On February 28, 2017, the Italian Parliament approved a long-awaited act, aimed at providing new tools to improve the quality of health care services and to fight the downsides of the so-called defensive medicine.
The act has been proposed and announced as a historical step for Italian health care legislation by Federico Gelli, head of the health care committee of the Italian Democratic Party.
The bill, in its 18 articles, offers a new comprehensive regulation of major aspects of medical malpractice and related issues, such as litigation management and insurance.
- Article 2 and 3 introduce new administrative authorities: the health protection authority and the national observatory on health care good practices;
- Article 5 formalizes and regulates the publication of guidelines and good practices for better visibility and increased certainty;
- Articles 6 and 7 (re-)define the nature and limits of criminal, contractual and tortious liability of health care professionals and hospitals;
- Article 8 introduces compulsory ADR mechanisms to reduce (discourage?) court litigation;
- Article 10 establishes insurance obligations for public and private hospitals and health care professionals;
- Article 12 allows direct compensation from insurance companies to victims of medical malpractice;
- Article 14 creates a guarantee fund for medical malpractice victims.
Everything looks very promising, at first, but medical malpractice is a too delicate and too complicated subject to think that a simple act could really solve all the outstanding issues.
For example, Italian lawyers and health care professionals certainly remember the goofy attempt to limit health care professionals’ liability by the Italian legislator in 2012 that was not upheld by Italian courts’ decisions, thus nullifying the legislator’s intentions.
From another angle, compulsory ADR mechanisms and insurance obligations always carry the risk to become an obstacle to the effectiveness of the rights of individuals, if not a gift to insurance companies.
Lastly, it is worth noting that the ambitious goals set forth by the Italian legislator would have to be achieved without any additional public investment, as article 18 of the act expressly prohibits such spending. Indeed, it is hard to predict whether a true improvement of health care safety is achievable – automatically and free of costs – just because of a new bill.
In order to have a better understanding of the true potential of the new legislation, stay tuned for more reflections, which will appear on this blog.