Mismatches in the Formal Sector, Expansion of the Informal Sector

Italy has an aging population which is placing a strain on the public health system and on families. Atthe same time, it has a distorted market of supply of health professionals. Past over enrolment in medicalfaculties has produced a current glut of doctors, although shortages will appear as this cohort retires. It isdifficult for foreign-trained doctors, and Italian-trained foreigners, to practice medicine in Italy. In nursing,the situation is more critical, with far fewer graduates of nursing schools than necessary even to meetreplacement needs. Care for the aged, which was traditionally borne by families, has increasingly beendelegated to informal immigrant workers. In the absence of major changes in the care industry, recruitmentefforts for nurses and other health technicians has expanded to include other source countries. Obstacles tointernational recruitment of nurses have been reduced, both by simplifying recognition of foreignqualifications and by exempting nurses from limits on labour migration to Italy. However, a ban onpermanent employment in the public sector has relegated foreign nurses largely to private sector andshorter-term contract work. National and local health authorities have also become involved in supportinginternational recruitment of nurses, often through private agencies. In the home-care sector, families havebeen granted more opportunities to hire care workers from abroad legally, and many local authorities areattempting to integrate this spontaneous private care into their eldercare system through skill upgrades andsupport. Nonetheless, international migration will not be sufficient to solve Italy’s health care professionalneeds.