Varese: over 20,000 without a doctor, a challenge for border workers

Context

In short

• 15,177 patients without a doctor in Asst Sette Laghi: immediate emergency
• 4,983 patients without a doctor in Asst Valle Olona with 92 doctors retiring
• Shortage persists for over 2 years in some districts; temporary clinics cover the emergency

Key facts

• What: Severe shortage of general practitioners in the province of Varese
• Where: Asst Sette Laghi (15,177 citizens) and Asst Valle Olona (4,983 citizens)
• When: 2026-2027; 17 doctors retiring in Sette Laghi, 92 in Valle Olona by the end of 2027
• Who: PD councilor Samuele Astuti raised the alarm through access to documents
• Impact: Over 20,160 citizens without a stable reference for primary healthcare

Over 20,000 citizens in the province of Varese do not have a general practitioner. This is the alarming picture that emerges from official data provided by the two local health and social care companies following an access to documents presented by the regional councilor of the Democratic Party Samuele Astuti. In total, 15,177 patients are uncovered in Asst Sette Laghi, while 4,983 are in Asst Valle Olona, for a total of over 20,160 residents without a stable figure for primary healthcare.

The situation does not represent a temporary emergency but a chronic shortage that has now lasted for years. In the Gazzada district, for example, the difficulty has persisted for about two years: uncovered patients in Daverio must turn to the temporary clinic in Gazzada to obtain essential prescriptions and visits. The province of Varese is geographically significant for Ticino-Italy commuters: many of them reside in the municipalities of Varesotto (Varese, Busto Arsizio, Gallarate, Saronno, Somma Lombardo, Azzate, Luino, Tradate, Arcisate) and are directly affected by this daily shortage. For those living on the Swiss-Italian border and working in Ticino, the lack of a stable doctor represents a concrete obstacle in managing healthcare continuity.

The wave of retirements in the next two years

Adding to the complexity, a massive wave of retirements is already planned. In Asst Sette Laghi, 17 doctors will reach retirement age by the end of 2027. Specifically, four doctors will cease activity by the end of 2026: one in the Sesto Calende district, one in Tradate, two in the Varese district. During 2027, another thirteen professionals will leave the activity (two in Arcisate, three in Azzate, one in Laveno Mombello, two in Luino, two in Tradate, three in Varese).

The situation in Asst Valle Olona is even more critical. There are 37 doctors who will reach 70 years by the end of 2026 and another 55 by the end of 2027, for a total of 92 professionals potentially leaving within two years. Not all will necessarily leave the activity as soon as they meet the requirements, but the data clearly reveals the scale of the generational turnover that will need to be addressed to contain the crisis. Districts such as Gallarate and Busto Arsizio will see a particular concentration: ten doctors in Gallarate by the end of 2026, another fourteen by the end of 2027; fourteen in Busto Arsizio-Castellanza by the end of 2026, another twenty-one by the end of 2027.

The limits of temporary medical clinics

Temporary medical clinics allow for the provision of prescriptions, urgent visits, and essential medical certificates. However, they represent a response born to manage the emergency that risks becoming the ordinary mode of access to care. For elderly patients, people with chronic diseases, and vulnerable subjects—including many elderly commuters—the continuity with a family doctor is essential. Without it, the quality of primary healthcare suffers a significant decline.

Operational details

What it means for the border worker resident in Varese

Ticino-Italy border workers who reside in the province of Varese are in a particularly delicate situation. This group of workers resides in Italy and works in Switzerland: a geographical configuration that exposes them to the problems of Italian health, but which also allows them to access the Swiss health system. The shortage of primary care physicians in Varese is not a purely local issue-it is a concrete problem that impacts the continuity of care, especially for elderly border workers or those with established chronic diseases.

A stable general practitioner provides diagnostic continuity, knows the patient's medical history, coordinates any specialist examinations and provides medical certificates necessary for work and administrative procedures in Switzerland. When this figure is missing, the border worker must resort to temporary surgeries, which guarantee the essential services (request for medicines, urgent visits, short-term certificates) but not the relational and diagnostic continuity that characterizes family medicine. The lack of continuity is particularly problematic for those who have to coordinate their health between two health systems - the Italian one of residence and the Swiss one of work.

Deadlines and numbers to keep an eye on

By the end of 2026, four doctors from Asst Seven Lakes will have reached pension requirements.

Useful planning tools

To estimate your pension strategy, use the pension planner and the pillar 3 simulator.

Key points

What to do if you are a resident of Varesotto without a family doctor

If you live in Varesotto and do not have a stable general practitioner, your immediate options are two: access the temporary clinic of your district or, if you have a G permit (cross-border worker), consider enrolling in the Swiss healthcare system as a structural alternative.

1. Contact the relevant ASST (Sette Laghi or Valle Olona depending on your district) to find out the location and hours of the temporary clinic in your area. 2. Bring essential documentation: national health card, identity document. 3. Obtain essential services: prescriptions for medications, urgent visits, medical certificates for a short period. 4. Request guidance for specialists: the temporary clinic can provide indications on how to access specialist visits if necessary.

The procedure is simplified, but remember that temporary clinics do not replace the family doctor: they do not have access to your previous medical history, cannot manage chronic conditions continuously, and the service is limited to the most urgent services. For the cross-border worker, this solution represents a temporary measure, not a cure.

Alternative option for the cross-border worker: access to the Swiss healthcare system

If you have a G permit (cross-border worker), you have the right to choose whether to insure yourself with a Swiss health insurance (LAMal) or to maintain enrollment in the Italian healthcare service. This right is called the 'right of option'. If you choose to insure yourself in Switzerland, you will be able to access Swiss family doctors and benefit from the Swiss healthcare system, ensuring continuity of care even during periods of work in Ticino.

For the cross-border worker residing in Varesotto who works in Ticino, this option allows you to bypass the shortage of Italian doctors and ensure structural continuity of care through the Swiss system. However, this choice involves significant fiscal and administrative implications: it entails the obligation to pay different AVS/AI contributions, determines a change in the tax regime for income taxation, and affects declarations to Italian authorities. Check the documentation related to the cross-border option at the Italian Revenue Agency or contact a professional specializing in cross-border taxation directly.

Monitoring the system in 2026-2027

The situation in the next 12-18 months could significantly worsen: the flow of retirements is already scheduled, and the Lombardy Region has not yet communicated a structural generational replacement strategy. Periodically monitor the communications of the relevant ASST to understand if:

• New doctors are being recruited and when they will start their activity
• Temporary clinics will remain available or will undergo reductions in hours
• Your geographical area (district) will receive priority in recruitment
• New planning measures are announced by the Lombardy Region

Periodically check the website of ASST Sette Laghi or Valle Olona (depending on where you reside) in the section dedicated to territorial medicine and enrollment with family doctors. Some municipalities manage the updated list of available doctors directly.

Concrete steps: planning your healthcare coverage

In parallel with monitoring actions, plan your healthcare strategy:

• If you have chronic conditions, make sure to obtain prescriptions from the temporary clinic with extended validity;
• If you work in Ticino and need medical certificates for absence from work, clarify in advance with your employer which entities are recognized in Switzerland (generally, Italian certificates are not automatically valid in CH);
• If you are considering the option of enrolling in LAMal, contact at least two Swiss insurers to understand the costs and available coverage in your situation.

The shortage of doctors in Varesotto is a structural problem affecting the entire province, but with the right information and careful planning of your healthcare coverage, you can ensure continuity of your care. Consult our calculator to understand how a choice of enrollment in LAMal could affect your fiscal situation as a cross-border worker.

Source: varesenews.it