Doctors and nurses: competitions are more attractive if there is service accommodation.

All those in the field are well aware of the significant difficulties healthcare organizations face in recruiting healthcare personnel, particularly—if not exclusively—nurses and doctors specializing in four or five specific disciplines. Competitions are either closed or receive a completely insufficient number of applications to ensure a reliable and long-lasting ranking. There are essentially two reasons: a general one—the inability of current regulations to meet the needs of organizations—and a subjective and cyclical one—namely, the lack of attractiveness that the nursing and medical professions have now achieved, limited to the disciplines of pathology, anesthesia and intensive care, emergency medicine, geriatrics, and radiotherapy, to name just the most critical of the twenty for which the 2025 Budget Law has increased scholarships. Some attempts have been made in the recent past, such as the case of the Tuscany Region which - despite applying the infamous Presidential Decree 483/1997 - with the "Start-smart Competition - water/land" operation attempted to direct the procedure towards specific business needs, providing a targeted addendum to the tender.

Recently, several press reports have appeared regarding two initiatives that could make hiring the aforementioned healthcare workers more attractive for the National Health Service (NHS). The first, reported in La Stampa on June 22, concerns the initiative by the Municipality of Verbania, which, as part of its property disposal plan, will no longer auction off its last remaining unsold apartment. The three-room apartment will be offered to the VCO Local Health Authority (ASL) for its Healthcare Reception Plan (PAS). These are initiatives the healthcare authority is attempting to implement with the help of mayors to offer incentives for the relocation of healthcare professionals, at a time when there is a shortage of doctors and nurses nationwide. Other municipalities in the area have also approved the possibility of reserving a portion of municipally owned housing for healthcare professionals in their tenders. Furthermore, the regional law on social housing includes a specific provision regarding the assignment of housing to law enforcement and firefighters, and the current emergency in hospitals would certainly justify classifying healthcare workers as such.

But the initiative mentioned is certainly not entirely new, as the issue of providing staff housing is by no means a new one. Already 21 years ago, the National Collective Bargaining Agreement (CCNL) for the former Area IV of February 10, 2004, included this clause in Article 22, paragraph 4: "The company, at its own expense, may regulate the use of staff housing for special needs related to the specific type of duties performed by previously identified categories of managers." An identical provision had already been established for the sector in Article 27, paragraph 4, of the National Collective Bargaining Agreement of September 20, 2001, when the healthcare system was experiencing a serious nursing shortage. Just as university housing exists, corresponding hospital housing should be implemented: internal spaces in company facilities exist, and with a little foresight, funds from the PNRR or, even before that, those from the ESM could have been used, although some have said that "we don't need them."

The second piece of news comes from the Veneto region (Regional Portal, press release no. 1148 of July 1) and concerns the new measure implemented by the Zaia Regional Government, the first region to propose it to address the staffing crisis in local hospitals. This involves a €1,000 annual grant for each of the three years of the program for new students enrolled in the Nursing Faculties of Padua and Verona who pass the annual internship exam. The incentive will be paid out for each year of the degree program in the form of vouchers, through the Employment Centers, for a total investment of €9 million. As might be expected, even such an initiative has generated dissent, with some considering it an electoral ploy and, in any case, not structural. However, the underlying idea is absolutely legitimate and aimed at recruiting more nurses than those currently applying for positions.

Nonetheless, out of a dutiful debt to the historical memory of our public healthcare system, I would like to recall that many, many years ago, the Pio Istituto di S. Spirito in Rome—the largest hospital in Europe—in its numerous nursing schools not only provided books, uniforms, lessons, and meals to students, but also paid a rising "pre-salary" over the three-year course. Furthermore, the school was completely free, excluding the current regional DSU taxes. If we then add that students who graduated within a month or two were hired directly by the hospital where they studied, which had invested considerable resources in them, a possible solution to the nursing staff crisis can be found: a training and work contract, to be signed in the second year of the three-year degree. This solution would avoid public competition, increase nurse loyalty, and prevent the loss of existing investments. This solution, with due distinctions, could also apply to doctors.