Not just Targets: Human Prospects in Health Services for All—Insights from an Italian Case Study on Covid-19 Vaccination and Preventive Services

The sustainability of national health services focuses on the efficient and effective use of devoted public resources. On the one hand, new public management (NPM) theories guide public systems toward a more managerial and competitive approach. On the other, the new public governance (NPG) paradigm takes a relational service-dominant approach. Framed by this dichotomy in the literature, this chapter—based on an Italian case study on Covid-19 vaccinations and preventive services—examines which factors foster the planning and implementation of effective universal public health services. In particular, this study—through an analysis conducted in the field that incorporates semi-structured interviews and surveys with both health professionals and users—outlines effective and efficient elements which were found to be foundational, independently of whether they could be traced back to NPM or NPG frameworks. On the one hand, targets and logistics, as well as the “use” of already structured components (e.g., military forces), and downsizing, etc., appeared to be central in spinning the wheel and measuring achievements. On the other, trust in the system as well as in the personnel (from civil servants to general practitioners and health staff), and the existence of solid relations between practitioners and users, etc., were fundamental in motivating people to become vaccinated also if, in the analyzed phase, there were no obligations. In the conclusion, based on our results, we sketch some features determining a scheme of interrelations among the different factors that should be considered in planning effective and efficient health services for all.