Italy withdraws family doctor reform after regional backlash; Lombardy health chief resigns in protest
The Italian health ministry has withdrawn a decree-law that would have moved family doctors into community health centres and made some of them salaried employees, triggering the resignation of Lombardy's health assessor from a key regional coordination role.
The withdrawn decree
The reform of territorial medicine, championed by Health Minister Orazio Schillaci, would have integrated family doctors into the newly established Case di Comunità (Community Health Centres) and shifted a portion of them from independent contractor status to direct employment by the national health service. The text had been presented to the Conferenza delle Regioni and reworked by the regions, but was never formally introduced as a decree. It had drawn sustained opposition from medical unions, who argued they were excluded from decisions affecting them directly.
A reform that has neither head nor tail. In a context of scarce resources, you cannot expect serving doctors, already burdened with enormous patient loads, to be in their practices and, for a set number of hours, in the Community Health Centres at the same time.
The withdrawal
During a meeting between ministry technical staff and regional health assessors on 10 June 2026, the head of the health ministry's cabinet, Marco Mattei, communicated the decision to pull the decree. According to ministry sources, the decree will be replaced by an agreement to be approved either through an amendment to a government bill or by inserting it into the directive for the renewal of the family medicine convention, which is nearing its deadline.
Mattei outlined that doctors will be asked to dedicate six hours of activity to the Community Health Centres, aiming to cover staffing needs in the new facilities financed by the PNRR. These centres remain understaffed in almost all regions except Tuscany and Emilia-Romagna. A subsequent phase, he added, would launch the actual reform, reintroducing some measures from the draft decree — such as the establishment of a specialisation in general medicine and the extension of paediatric care up to age 18 — without addressing the employment status question.
Bertolaso's protest
The withdrawal provoked a sharp reaction from Guido Bertolaso, the Welfare Assessor for the Lombardy Region and one of the reform's strongest backers. Bertolaso expressed "profound dissent and bitterness", calling the affair "disheartening". He resigned from his post as vice-coordinator of the health assessors' commission and walked out of the meeting. In his view, the six-hour provision was insufficient without a broader, structural intervention. The reform ultimately foundered on resistance from within the same centre-right majority that had promoted it.
Political fallout
The episode has drawn criticism from opposition figures over parliamentary exclusion. Senator Sandra Zampa, the Democratic Party group leader in the Senate Health Commission, stated that Parliament had been "totally sidelined", learning of the reform's existence and its internal opposition only through media reports and intercepted phone calls involving Lazio Region President Rocca. She has formally requested a hearing with Minister Schillaci to understand the reform's contents, why it collapsed, and who within the government pressed for its withdrawal.
I think it is inadmissible that Parliament can be ignored and bypassed in this way. Italians have the right to know.
