Healthcare, evening and holiday shifts to reduce waiting lists. Gemmato told Affari: "The Piedmont model should be extended nationwide."

Undersecretary, the complex puzzle of American tariffs, which threaten to seriously impact even such a crucial sector of the economy as pharmaceuticals, doesn't seem to be resolved. What do you think the government is doing about it?

We await developments in the negotiations because, as has often been emphasized, a trade war benefits no one. We are talking about a strategic sector, the pharmaceutical sector, which directly impacts the health of citizens and our country's economy, but also the health of Americans themselves, who, with a block on imports from the EU, would risk potential drug shortages. The Meloni government is working with the European Commission to find a shared solution that protects our businesses and jobs, keeping Italy a leading player in international dialogue. Our approach is firm but open to dialogue; we want to avoid any destabilizing scenario and protect Made in Italy products and the health of Italians.

Going into more detail about your work at the ministry, a very hot topic is that of medical and paramedical personnel, whose shortage has been a serious problem for public health for years. What is the government doing to try to resolve this problem?

The shortage of medical and healthcare personnel is one of the most serious problems inherited from the past, due to flawed planning of personnel needs. The Meloni government has chosen to address it with structural reforms: I'm thinking of the different admission procedures to medical school, which no longer require an entrance exam, but a transitional semester. Or, again, the enhancement of specialization scholarships, especially for less attractive medical fields and, for the first time, also for non-medical specialties.

We recognize that public healthcare needs to be an attractive environment, both humanly and professionally. This is why we invest in training, planning, and concrete recognition of the value of healthcare workers, both medical and non-medical, safeguarding their professional practice by ensuring safety and penalties for those who attack a white coat. We are also addressing particularly critical areas such as emergency care, a crucial specialization but unattractive due to its demanding conditions. A change of pace is needed here too, and we are working to make these roles more sustainable and valued, with targeted incentives and training programs more compatible with the real needs of those on the front lines. All of this is part of a broader strategy: rethinking healthcare not only for citizens, but also for those who work in it every day.

The staffing shortage is a contributing factor to the waiting list phenomenon. The Piedmont region is addressing the problem by introducing visiting shifts in the evenings and on holidays, with significant participation from medical and paramedical staff. This could also be implemented nationwide. Do you think the signing of the preliminary agreement for the renewal of the National Collective Bargaining Agreement for the healthcare sector for the three-year period 2022-2024 could finally change things?

I believe that the signing of the preliminary agreement for the renewal of the National Collective Bargaining Agreement for the Healthcare sector for 2022–2024 represents a concrete and significant first step towards starting to change things. We know that reducing waiting lists obviously also depends on an adequate supply of medical and healthcare personnel, so action is needed on multiple fronts.

The average monthly increase of 172 euros, the new protections, and the increased career opportunities provided by the agreement are aimed precisely at making public healthcare more attractive and sustainable, restoring dignity and motivation to those who ensure the functioning of our National Health Service every day.

Experiences like that of the Piedmont Region, which introduced evening and holiday shifts to reduce waiting lists with the active collaboration of healthcare workers, demonstrate that with proper recognition and good organization, effective results can be achieved. This model can and must also be considered at the national level, as part of the broader strategy we discussed: rethinking healthcare not only for citizens, but also for those who work there. It is also a clear demonstration that the Schillaci Decree on waiting lists is working, as demonstrated by other regions that have significantly reduced the backlog of services in recent months.

This situation is becoming more tragic in some particularly disadvantaged regions, especially in the South. Is the government doing anything to address these disparities and reduce the phenomenon of so-called health tourism?

Regional disparities, especially between North and South, are an open wound for our National Health Service, and so-called health tourism is a direct consequence. We want to bridge these gaps by ensuring all citizens have the same right to healthcare, regardless of their region. Data shows a slight decline in healthcare mobility for low-complexity procedures, but a stronger increase for high-complexity procedures. Yet, as a Southerner, I want to emphasize that there are many centers of excellence in the South and that it is important to network synergistically, also leveraging the potential of digital healthcare.

Regarding low complexity, one of the tools we are focusing on is the service pharmacy, which provides concrete support, especially in remote and disadvantaged areas. Thanks to this widespread network, even small towns or inland areas can access basic diagnostic services, such as tests and screenings, without having to travel to a hospital or large centers. It is a form of community healthcare that helps reduce inequalities and prevent the worsening of clinical conditions. Naturally, overcoming regional inequalities also requires structural investments, new hires, digitalization, staff training, and strengthening community care. The service pharmacy is part of this broader vision: bringing healthcare closer to citizens, wherever they are.

