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Will rapid coronavirus tests soon be available from your doctor in Italy?

Under new plans from the Italian government, testing for Covid-19 could be carried out at all doctors' surgeries. But is this really going to happen? Here's what we know so far.

Published: 29 October 2020 10:34 CET

Will rapid coronavirus tests soon be available from your doctor in Italy?

A healthcare worker conducts a nasal swab at a testing centre in northern Italy. Photo: AFP

Italy's government has announced that family doctors will soon carry out testing at surgeries, rather than referring patients by phone to specialist testing centres as is currently the case.

The government hopes that making testing more widely and quickly available could help contain the spread of infections in the country, which reported almost 25,000 new cases in a day on Wednesday.

“General practitioners and pediatricians will help to improve patient care by providing a greater number of first-level diagnostic services and by carrying out rapid antigenic swabs,” said Stefano Bonaccini, president of the Conference of the Regions, on Wednesday.

“Now our country has one more tool to use to counter the spread of Covid-19.”

However, Italy's doctors' unions haven't actually agreed to the testing plan yet as they say it carries significant risk.

While the new rules would oblige every GP in the country to carry out the tests, unions say not all surgeries have the capacity to do them safely.

While the government has set aside 30 million euros for the testing scheme, unions argue that this amount wouldn't fund enough tests to make a real difference to contagion rates, and that participation in the scheme should not be mandatory as it could put family doctors and other patients in danger.

As well as more personal protective equipment and increased sanitation, surgeries would need separate rooms and entrances for patients with Covid-19 symptoms, unions point out.

A doctor enters a changing room set aside for putting on and removing PPE equipment at a hospital in Milan. Photo: AFP

National secretary of the Italian doctors union (SMI) Pina Onotri said the plan would “affect the safety of doctors' offices and citizens.”

In a statement to local media, she explained that the union did not agree to the plan because “to give this obligation at this moment to a group of professionals already suffering seemed ungenerous to us.”

“We believe that it is important for family doctors to conduct rapid tests voluntarily.”

Regional doctors' unions also refused to agree to the plan, with the head of Abruzzo's doctors union, Michele Di Paolantonio, saying it risked causing an “epidemic explosion”.

“The doctors' offices are cramped and limited, and often located inside residential condominiums where someone could become infected,” he told local media.

“There are many frail and elderly doctors among us and this could represent a serious problem.”

Doctors and other healthcare workers have been at high risk of contracting the coronavirus. A list kept by Italian doctors' unions states that 183 doctors have so far died in Italy after being infected with Covid-19 .

If testing does become available at doctors' surgeries in Italy it may not be for some time yet, as ministers and unions continue discussions.

Until now, the government has only authorized certain healthcare facilities in Italy to carry out swab tests. You can't currently get tested at your local doctor's surgery, nor every private lab, due to protocols intended to keep regional heath authorities immediately informed of every new positive case.

The testing procedure varies according to your reasons for getting a test, and where you are in Italy. Check your local health authority's website for details of the process where you are, and if in doubt, ask a doctor.

If you suspect you may have Covid-19, do not go to a doctor or hospital: call your GP, your region's dedicated coronavirus helpline (full list here), or the nationwide 1500 number for assistance.

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Public vs private: What are your healthcare options in Italy?

Italy is well-known for having one of the best healthcare systems in Europe: skilled physicians, advanced technology, and quality facilities available free of charge to every citizen.

But is that actually the case? In reality, across the country, access to quality healthcare varies widely — and since the 1990s, Italy’s world-famous public system has gradually given ground to a growing number of private providers who offer top-notch services at a top-shelf cost.

That means, when you need health services the most, navigating Italy’s system can be a complicated and potentially costly affair.

Here’s what you need to know about Italy’s public and private systems before a health crisis hits.

Your rights to care

The right to public healthcare is enshrined in Italy’s constitution, which recognizes “health as a fundamental right of the individual and the interest of the community.”

Since 1978, when Italy’s national health service (Servizio Sanitario Nazionale, or SSN) was first established, it has provided free, public health services based on the principles of universality, equality, and fairness.

In practice, this all means that all Italian citizens and most legal Italian residents have a right to access public healthcare free of charge, most of the time.

If you are resident in Italy for reasons of work, family reunification, asylum, or medical care, it is mandatory that you are registered with the public health insurance system. This means applying for your tessera sanitaria or health card after your residency paperwork is complete.

See our guide to who can register for national healthcare, plus more information about applying for (and renewing) your tessera sanitaria here.

