Health Professions in Italy: Doctors Are Not Lacking, but Leaving the Public Health System

Physician supply above OECD average

Italy has 5.4 physicians per 1,000 inhabitants, a figure well above the OECD average of 3.9. Despite this relatively high availability, more than 92,000 doctors currently work outside the National Health Service (SSN), either in the private sector or abroad. The data highlight a structural mismatch between overall supply and effective availability within the public system.

Shortages concentrated in key clinical areas

Physician shortages persist in specific sectors rather than across the workforce as a whole. The most critical gap concerns general practice, with an estimated shortfall of over 5,500 family doctors. Additional deficits are reported in emergency medicine, radiation oncology, nuclear medicine, palliative care, and community and primary care services.

Findings presented to Parliament

These figures were presented by Fondazione GIMBE during a parliamentary hearing at the Camera dei Deputati on the draft law reforming health professions. According to the foundation, the data reflect a long-term erosion of the attractiveness of public-sector medical careers.

Declining investment in healthcare personnel

Between 2012 and 2024, spending on healthcare personnel in Italy decreased in relative terms by an estimated €33.04 billion. Over the same period, the share of personnel expenditure within total health spending fell from 39.7% to 36.6%, indicating a progressive shift of resources away from the workforce.

Nursing workforce under pressure

Challenges also affect the nursing profession. Italy has 6.9 nurses per 1,000 inhabitants, compared with an OECD average of 9.5. In addition, for the 2025–2026 academic year, applications to nursing degree programs were lower than the number of available training places, raising concerns about future workforce sustainability.

Limits of the current reform proposal

According to the foundation, the proposed reform of health professions contains broadly shared objectives but lacks dedicated financial resources. The inclusion of a financial neutrality clause means that many measures may remain purely formal. Without funding to improve working conditions and career prospects, the reform risks having limited practical impact.

Professional liability as an unresolved issue

Another area of concern relates to changes in professional liability rules. The proposed alignment of clinical guidelines with good clinical practices may introduce legal uncertainty rather than strengthening professional protection, potentially complicating risk management for healthcare workers.

A system under strain

Overall, the data suggest that Italy’s healthcare workforce challenges are not driven by insufficient numbers of doctors, but by retention failures within the public system, combined with underinvestment, uneven workforce distribution, and unresolved regulatory issues.