Only three southern regions—Puglia, Campania, and Sardegna—were promoted for meeting essential healthcare standards in 2023, while eight regions, including the wealthy Lombardy, deteriorated compared to 2022. A total of 13 regions achieved full compliance, led by Veneto.
This is the picture of Italy’s provision of essential levels of care (Livelli essenziali di assistenza, Lea) in 2023, according to the latest analysis by the Gimbe Foundation. The independent study, based on the Italian Health Ministry’s monitoring report published on August 6, assessed regional performance in prevention, district healthcare, and hospital care.
The analysis revealed that eight regions saw their performance worsen from the previous year. The most significant declines were in Lazio (-10 points), Sicily (-11), Lombardy (-14), and Basilicata (-19). Gimbe’s President, Nino Cartabellotta, stated that the decline in historically solid regions is “an alarm bell that cannot be ignored,” demonstrating that the national health system’s stability is no longer guaranteed even in resource-rich areas.
Lombardy’s regional government immediately contested the findings. Regional Undersecretary Mauro Piazza accused Gimbe of manipulating the ministry’s data, asserting that “Lombardy shows a compliance profile above the threshold in all three areas of care,” and dismissed the reported 14-point loss.
In contrast, the report highlighted a stark improvement in two southern regions: Calabria (+41) and Sardegna (+26). From 2022 to 2023, Campania and Sardegna moved into the compliant category, while Basilicata and Liguria fell to non-compliant status for failing to meet the minimum threshold in one area. The North-South divide remains pronounced: six of the top ten regions are from the North, three from the Centre, and only one from the South. The bottom seven positions, with the exception of Valle d’Aosta, are exclusively held by southern regions.
“The 2023 monitoring certifies that the protection of health depends largely on the region of residence and that the North-South divide shows no sign of narrowing,” emphasized Cartabellotta. Gimbe has called for an expansion of the indicators used and a “radical revision” of the recovery plans and commissioners appointed to oversee struggling regions, arguing they have improved budgets but not the quality of care.
Commenting on Calabria’s dramatic improvement, Regional President Roberto Occhiuto called the +41 point score a “concrete result” but acknowledged, “Healthcare in Calabria does not work well yet; no, not yet. There are still many things to do.” He concluded, “Those who pontificate today left us a desert and rubble. We are reversing the course.”