Overview

• The Ministry of Health’s decree effective July 31 bars renewal of all freelance cooperative contracts for doctors and nurses in the SSN, marking a shift to curb €2.1 billion in spending over five years.
• Without a structural plan to hire permanent staff, 30% of ER medical posts—some shifts up to 80%—are at risk of remaining vacant as contracts expire over the next 12 months.
• Regional authorities from Veneto to Lazio have filed requests for derogations, with some proposing rehiring retired physicians to backfill critical roles.
• Contractual clauses in many cooperative agreements prevent doctors from joining the SSN for two years after contract end, further limiting the pool of replacements.
• Officials warn that this staffing crisis will worsen under high summer temperatures and the influx of pilgrims for the upcoming Jubilee, threatening emergency service continuity.