‘Intended’ and ‘unintended’ consequences of the privatisation of health and social care systems in Italy in light of the pandemic

Abstract

This article analyses the long-term effects of privatisation and marketisation on the Italian regional health and social care systems. The research focuses on three Italian regions – Lombardy, Veneto and Lazio – which are representative of three different models of governance in these sectors. We examine the effects of privatisation and marketisation on the health and social care system by discussing how the regional health-care systems have managed the impact of the COVID-19 pandemic. We also shed light on the dramatic consequences of the pandemic crisis on employment levels and working conditions.

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

“…Another explanation could be that these contradictory findings are merely a reflection of contradicting priorities between different actors within the healthcare system; increased private investment on profitable medical technology and coexisting public disinvestment from hospital care and healthcare workers due to austerity measures, especially during the Great Recession. 61,67 Similarly, the scarcity of regional financial resources for the training of new GPs to replace retiring ones explains the reduction of primary care physicians. 36,68 Austerity measures during the Great Recession may have contributed to further lower availability.…”

“…Another explanation could be that these contradictory findings are merely a reflection of contradicting priorities between different actors within the healthcare system; increased private investment on profitable medical technology and coexisting public disinvestment from hospital care and healthcare workers due to austerity measures, especially during the Great Recession. 61 , 67 …”

Unequal Access to Testing and Vaccination Services for the Homeless and Undocumented Population During COVID-19 Pandemic

“…Provision of vaccines should be as decentralised as possible to favour the reachability of the service [ 31 ]. However, leaving the organisational responsibility to the third sector and local providers alone is not a feasible long-term solution since attaining a comprehensive vaccination distribution and coverage diverges from the main tasks of local and private not-for-profit providers [ 14 ]. According to Ralli-Morrone et al [ 32 ], early identification of asymptomatic carriers is crucial in relatively unsafe settings like homeless shelters, where infections can easily spread and cause outbreaks with serious consequences for individuals and public health.…”

“…The Italian healthcare system is heavily decentralised [ 13 ]. Accordingly, the country’s pandemic response has been fragmented and inappropriate to the needs of the vulnerable population [ 14 ]. Since 2020, for example, every region has been responsible for the organisation, management, and provision of essential epidemiological surveillance and prevention in the context of COVID-19 [ 15 ].…”