underway in the NHS could allow for an improvement in efficiency, relying on future spending savings may not be prudent – still writes the Parliamentary Budget Office – especially in a sector, such as the health sector, in which the absorption of technical progress can often imply an increase in costs”.
The increase in resources for the NHS planned for the next few years from budget law 2022, then, "will be destined in part to actions to strengthen the system (starting with the amount of 1,015 billion when fully operational for territorial assistance), but other charges connected with the renewal of staff contracts and with the application of the new essential levels of assistance”, concludes the Upb.