Don't you think that help for this, and for the entire national healthcare system, could come from digitalization or perhaps the assistance of artificial intelligence, as the Piedmont Region is preparing to do, which should significantly reduce waiting times?

Absolutely. I believe that digitalization and artificial intelligence can make a significant contribution to improving the efficiency of the National Health Service, especially with regard to waiting lists, which remain one of the most pressing concerns among citizens. The Government has initiated concrete actions to address this. The National Waiting List Platform is fully active on the Agenas website, a tool that allows for centralized and transparent monitoring of waiting times for healthcare services, with particular attention to priority classes. This is a fundamental step towards more effective intervention where critical issues are greatest. The use of artificial intelligence in managing scheduling and bookings can help reduce waiting times and optimize the use of available resources, to the benefit of citizens. But our commitment to a modern, more localized healthcare system also involves structural investments. With the PNRR, we have allocated €500 million to Telemedicine, and we are building a digital ecosystem that includes tools such as the new Electronic Health Record, the National Telemedicine Platform, and the Health Data Ecosystem. These interventions, if well-coordinated, can strengthen the connection between citizens, doctors, and the local community, especially in the most vulnerable areas of the country. Innovation is not just about introducing new technologies or resources, but also knowing how to leverage and best utilize those already available, with a vision focused on more accessible and sustainable healthcare.

And then we certainly need to strengthen local healthcare. Is the government taking action on this front?

Certainly, strengthening community healthcare is a top priority for the Meloni Government, as it means bringing healthcare services closer to citizens, especially in the most vulnerable areas. Thanks in part to PNRR resources, we have begun over 90% of the planned construction work on community homes and community hospitals, with the goal of completing them by June 2026. These are key community healthcare facilities, involving primary care professionals, with a view to integrated healthcare capable of easing the burden on emergency rooms, ensuring patients have a more effective and organized first point of access. Investment in the Territorial Operations Centers, which coordinate services across the region and facilitate patient care, especially for frail and chronically ill patients, has also been completed.

Another important step concerns home care: we have increased funding by €250 million, reaching over 8% of over-65s cared for at home today, with over 400,000 more patients than previously. The goal is to reach 10% by 2026.

Meanwhile, thanks to her, the lives of many cats will be saved with the authorization to use the drug remdesivir for the treatment of FIP in felines. A great relief for the approximately 8 million cat owners in Italy.

Last May 20th, I made a specific commitment: to make remdesivir available for veterinary use as well, to treat Feline Infectious Peritonitis (FIP), a viral disease that, unfortunately, is almost always fatal for cats. On June 6th, that commitment became a reality: I signed the circular officially authorizing, by way of derogation, the use of remdesivir—the active ingredient in human Veklury—also for veterinary use, more than a year ahead of the European regulation that will only allow it in 2026. This is a concrete breakthrough, awaited for years by millions of families, veterinarians, and volunteers throughout Italy: we're talking about approximately 7 million families who host a cat. Until now, there was no authorized treatment in Italy. In just a few days, thanks to collaborative efforts, we managed to break a deadlock that had been stalled for far too long. We couldn't wait: when there's a treatment that can make a difference, action is needed. And we did.

How do you respond to those like the Democratic Party secretary who accuse you of having reduced healthcare spending, when in fact the data shows a different outcome?

The truth is that the Meloni government has made healthcare a concrete priority, translating words into numbers: the National Health Fund has risen to unprecedented levels, from €128.7 billion in 2023, to €134 billion in 2024, and a projected €141.3 billion for 2027. I recall that in 2019, pre-pandemic, the fund was approximately €114.5 billion. It's difficult to talk about cuts with these figures in plain sight. And we haven't stopped at simply allocating more resources: we've addressed one of the most pressing issues facing citizens—waiting lists—with a decree that, after years of inaction, provides concrete answers. We've renewed the contract for medical management with over €2.3 billion in 2024.

In short, it's not about cutting resources or underspending, but rather a serious plan that invests existing funds wisely, something that, evidently, not everyone is able to achieve. In addition to increased financial resources, however, we need to focus on new organizational models that are more in line with current socio-demographic conditions and the associated healthcare needs, which have changed profoundly since 1978, the year our National Health Service was established—which, I recall, is still ranked fourth in the world.