Terms of the preliminary agreement
Representatives from Italy's public employment agency ARAN and all healthcare trade unions signed a preliminary agreement on 7 October 2026 for the 2025–2027 collective bargaining contract covering executive healthcare staff. The national collective agreement applies to roughly 138,000 professionals across the National Health Service, including 120,000 medical doctors and 17,000 non-medical health directors such as veterinarians, pharmacists, psychologists, biologists, chemists, and healthcare sector executives. Eligible employees will receive an average gross monthly salary increase of up to €560 distributed across 13 annual payments. This total combines a negotiated base increase of €393 per month from the contract renewal alongside €167 per month sourced from dedicated statutory funds established by state legislation.
Workplace protections and artificial intelligence
Beyond financial adjustments, the draft contract introduces operational modifications concerning workplace security, career pathways, and technology governance. The agreement strengthens protective measures for healthcare personnel facing on-the-job aggression and physical violence inside public hospitals and clinics. It introduces extraordinary leave provisions for executives suffering from serious medical conditions and outlines initial regulatory standards for deploying artificial intelligence in clinical workflows and labor relations. Career development systems receive structural updates, establishing new salary progression benchmarks at the third and tenth years of service while maintaining established tiers at five, 15, and 20 years. Union federation Fassid noted that the revised seniority tiers aim to increase the recruitment appeal of public health careers for younger professionals. The framework also formalises union consultation procedures whenever health trusts introduce automated diagnostic or management algorithms.
It is a contract that intervenes concretely on the organisation of work, on professional responsibilities, and on protections.
Dedicated allowances and supplementary welfare
The contract earmarks targeted financial allocations for specific hospital divisions and medical branches, directing €362 million to doctors and veterinarians, €15 million to emergency departments, and €8 million to non-medical health managers. Corporate welfare frameworks are established to provide practical resources for healthcare workers, assisting with child care and elderly dependent support. Union negotiators also secured revised terms for holiday allowances, on-call guard duties, and overtime pay structures to alleviate pressure from ongoing staff shortages and heavy shift rotations.
Taking care of citizens begins with taking care of those who assist them.
Union reactions and bargaining calendar
Union leaders and government representatives noted the exceptional timing of the accord, which was concluded in the same year as the delayed finalisation of the 2022–2024 contract cycle. Combined with that earlier settlement, cumulative monthly pay rises for Italy's public hospital doctors now exceed €1,000 per month. Trade union representatives noted that the revisions represent an approximate 20% salary increase overall while restoring predictability to public health bargaining cycles. CISL General Secretary Daniela Fumarola described the agreement as a necessary step to recognise the responsibilities of healthcare managers operating amid growing service complexity and workforce deficits. Undersecretary Marcello Gemmato stated that aligning contract cycles provides stability for staff and ensures continuity for the broader public health network.
Another concrete step to value those who take care of the health of Italians every day.