Italian hospitals crying out for emergency treatment

Health care/ a catalogue of errors

THE RECENT health reports from Naples have not been reassuring. A three-year-old boy with a malformed right hand had his left hand operated on by mistake. A middle-aged man with kidney problems died while two doctors bickered about how to use the dialysis machine. A six-year-old girl failed to wake up after a tonsillectomy .

Italy is not exactly famous for the quality of its health care. Indeed, some say that if you get ill you should go not to hospital, but to the airport. But these days the scare stories are proliferating. The low point came at the end of last month, when a group of Aids patients - again in Naples - revolted against the degrading conditions in which they were being kept by hurling their hospital meals and rusting beds and tables out of the ward windows.

Yet the health sector, like everything else in Italy, is supposed to be undergoing a revolution. Bled dry by a generation of politically appointed managers who handed out jobs to their friends like sandwiches and spent money freely, the Italian health service has now opted for a very British solution.

Since the beginning of the year, local health authorities and certain target hospitals have been run as trusts, meaning they can no longer rely on the state to mop up their deficits but have to become financially self- sufficient. As in Britain, the regional authority will pay for patients according to their condition, not the length of their stay in hospital, which gives hospitals a strong incentive to treat them quickly and efficiently.

Applying the logic of the free market to such a place as Naples is surreal to behold. Where, after all, do you start in a city whose largest hospital is so poorly run that a patient once died on the operating table because the stitching thread had run out? A city where bodies disappear from mortuaries, stretchers are stained with vomit and blood, many orderlies are ex-convicts on the payroll of the local Mafia, and where patients are left to rot in corridors because of lack of bed space or medical staff to attend to them?

Enter Domenico Pirozzi, a strange breed of Italian-style yuppie manager. He was recently appointed director-general of two specialised hospitals in Naples, including the Cotugno, where the Aids riot took place. Mr Pirozzi does not come from the private sector - no successful entrepreneurial manager would touch hospitals with a barge pole - but is a former official in the Interior Ministry.

He dresses sharply, chews gum, and has a sideline selling Lancias. Above all, he is image-conscious, and indeed, has a book called The Importance of Multi-Media Systems in Managerial Life lying prominently on his desk.

"All these reports of medical errors are highly exaggerated. These things happen in every country in the world," he said cheerfully. Mr Pirozzi happily accompanied journalists to the notorious Aids ward, where the rooms have been repainted, cleaned, and kitted out with new furniture, telephones and television sets. Patients are no longer isolated, but receive as many visitors as they want. "It's not exactly hell, is it?" Mr Pirozzi remarked.

Not exactly, no, but what about the rest of the hospital, where doctors say six people are crammed into each room and hygiene remains dire? And the food, which one Aids patient described as "inedible"? "It's fine. I had some myself the other day," Mr Pirozzi said. Even he conceded, though, that past mismanagement had created a fertile environment for medical horror stories. Previous administrators were more concerned with empire-building than health care, creating vastly overstaffed departments that did not correspond to patients' needs.

For example, Italy has as many heart transplant facilities as the United States. But because of hospital inefficiency, it can take weeks for a patient to gain access to basic medical services.

"The No 1 problem is that patients are staying too long in hospital," Mr Pirozzi said. "They have to wait five to ten days for a CAT scan."

Soon staff will be on a 12-hour day, with numbers cut from 3,200 to 2,700 to look after 1,200 patients. Each day doctors beg Mr Pirozzi for their departments, their jobs, and their equipment. So far, the reforms have raised little protest, or even public interest: anything that improves the Italian health system must, after all, be welcome.

Waste disposal experts recently grew angry enough to block the entrance to the hospital complex with their lorry for an hour. To British eyes, it doesn't look entirely unfamiliar.

