Primary care in a National Health Service: time for radical reform

Italy was the first European country dramatically hit by the Covid-19 pandemic.1 This catastrophic event has put the Italian NHS (INHS) under intense pressure and crudely exposed its structural weaknesses, particularly regarding general practitioners (GPs), who are the front-line service in primary care such as their colleagues in the UK NHS. The forthcoming National Programme for Recovery and Resilience (NPRR),2 funded by the European Union, should support refurbishing the INHS, especially in primary care. Here, we first summarize the main weaknesses of primary care in the INHS, exploiting the UK NHS as comparator to better stress them. Then, we put forward a proposal aimed to consolidate its present fragmentation, potentially useful for other European health systems too. The INHS was born in 1978 in the wake of the UK NHS, historically the first and most widely acknowledged public health care system in the world.3 In contrast to...