In these dark days of the coronavirus pandemic, our screens are often filled with images of people applauding health personnel outside hospitals – a striking recognition of how crucial public health has become for our individual and collective destiny. Revisiting the history of these public health services is essential to understanding not only the ‘frontlines’ of the fightback against the pandemic, but also the institutions, policies and resources that make such a fight feasible.
In this perspective the case of Italy is of particular interest, not only because of the scale of the pandemic it has had to face before other European countries, but also because of the history of its public health service, rooted in a major transformation, driven by the clear vision of key experts, a solid commitment by left parties and the wideranging mobilisation of trade unions and social activists. The outcome – the 1978 reform – was a universal, public, free health service, offering a wide range of provision outside the market, largely modelled on the British NHS and reflecting the definition of health spelt out by the WHO in 1946.
Italy is a major case of policy success in health. According to the 2017 OECD data, life expectancy at birth in Italy is 83.1 years, compared to the 80.9 years of the European Union average: but the total health expenditure per inhabitant is 2,483 euros, against 2,884 of the average EU (a 15% gap). It is a paradox worth probing that the European country with the longest life expectancy has achieved this result with reduced spending. ).
