VERBANIA – A hospital with no doctors and no nurses.
A slow death? “No, a very quick one. If nothing changes soon, in two years, the hospitals in Verbania and Domodossola [in Italy’s northwestern Piedmont region] will be gone. No one wants to work here anymore. That’s just the reality. And there’s a reason for it,” says Filippo Garboli, a nurse and member of the Nurse Up Labor Union who has been working in the emergency room at Giuseppe Castelli Hospital in Verbania for eight years. You can see the frustration in his eyes as he looks around.
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A light drizzle falls, mist rises from the lake and the mountains loom in the distance. “We’re right on the border with Switzerland, and that’s exactly where all the medical professionals are heading,” he explains.
Borders, as always, are where you can glimpse the future. If we want to see where the Italian healthcare system is headed after years of grand promises, it’s to this border we should be looking. Has anything changed since COVID-19?
“When the pandemic hit, they were calling us heroes. Now that life’s back to normal, they’ve forgotten about us. And we’re fed up,” Garboli says.
No one wants to work here
Despite numerous job openings, hardly anyone’s applying. There were three cardiology positions available, but only two candidates showed up. And they both backed out at the last minute for better opportunities.
Why? Because Switzerland offers at least triple the pay. Private healthcare is better, too. Even working as a freelance doctor in public hospitals pays far more. Freelancers hop from one public hospital to another, filling the gaps. They get 1,000 euros for a 12-hour shift, which drops to 300 after taxes—but it’s still 300 euros a day. Meanwhile, a full-time doctor here earns 2,600 euros a month, and an emergency room nurse makes around 1,700 euros, night shifts included.
I can’t blame my colleagues for leaving.
“I’m staying because I feel it’s the right thing to do, to support public healthcare,” says Garboli, “but I can’t blame my colleagues for leaving. Working here means pulling double shifts and skipping holidays. We’re short-staffed and exhausted. But if you live here and work just across the border in Locarno, Switzerland, you’re set for life. You enjoy Italy’s cost of living while earning a Swiss salary.”
With fewer doctors and nurses, waiting times for patients grow. It’s simple math: too much work, not enough hands. “I took my wife to the ER, and it took two and a half hours before anyone visited her,” says Giovanni Lombardo.
Worldcrunch Extra️
Know More: The decay of Italy’s healthcare infrastructure is just a snapchat of a larger phenomenon occurring in western countries. In the United Kingdom, England’s famous National Healthcare Service was deemed in ”critical condition” by a government commissioned report. Residents in England suffer from long wait times for treatment, crumbling hospitals, mental health patients in “vermin-infested cells” and far fewer M.R.I. scanners than in comparable countries.
Similar to Italy, France is suffering from chronic doctor shortages, causing what is being termed “medical deserts.” In rural regions of France, doctors have already been putting in extra shifts to cover for their colleagues and billing over time in order to plug the gaps, a scenario that is repeating itself across the country amid a chronic shortage of doctors.
In the United States a recent John Hopkins study revealed that medical errors cause around 250,000 deaths per year accounting for 10% of U.S. deaths. Undeniably a catastrophic failure for the Country that spends more per capita than its western peers. This among many other shortfalls leaves the majority of Americans feeling ”failed” by their healthcare system.
There is no quick fix
Chiara Serpieri, the general director of the Local Health Coordination Agency (ASL), doesn’t sugarcoat the situation: “The healthcare system is in a truly critical moment. We’re doing everything we can, but it’s hard to attract professionals with wages this low.”
Years of budget cuts and a sluggish economy have pushed Italy’s public healthcare system to the brink, and the border with Switzerland is where the cracks are most visible.
Retired doctors including Dr. Carlo Maestrone, who headed Resuscitation and Anesthesia in Verbania and Domodossola until last June, have had to come out of retirement as private consultants to help cover the shortage: “This way, I can provide the hospital with 150 more hours of operating room time.”
Meanwhile, the full-time doctors at these border hospitals are slashing their own vacation times to reduce the need for freelance doctors. But freelancers are still essential — there just aren’t enough permanent staff. And as soon as they come, they’re off to another hospital. This constant turnover breaks the continuity of care, leaving chronic patients in the hands of an ever-changing roster of doctors.
“We’re not the bad guys here.”
Dr. Fabrizio Comalta, head of Pediacoop, a cooperative of freelance doctors born out of this border crisis, is quick to clarify: “We’re not the bad guys here. We send doctors to fill gaps wherever they’re needed — Gaslini Hospital in Genoa, Sacco Hospital in Milan — not just to the hospitals near Switzerland. In our own way, we’re helping the system. It’s not our fault that the state doesn’t provide adequate salaries for its employees.”
Even regional health counselor Federico Riboldi is acutely aware of the growing threat to public healthcare: “There’s no quick fix for the shortage of medical staff. We talked about it recently in a commission meeting in Rome. We’re trying to bring in professionals from abroad. We need financial incentives for these underserved areas. We’ve launched an experiment: offering 500 euros extra to doctors who work in Verbano Cusio Ossola. And soon, we hope to extend this incentive to other disadvantaged parts of Piedmont.”
In the end, it all boils down to low wages, Italy’s Achilles’ heel.
