Abstract

35 years after the institution of the Italian National Health Service, only one of the two main pillars of its organizational structure has been fully developed: general medicine. Territorial nursing services, which were supposed to represent the other pillar, are largely underdeveloped. Moreover, while general practitioners have started to work in teams and collaborate with each other, there is very little evidence of collaboration with other medical specialists and hospital doctors. This distorted implementation of the original design not only affects the ability to meet future healthcare needs effectively but it also undermines the possibility to limit current expenditures. The debate on the sustainability of healthcare services should not be limited to economic and managerial aspects, despite their obvious importance. Sustainability efforts should also return to the foundations of the NHS by re-emphasizing the need for greater and responsible collaboration among all the healthcare personnel, starting from general practitioners and territorial nurses.