There is genuine progress in Italy’s public healthcare system. According to figures released on 22 October by AGENAS, the national agency for regional health services, the number of specialist appointments and diagnostic examinations booked through the monitored system rose from 19.7 million to 21.8 million during the first nine months of 2026. A greater proportion also fell within the maximum waiting times established for each priority category.
Those are improvements worth recognising. But they do not mean the waiting-list problem has been solved.
In his report for Il Fatto Quotidiano, journalist Alessandro Mantovani examines the other side of the figures: approximately four million bookings still exceeded their permitted waiting periods. The distinction matters because a healthcare system can become more productive without becoming sufficiently accessible to everyone who needs it.
The numbers behind the improvement
Between January and September 2026, 78.6% of monitored first specialist consultations were booked within their required time limits, compared with 76.9% in the corresponding period of 2025. For diagnostic examinations, compliance increased from 83.3% to 85%.
More than two million additional appointments and examinations were therefore scheduled within the prescribed timeframes compared with the previous year.
Yet the detail in AGENAS’s official report is revealing. Approximately 3.2 million bookings exceeded the applicable deadline by more than ten days, while another 858,000 fell within the first ten days after it. Together, they account for roughly four million late bookings.
It would be misleading to describe this as evidence of a system making no progress. It would be equally misleading to call the problem substantially resolved.
Where a patient lives still matters
The national averages conceal pronounced regional differences. In Basilicata, the report records approximately 99% compliance with waiting-time targets for first specialist visits. In Puglia, the figure is 55.3%. Umbria and Sardinia also remain below 70%.
Not all comparisons are straightforward. Regions differ considerably in how they assign medical priority categories, which affects the deadlines against which performance is measured.
A consultation classified as urgent must be provided within three days; a programmable appointment may have a maximum window of 120 days.
That makes the classification itself an important part of the story. If too many requests enter the least urgent category, apparently satisfactory waiting-time statistics may offer an incomplete picture of patients’ experiences.
The fact that a booking meets its administrative deadline is not, by itself, proof that the patient has received timely care in a broader clinical sense.
What the data still cannot tell us
There is another limitation. The current monitoring covers 14 categories of first specialist consultations and 22 types of diagnostic examinations. Follow-up appointments are excluded, and the figures do not provide a complete account of every healthcare service.
Nor does a booking record alone tell us what happens to patients who decide not to wait, pay for private treatment or abandon the attempt to obtain care.
These are not minor questions. A healthcare system may improve its performance indicators while some patients continue to experience serious barriers to access. Conversely, an increase in the number of appointments can represent meaningful progress even when waiting times remain unsatisfactory.
The challenge is to understand both realities without allowing one to obscure the other.
The latest AGENAS bulletin is an important step towards greater transparency. Publishing comparable figures makes it easier to identify weaknesses, recognise improvements and ask more precise questions about regional performance.
But transparency is a starting point, not an outcome.
THE ITALIC View
Italy’s healthcare debate is too often reduced to a choice between defending the public system and declaring it broken. The latest figures show why neither position is particularly useful. Progress should be acknowledged, but performance must ultimately be judged from the patient’s perspective. An appointment that satisfies an administrative target is not necessarily an appointment that arrives when it is needed. The challenge for Italy is therefore not simply to shorten waiting lists, but to ensure that improvements are experienced by patients across the country. A public service earns trust through what it delivers, not merely through what it measures.