Implementation difficulties stemming from this new regulation were manifold. For local health authorities (both local health enterprises and hospital enterprises), the major problem was to guarantee doctors wanting to provide private patients with specialist or hospital care with the facilities needed as well as administrative and nursing personnel. In most cases, this means restructuring existing buildings, ie making substantial investments in a short period. On these grounds, if the hospital was unable to provide the relevant facilities, hospital doctors choosing intra-moenia professional activity were temporarily allowed to treat private patients in their own offices or private clinics. In this case, they were granted a 10% deduction on taxable income to cover production costs. The whole arrangement caused a great deal of discontent on the part of the medical personnel involved. The 10% deduction was considered far too low, but first and foremost hospital doctors resented that whereas every year doctors could switch from extramoenia to intra-moenia, the contrary was not possible: according to the Legislative Decree No. 229, opting for intra-moenia professional activity represented a life-time choice. Medical associations appealed the Constitutional Court on the issue, and in 2004 a new measure was introduced by the centre-right government enabling doctors to make their choice every year.