Sardinia Region and Central Government: Health issue and autonomy at the center of the debate

The confrontation between the Sardinia Region and the central Government does not seem to be abating.

The Meloni Government, and more precisely the Council of Ministers on the proposal of the Minister for Regional Affairs and Autonomies Roberto Calderoli, in fact, would have recently decided to challenge Regional Law number 12 of 2024 containing "Amendments to Regional Law no. 5 of 2023 on primary care" for the recall to service of retired general practitioners in order to address, at least until the end of the year, the serious shortage of medical personnel.

According to what can be learned from the press, the appeal would find its justifying reason in the circumstance that "some provisions in the field of civil order, exceeding the statutory competences and conflicting with state legislation, would violate Article 117, second paragraph, letter l), of the Constitution".

The Health Councillor, Armando Bartolazzi, in wanting to underline that it would seem to be an "incomprehensible" appeal, did not fail to highlight, reiterating it with conviction, that the measure, in the intentions inspired and aimed at maximum concreteness on a practical level by the Sardinian legislator, "was created to cover a clear and serious emergency with shortages of general practitioners for thousands of inhabitants in some territories".

It would therefore be an extremely necessary measure, "exclusively on a voluntary basis" that should support the needs of the populations of the most disadvantaged areas.

In essence, and to be as clear as possible, with the Law referred to, the Local Health Authorities were authorized to draw funds from their own budget in order to ensure, in the meantime, the continuity of essential health services. The measure, net of any possible evaluation, would therefore appear to be entirely appropriate.

Yet, although Sardinia represents a sort of concise realization of the substantial essence of a legislative and programmatic specialty recognized by law, legitimizing a legal regime differentiated from the beginning compared to most of the other Italian regions, and although the Region itself, as noted by the President of the Sardinia Region Alessandra Todde, "pays entirely for its own healthcare" (see Alessandra Todde's Facebook page), nevertheless, it would have exceeded its statutory powers. Well. The issue, beyond the concrete relevance of its managerial relevance, would seem to raise at least two orders of reflections. On the one hand, if the search for a direct relationship between the individual Regions, and not only those with Special Statute, with the State would seem to have increased excessively in recent times, considering the in any case contested reform concerning the so-called "Differentiated Autonomy", on the other hand it would seem to be witnessing (the doubtful formula seems necessary) a sort of contraction of that same autonomist regime which, in the intentions repeatedly proclaimed by the Central Government on the initiative of its Minister for Regional Affairs Roberto Calderoli, seemed to constitute the backbone of a new and unprecedented administrative organization (if one wishes to define it as such) of the State. On the other hand, the other for which, considered on the level of loyal collaboration between the Central State and its territorial articulations, the initiative in health matters recently undertaken by the Sardinia Region would seem to be placed and proposed precisely in the most representative and expressive terms of the principle itself, placing itself, it would seem, on the programmatic path of what would be the core of the autonomist reform. Therefore, at least at a first necessarily summary analysis, and pending further specifications on the motivations supporting the announced challenge, the Sardinia Region would seem (the conditional seems appropriate) not to have incurred any violation considering that precisely in the health sector the Region itself can legislate within the principles established by State law. Even more so when one considers that precisely the health policies would seem to constitute the concretization of the idea of regionalism as expressive of an alternative relationship, if one wishes to define it that way, of management efficiency suitable for determining the overcoming of a centralized system and useful for promoting the best geographical uniformity of the service.

The initiative of the Sardinia Region, to put it more simply, and considering the current needs of the territory, would seem to guarantee the full implementation of Article 32 of the Constitution through a regional organization inspired by maximum practical efficiency.

Giuseppina Di Salvatore – Lawyer, Nuoro