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
Have you tried new the Independent Digital Edition apps?
ebooksAn unforgettable anthology of contemporary reportage
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

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

iJobs Job Widget
iJobs General

Recruitment Genius: 3rd Line Virtualisation, Windows & Server Engineer

£40000 - £47000 per annum: Recruitment Genius: A 3rd Line Virtualisation / Sto...

Recruitment Genius: Refrigeration and Air Conditioning Service Engineer

£26000 - £35000 per annum: Recruitment Genius: A successful national service f...

Recruitment Genius: Business Development Executive / Sales - OTE £25,000

£15000 - £25000 per annum: Recruitment Genius: This is an opportunity to join ...

Recruitment Genius: Sales Administrator - Fixed Term Contract

£17500 - £20000 per annum: Recruitment Genius: We currently require an experie...

Day In a Page

Syria civil war: Meet the military commander who says his soldiers will not rest until every inch of their war torn country is free of Islamist 'terrorists'

‘We won’t stop until Syria is back to normal’

Near the front lines with Islamist-controlled towns where Assad’s troops were besieged just last month, Robert Fisk meets a commander confidently preparing his soldiers for battle
The inside story of how Bill Clinton built a $2bn global foundation may undermine Hillary's chances

The inside story of how Bill Clinton built a $2bn global foundation...

... and how it may undermine Hillary's chances in 2016
12 best olive oils

Extra-virgin, cold-press, early-harvest, ultra-premium: 12 best olive oils

Choosing an olive oil is a surprising minefield. Save yourself the hassle with our handy guide
Sepp Blatter resignation: The beginning of Fifa's long road to reform?

Does Blatter's departure mean Fifa will automatically clean up its act?

Don't bet on it, says Tom Peck
Charles Kennedy: The baby of the House who grew into a Lib Dem giant

The baby of the House who grew into a Lib Dem giant

Charles Kennedy was consistently a man of the centre-left, dedicated to social justice, but was also a champion of liberty and an opponent of the nanny-state, says Baroness Williams
Syria civil war: The harrowing testament of a five-year-old victim of this endless conflict

The harrowing testament of a five-year-old victim of Syria's endless civil war

Sahar Qanbar lost her mother and brother as civilians and government soldiers fought side by side after being surrounded by brutal Islamist fighters. Robert Fisk visited her
The future of songwriting: How streaming is changing everything we know about making music

The future of songwriting

How streaming is changing everything we know about making music
William Shemin and Henry Johnson: Jewish and black soldiers receive World War I Medal of Honor amid claims of discrimination

Recognition at long last

Jewish and black soldiers who fought in WWI finally receive medals after claims of discrimination
Beating obesity: The new pacemaker which helps over-eaters

Beating obesity

The new pacemaker which helps over-eaters
9 best women's festival waterproofs

Ready for rain: 9 best women's festival waterproofs

These are the macs to keep your denim dry and your hair frizz-free(ish)
Cycling World Hour Record: Nervous Sir Bradley Wiggins ready for pain as he prepares to go distance

Wiggins worried

Nervous Sir Bradley ready for pain as he prepares to attempt cycling's World Hour Record
Liverpool close in on Milner signing

Liverpool close in on Milner signing

Reds baulk at Christian Benteke £32.5m release clause
On your feet! Spending at least two hours a day standing reduces the risk of heart attacks, cancer and diabetes, according to new research

On your feet!

Spending half the day standing 'reduces risk of heart attacks and cancer'
With scores of surgeries closing, what hope is there for the David Cameron's promise of 5,000 more GPs and a 24/7 NHS?

The big NHS question

Why are there so few new GPs when so many want to study medicine?
Big knickers are back: Thongs ain't what they used to be

Thongs ain't what they used to be

Big knickers are back