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Next Generation EU: new investments in healthcare

  • Italy
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Slovak Republic has reached limit of its possibilities in healthcare in some periods of COVID-19 pandemic, whereas the inadequate infrastructure of institutional healthcare emphasized by insufficient capacity of the public sector to respond promptly and effectively to sudden and unexpected shocks was fully exposed.

Due to this reason Slovak Recovery Plan contains investments and reforms in healthcare aiming to eliminate shortcomings, improve healthcare and its accessibility for all citizens of Slovakia[1].

There are three key components in the field of healthcare in the Recovery Plan:

  • Modern and accessible healthcare,
  • Humane, modern and accessible mental healthcare,
  • Accessible and quality long-term social - healthcare.

Italy was one of the first European countries affected by the major negative effects of COVID-19 pandemic. How did the Italy coped with this situation and what kind of action or investment they proposed to mitigate impacts, may be found below in the article.



The COVID-19 pandemic has undoubtedly been the most significant shock that the Italian National Health Service (NHS) has had to face since its establishment in 1978.

Up to March 31 2021, more than 125,000 people died and more than 2 million people. have been infected with the virus COVID-19. This pandemic provides significant insight into the future sustainability and resilience of the Italian health system.

The Health System has made a strong effort to counteract the pandemic, but this has wider implications: the Italian NHS had to stop most elective care during the first phase of the emergency and, for some regions, in November and December 2020, too. However, there are also positive aspects to be drawn, for example the response to the crisis has given a strong impetus to the diffusion of telemedicine, particularly for cancer and chronic patients.

During the first and the second waves, the Italian Government allocated a total of EUR 9.5 billion to strengthen the hospital network to ensure the provision of personnel, tools and means for the health system, civil protection and law enforcement agencies to assist people affected by the disease and for the prevention, mitigation and containment of the epidemic.

But this is not enough.

Extraordinary situation needed a common European response to the coronavirus outbreak. Due to that EU took resolute action to reinforce public health sectors and mitigated the socio-economic impact in the European Union. The European Commission mobilized all means at its disposal to help European Member States to coordinate their national responses to contain it the virus.

The first action was the Next Generation EU (NGEU). The NGEU marks a transformative change for the EU: the amount of resources deployed to boost growth, investment and reforms amounts to Eur 750 billion, of which more than half, EUR 390 billion, are grants.

In particular, the Italian RRP’s “Mission 6” aims to renew Italian healthcare. EUR 20.7 billion - of which EUR 19.7 billion will come from Next Generation EU - have been allocated for strengthening Italian healthcare system, with actions on two fronts: the development of a local network that is increasingly close to people and the modernization of the National Health Service's (NHS) technological equipment.

The Italian Government’s objectives are:

  • strengthening the hospital system in, particular the territorial assistance network, in order to ensure homogeneity in the ability to provide integrated responses (health and social health issues), as well as equal access to care;
  • strengthening the resilience and timeliness of the health system’s response to emerging infectious diseases characterized by high morbidity and mortality, as well as other health emergencies.
  • boost digital health care, design digital solutions for multidisciplinary and multi- professional care and assistance processes;
  • promote and strengthen the field of scientific research, increasing resources for biomedical
  • and health research;
  • provide safe, technologically advanced, digital and sustainable hospitals, with particular reference to high-tech equipment and digitization;
  • strengthening the country’s capacity, effectiveness, resilience and equity in the face of current and future health impacts associated with environmental and climate risks;
  • enhance the technical-professional, digital and managerial skills of professionals in the National Health Service (NHS) and resolve shortages within the ranks of specialists and general practitioners.

The mission consists of two components with regard to the interventions:

  • territorial health care assistance and telemedicine which has a budget of EUR 7.9 billion;
  • innovation, research and digitization of healthcare which is worth a total of EUR 11.82 billion.

The first component, namely Proximity Assistance and Telemedicine, is aimed at strengthening and redirecting the NHS towards a model focused on territories and social, and health care networks to overcome the fragmentation and structural gap between the different Regional health system by ensuring homogeneity in access to care the provision of Essential Care Levels (LEA); to enhance prevention and territorial care by improving. the capacity to integrate hospital services, local health services and social services, to ensure continuity of assistance, multi- professional and multidisciplinary approaches, integrated hospital-domicile pathways for the whole population; to strengthen the capacity, effectiveness, resilience and equity of the country in the face of the current and future health impacts, associated with environmental and climate risks, in a “One-Health” vision and in the evolution of “Planetary health”.

The second component, namely Healthcare Innovation, Research and Digitization, aims to promote and strengthen the field of scientific research by: prioritising the establishment of clinical and transnational networks of excellence; strengthening health information systems and digital tools at all levels of the NHS; enhancing human resources through the modernization of training tools and content and the development of technical-professional, digital and managerial skills of NHS professionals; overcoming the critical issues related to the limited and heterogeneous spread of the Electronic Medical Record; to address the problem of the ageing of equipment and the low use of health technologies in hospitals, achieving higher standards of efficiency and effectiveness; building safe, technological, digital and sustainable hospitals; overcoming the limited dissemination of telemedicine tools and activities.

In Italy, the government measures adopted for the current health emergency contain explicit reference to the performance of launched tender procedures and the execution of ongoing public contracts. Italian RPP provides for simplification of administrative procedures and a radical rethinking of public action.

The last step of this aim is the Prime Ministerial Decree approved on last May, the 28th. The main innovations concern:

The RPP governance.

  • The responsibility for addressing the RPP is assigned to the Presidency of the Council of Ministers. A Control room is set up, chaired by the Premier in which competent Ministers and Undersecretaries participate. Control room is helped by Technical Administrative Office, to monitoring the RPP’s realization;


Public procurement.

  • Until October the 31st, subcontract cannot exceed 50 percent (compared to the ordinary limit of 30 percent). From November, the 1st, any quantitative limit to subcontracting is removed, but the contracting authorities will indicate on the tender documents services or work that must be performed directly by the tenderer.
  • Additional scores will also be awarded to companies that adopt work-life balance tools and that undertake to hire women and under 35 people.
  • Contracting authorities can launch negotiated procedure without publication of tender notice (art. 63, Public Procurement Code) for all the RPP aims, without economic limits.
  • In the event of disputes, the process is faster (art. 125, Code of Administrative Trial).


Therefore, new investment scenarios will arise in Italy for economic operators. 

To view the Slovak article, please look at the following link: Next Generation EU: Nové investície do zdravotnej starostlivosti