Suggested Topics
Start your day with The Independent, sign up for daily news emails
Arts and Entertainment
The Doctor and Clara have their first real heart to heart since he regenerated in 'Deep Breath'
TV
Arts and Entertainment
James Hewitt has firmly denied being Harry’s father
arts + ents
Arts and Entertainment
Jamie Oliver
filmTV chef Jamie Oliver turned down role in The Hobbit
News
The official police photograph of Dustin Diamond taken after he was arrested in Wisconsin
peopleDownfall of the TV star charged with bar stabbing
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
Life and Style
tech
Arts and Entertainment
Jeremy Clarkson, left, and Richard Hammond upset the locals in South America
tvReview: Top Gear team flee Patagonia as Christmas special reaches its climax in the style of Butch and Sundance
News
people
Sport
Ashley Barnes of Burnley scores their second goal
footballMan City vs Burnley match report
News
news
Arts and Entertainment
Peter Mayhew as Chewbacca alongside Harrison Ford's Han Solo in 'Star Wars'
film
News
i100
Arts and Entertainment
Man of action: Christian Bale stars in Exodus: Gods and Kings
film
Life and Style
Apple showed no sign of losing its talent for product launches with the new, slightly larger iPhone 6 making headlines
techSecurity breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
Arts and Entertainment
Catherine (Sarah Lancashire) in Happy Valley ((C) Red Productions/Ben Blackall)
TV
Arts and Entertainment
Clueless? Locked-door mysteries are the ultimate manifestation of the cerebral detective story
booksAs a new collection of the genre’s best is published, its editor explains the rules of engagement
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: LGV Driver - Category C or C+E

£23000 - £26000 per annum: Recruitment Genius: This national Company that manu...

Recruitment Genius: Sales Consultant - OTE £30,000

£13000 - £30000 per annum: Recruitment Genius: Scotland's leading life insuran...

Recruitment Genius: Maintenance Assistant

£25000 - £30000 per annum: Recruitment Genius: A Maintenance Assistant is requ...

Recruitment Genius: Business Manager

£32000 - £40000 per annum: Recruitment Genius: A Business Manager is required ...

Day In a Page

A timely reminder of the bloody anniversary we all forgot

A timely reminder of the bloody anniversary we all forgot

Who remembers that this week we enter the 150th anniversary year of the end of the American Civil War, asks Robert Fisk
Homeless Veterans appeal: Former soldiers pay their respects to a friend who also served

Homeless Veterans appeal

Former soldiers pay their respects to a friend who also served
Downfall of Dustin 'Screech' Diamond, the 'Saved By The Bell' star charged with bar stabbing

Scarred by the bell

The downfall of the TV star charged with bar stabbing
Why 2014 was a year of technological let-downs

Why 2014 was a year of technological let-downs

Security breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
Cuba's golf revolution: But will the revolutionary nation take 'bourgeois' game to its heart?

Will revolutionary Cuba take 'bourgeois' golf to its heart?

Fidel Castro ridiculed the game – but now investment in leisure resort projects is welcome
The Locked Room Mysteries: As a new collection of the genre’s best is published, its editor Otto Penzler explains the rules of engagement

The Locked Room Mysteries

As a new collection of the genre’s best is published, its editor explains the rules of engagement
Amy Adams on playing painter Margaret Keane in Tim Burton's Big Eyes

How I made myself Keane

Amy Adams hadn’t wanted to take the role of artist Margaret Keane, because she’d had enough of playing victims. But then she had a daughter, and saw the painter in a new light
Ed Richards: Parting view of Ofcom chief. . . we hate jokes on the disabled

Parting view of Ofcom chief... we hate jokes on the disabled

Bad language once got TV viewers irate, inciting calls to broadcasting switchboards. But now there is a worse offender, says retiring head of the media watchdog, Ed Richards
A look back at fashion in 2014: Wear in review

Wear in review

A look back at fashion in 2014
Ian Herbert: My 10 hopes for sport in 2015. Might just one of them happen?

Ian Herbert: My 10 hopes for sport in 2015

Might just one of them happen?
War with Isis: The West needs more than a White Knight

The West needs more than a White Knight

Despite billions spent on weapons, the US has not been able to counter Isis's gruesome tactics, says Patrick Cockburn
Return to Helmand: Private Davey Graham recalls the day he was shot by the Taliban

'The day I was shot by the Taliban'

Private Davey Graham was shot five times during an ambush in 2007 - it was the first, controversial photograph to show the dangers our soldiers faced in Helmand province
Revealed: the best and worst airlines for delays

Revealed: the best and worst airlines for delays

Many flyers are failing to claim compensation to which they are entitled, a new survey has found
The stories that defined 2014: From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions

The stories that defined 2014

From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions
Stoke-on-Trent becomes first British city to be classified as 'disaster resilient' by the United Nations

Disaster looming? Now you know where to head...

Which British city has become the first to be awarded special 'resilience' status by the UN?