If you are resident in Italy for other reasons — for example, to study at a university — you can still opt to enroll, for an annual fee.

Italy also recognizes health insurance provided by any EU country without a tessera sanitaria — you can show your European health card (EHIC). You are required to swap it for an Italian card if you’re in the country for more than six months.

Italy has also made international agreements with a handful of countries to recognize their state insurance as well — these include Australia, Argentina, Brazil, Bosnia-Herzegovina, Serbia, Macedonia, Montenegro, Monaco, and Tunisia. Talk to your local Italian embassy if you’re from one of these countries to get the documentation you need.

The public system

But, in reality, what does your tessera sanitaria get you?

First and foremost, it covers all emergency care. If you need an ambulance ride or a stop by the pronto soccorso (emergency room), this will be provided free of charge.

You will also be assigned a general practice doctor from a list in your region, who will be your first point of contact for any non-emergency care. Many of these doctors are also specialists in a particular field of health, though not all will be comfortable working in English.

In practice, though, these physicians are often massively oversubscribed, counting thousands of patients under their care. Wait times for an appointment can often be lengthy, if you can even get through to their booking line. If you don’t like your doctor, you can only change them once per year, by applying again to your local health authority.

Italy’s healthcare system is said to be among the best in the world, but stark regional imbalances persist. Photo by Miguel MEDINA / AFP

If you require any non-emergency care — blood tests, a specialist exam, or certain prescriptions — you will need to receive a referral from this doctor. This takes the form of a paper ricevuta, a card specifying the services you need with a barcode that will be scanned by the specialist in question.

You won’t have a choice in what specialist you are referred to, and you will likely face a lengthy wait for these services, which are often performed at the local hospital.

Not all of these services will be completely free. Even with a health card, you will be required to make copayments for some specialist visits and exams.

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For example, if your doctor orders full blood work — a procedure that involves more than a dozen different laboratory tests — you may pay as much as €100 in copayments or more, as the public system will only cover up to eight tests at any one time.

You will also need to make nominal copayments on certain prescription drugs. In theory, these fees are subject to certain maximums and should be geared to your household income. Dental care is free for children under 16, but only emergencies are covered for everyone else.

It’s important to know that, because Italy’s health system is managed by regional authorities, access to care varies greatly across the country. A 2015 report by the OECD found “profound regional differences” indicating many in the south of the country were not receiving timely access to preventative medicine.

Today, while many cities in northern Italy are known for their world-beating medical facilities, they are also often plagued by long wait times, partly because southern residents frequently travel north for care.

The private option

These concerns have given rise to an expanding market for private healthcare in Italy, which offers the chance to skip the line — at a cost.

Private providers can offer specialist services without a referral from your general practitioner, and often have much shorter wait times: a week or two, as opposed to several months.

Though they are discouraged from doing so, you may find your general practitioner advising you to seek out private care to avoid a long wait. This is particularly true for services like ultrasounds, for which there is a long delay.

See our complete guide to healthcare options during pregnancy in Italy.

It’s worth noting that these private practices do not necessarily offer better facilities than their public competitors. Some operate out of the same hospital facilities as their public counterparts.

The Policlinico A. Gemelli Hospital in Rome. Italy’s capital is home to several highly-rated hospitals and clinics, but some residents still travel north in search of better or faster treatment. (Photo by Filippo MONTEFORTE / AFP)

Their services can also be very costly. A single appointment can cost anywhere from €60 to €150 or more, and any follow-up exams or prescriptions will not be covered by the public system.

Though most Italians still pay these costs out-of-pocket, there are a number of private health insurance plans that can help spare you the financial headache.

At their most basic, these policies, known as polizze salute, cover emergency care and little else. Policies like these are sometimes a requirement for residency applications, and usually cost just a few hundred euro per year.

If you’re looking to supplement public health care with access to private specialists, however, expect to pay €100 per month or more. For this, you can expect perks like private rooms during hospital stays or cover for home care after discharge.

To apply, you’ll need to undergo a medical checkup and declare any previous conditions. These policies are usually subject to age limits and some common chronic conditions, like diabetes, may be uninsurable.

Unlike American policies, insurers usually require that you pay up front, and will reimburse you only when you provide the proper paperwork. In some regions, where accredited private hospitals provide private care, your company may have a relationship that allows for direct billing.

Ultimately, the decision to go with private care comes down to a cost-benefit analysis: how long are you willing to wait — and how much would you pay to skip the queue?

If you would like to share your own experiences of using Italy’s public or private healthcare services, please leave a comment below or get in touch by email.

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