Il riparto di competenze in materia sanitaria alla prova del Piano nazionale di ripresa e resilienza

di Silvio Roberto Vinceti

SOMMARIO: 1. Introduzione. — 2. La parabola della competenza legislativa regionale in materia sanitaria. — 3. L’impatto del PNRR: la riforma dell’assistenza sanitaria territoriale. — 4. Ulteriori spunti di riflessione. 5. — Conclusioni.

Italy’s National Recovery and Resilience Plan (NRRP) sets forth consequential reforms in the organization of the Italian health system, among which lies a comprehensive restructuring of primary care. While the new healthcare arrangement seems consonant with health organization literature, the reform amounts to a stark standardization of the regional health systems. Given the Italian Regions’ role as pivotal lawmaking institutions in healthcare, one could speculate about the constitutional soundness of their overall exclusion from the drafting of the NRRP. The Regions, however, did not take formal action against the central government or the NRRP, possibly for strategic reasons. This paper investigates the technical viability of a constitutional opposition by the Regions against a negotiated agreement between the central government and the European Union. Moreover, the paper raises some prospective remarks as to the relevance of the NRRP for the status of Regions as leading legislative institutions in healthcare, the place of the NRRP in the broader context of the “Europeanization of health” and the apparent conflict between the NRRP’s centralizing effect and the unfolding process of asymmetrical regionalism in the Italian constitutional system.