Italy Abandons Family Doctor Reform Decree After Regional Revolt

Italy's government has withdrawn a decree that would have overhauled the nation's family doctor system, backing down after intense opposition from regional authorities and growing tensions within its own political ranks. The decision was announced on June 11, leaving the future shape of Italian primary care in limbo.

The scrapped decree had been intended to redefine how general practitioners work within the national health service, including changes to how doctors operate inside so-called Community Health Houses — integrated local care centres that have been a centrepiece of Italy's post-pandemic health reform agenda. Officials at the health ministry sought to soften the blow, stressing that work on expanding the Community Health House network would continue regardless.

The planned reform included a provision that would have required family doctors to commit just six hours of service within the Community Health Houses, a figure that drew sharp criticism as inadequate. The limited hours requirement was seen by detractors as a symptom of broader half-measures in the legislation.

The most striking public reaction came from Guido Bertolaso, a senior figure associated with the governing right, who expressed undisguised anger at the retreat, describing the outcome as demoralising. His comments signalled a fracture on the right over health policy that officials have not yet moved to paper over.

Medical trade unions, by contrast, welcomed the withdrawal. Union representatives said the collapse of the decree opened the door to genuine negotiation, framing the government's step back as an opportunity to restart talks on better terms. Their response highlighted the gap between how the government and organised labour had each assessed the reform.

The standoff over family doctor reform is part of a longer struggle over how Italy implements structural changes to primary care that were partly funded through European Union post-pandemic recovery money. Community Health Houses were promoted as a way to ease pressure on hospital emergency departments by expanding neighbourhood-level care, but their rollout has been uneven across regions.

The resistance from regional governments reflects a persistent tension in Italian health policy, where the regions hold substantial constitutional authority over healthcare delivery and have repeatedly clashed with Rome over the pace and design of national reforms. That dynamic played a central role in collapsing this latest legislative effort.

What form any future reform attempt will take remains unclear. The ministry's insistence that Community Health House expansion will proceed suggests the government still intends to reshape primary care, but whether it will return to the family doctor question through a new decree, a parliamentary bill, or negotiated agreement with the regions and unions is not yet established.