Italy's cabinet wins confidence vote on measures reducing NHS expenditure

The Italian government won a confidence vote in the Upper House on Tuesday on a decree containing new measures to reduce the country's health system spending.

Prime Minister Matteo Renzi's cabinet received 163 votes in favour and 111 votes against, thus securing a swifter approval of the package.

The new measures were in fact contained in a wide cabinet's decree concerning local authorities, which was delivered early in June.

The provision needs to be passed by both chambers of parliament before August 18 in order to become law, and it would now go before the Lower House for final approval.

According to the decree, the expenditure on Italy's health care system (NHS) would be overall reduced by 2.35 billion euros (2.6 billion U.S. dollars) in 2015, and the same amount in 2016 and 2017.

The number of specialist medical examinations, laboratory and diagnostic tests currently provided free or at low-cost by the NHS would be cut, with citizens paying full costs for those checks considered as 'unnecessary' by the Health Ministry.

Tighter controls would also be applied on family doctors, in order to prevent them ordering non-essential analyses or tests.

Further savings would be obtained through other measures, such as halting admissions to smaller clinics co-funded by the NHS, a reduction in the average length of stay in hospital and in the rate of hospitalization, and a renegotiation of contracts for goods and services.

The voting in the Senate took place late on Tuesday after a two-day tense discussion, and the cabinet decided to call the confidence vote to cut debate and speed up the approval of the decree.

PM Renzi has a slim majority in the 315-seat Upper House, and his cabinet would have been forced to step down in case of a negative response to the vote.

The new measures met with strong criticism from opposition forces, which expressed fears further cuts to the NHS would undermine the health care and make medical treatments less and less affordable to citizens.

The cabinet claimed the package contains no fresh cuts to the NHS, but rather measures to rationalize the health spending and improve the system's cost-effectiveness.

"Unnecessary examinations and tests cost the NHS some 13 billion euros (14.3 billion U.S. dollars) per year," Health Minister Beatrice Lorenzin said on Tuesday.

An overall decrease in the government funding to regional authorities was already contained in the 2014 budget law, and these latest measures were agreed by the State-Regions Conference early in July in order to compensate such reduction, according to Constitutional Reforms Minister Maria Elena Boschi.

Italy has implemented heavy austerity cuts to tackle a deep economic crisis since 2011, and several of them have weighed on the NHS, whose budget is made of both regional and national funds.

Such previous measures included cuts to local health authorities, which implied citizens were required to directly pay a larger proportion of medical services and drugs; a reduction in the number of hospital beds per inhabitants; and a more centralized system for the purchase of pharmaceuticals.