The reform of family doctors stalls. After weeks of talks between the Ministry of Health, Regions and professional groups, the plan developed by Minister Orazio Schillaci together with the Regions failed to find political consensus within the governing coalition and was thus blocked.
Despite the agreement reached by all Regions, the center-right would effectively have pushed to halt the measure.
The majority’s motives
The political slow‑down concerns mainly the employment relationship of general practitioners. The draft drawn up by the Ministry and the Regions aimed to overhaul the current setup through a twofold path: on one side a reformed contract as the standard model, and on the other a form of selective dependence for the duties to be carried out within Community Health Centers.
A substantial portion of the majority, however, does not believe that dependence is the right path. The Fratelli d’Italia representatives oppose the idea of turning family doctors into public employees, arguing that the conventional contract should remain the primary pathway for general practice and pediatrics under patient choice.
Forza Italia rejected the notion of pushing family doctors back to being “anonymous bureaucrats” confined within the Community Health Centers, instead calling for an act of guidance to modify the contracting arrangement in favor of group practices capable of ensuring on‑call availability, trust and proximity.
Schillaci, however, responded to the criticisms by clarifying that he does not intend to dismantle the role of the family physician, but rather to strengthen it.
The slowdown comes at a moment when the Government must demonstrate that it can implement the Community Health Centers, conceived to transfer care directly to the local territory.
The doctors’ perspective
On the medical front, the FIMMG had declared a state of agitation against the project, denouncing the lack of prior consultation and even threatening a strike.
The criticisms concern not only the possible shift toward dependence, but also the fear that the new model will end up weakening the fiduciary relationship with patients, increasing organizational constraints and making an already struggling profession even less attractive.
Future prospects
Now the Government will have to decide whether to rewrite the text, scaling back the hypothesis of dependence and strengthening the contract, or postpone the intervention for a broader discussion with Regions, unions and Parliament.
However, time is not a trivial factor. The Community Health Centers have already been built or planned with European funds and must become operational: to date only 4% of those planned are fully functioning. Without doctors, nurses, specialists and truly integrated services, the risk is that the reform of territorial care remains unfinished.
Abbonati a Karla Miller
