1. ITALIADECIDE “ADMINISTRATION, CITIZENS, ENTERPRISES” AWARD 2016
INTERVENTION BY VITO GAMBERALE
During the presentation of the 2016 Italiadecide report “Digital Italy: eight concepts for innovation
and smart growth”, held on March 21st at Palazzo Montecitorio – seat of the Chamber of Deputies,
Vito Gamberale was one of the participant speakers, and Chair of the Committee that, as of this
year, is in charge of awarding the “Administration, citizens, enterprises” prize established by the
Italiadecide Association. Below is the transcript of Gamberale's speech:
Good morning everyone. I would like to particularly welcome the President of the Republic and
thank Minister Madia for supporting the work I'm about to present. The Committee for the design
and launch of this award was established last year during the presentation of the Italiadecide 2016
Report. Its members are: Architect Elisabetta Spitz, Professors Pierluigi Ciocca, Piermassimo
Chirulli, Cesare Pinelli, and Filippo Satta, Member of Parliament Stefano Quintarelli, Italiadecide
Director Enrico Seta, and myself. We analysed the ISTAT (Italian National Statistical Institute)
mapping of public administration to identify the areas to focus on in order to award the prize of
this year’s report.
We initially identified three areas: the unification of municipalities and/or services provided by
municipalities, as we believed that highlighting virtuous examples of practical application of the
spending review could be a positive approach. The second area we evaluated was the launch of
the Single Contact Point for Productive Activity (SUAP), because of the importance to enhance
computerisation as a simplification tool for enterprises. We then conducted an in-depth
examination of clinical services and their efficacy, managerial efficiency, as well as humanisation of
patient relationship in hospitals, in order to show virtuous examples of good healthcare. To
address the first two areas – municipality unification and SUAP – we involved the National
Association of Italian Municipalities (ANCI). To examine the third area, hospitals, we resorted to
Agenas, the National agency for regional health services, responsible for the standardisation of
healthcare service efficiency, among others.
Both institutions – ANCI and Agenas – were very open to cooperate and help us understand how
to classify such different realities in a country that has such a variety of homogeneous structures in
a way that would allow comparisons, and therefore objective evaluations. This task required a
long amount of time. In November, we eventually understood that we could not analyse
municipalities on a general and homogeneous basis. We therefore focused on the hospital system,
also because it was clear that Agenas, represented here today by its General Manager, Mr Bevere,
had progressed in its installation of standard features that consequently allow for objective and
mutually comparable evaluations.
Such support allowed us to develop a call for competition open to all public hospitals in Italy. On
December 16th, the call was online and then also promoted through the Health Commission of the
Conference of Autonomous Regions and Provinces, coordinated as to that date by the Emilia
Romagna Regional Counsellor Sergio Venturi. Of the 20 participating regions (actually, 19 regions
and two provinces with special status), 12 committed at least their local centres of excellence. Out
of the 300 Italian hospitals, 34 participated (11%): not an excellent, but still honourable result.
Some of the biggest regions were missing. It is probable that our most stringent questions
prompted them to not reply. The participants prevalently included general hospitals, often
connected with universities. Scientific Research and Health Care Institutes (IRCCS) – mainly
oncological – largely participated. The call for competition based on specific parameters of
statistical efficacy of special services, such as C-section rates, successful treatments of acute
myocardial infarction, as well as the absence rate of hospital personnel and special attention to

2. patients. The Committee produced comparable profiles based on the documentation submitted by
each participating hospital. The analysis disclosed a broad spectrum of extremely well-organised,
specialised hospitals and healthcare structures, oriented to high-level benchmarks of services, care
for the patient's needs, transparency and efficiency.
Therefore, our work on a still significant sample confirms that Italy's healthcare systems – despite
all the scandals and negative episodes – is very advanced in terms of services, very attentive to
human aspects, and is more and more oriented towards combining cost-effectiveness with clinical
result efficiency. There is widespread criticism in Italy concerning the country itself and its
infrastructures, which apparently ignores our excellence. However, Italy fosters many examples of
excellence in every field, as is the case of our healthcare system, characterised by higher standards
compared to other European countries. Our comparative analysis produced a short-list of
excellence. The Committee eventually decided to award a hospital and an IRCCS.
The final decision cannot and must not have scientific relevance, as none of the Committee
members are doctors. The award merely aims to highlight two examples of organisational
efficiency and human approach to patients: among hospitals, the University Polyclinic Sant'Orsola
Malpighi in Bologna was selected, as was the Cancer Care Referral Centre (Crob) in Rionero in
Vulture (Potenza, Italy) for the IRCCS category.
A few words to explain the reasons behind our selection. The Sant'Orsola Malpighi Hospital in
Bologna, as part of an extremely advanced regional setting, impressed us for the wide array of
specialised disciplines treated, its efficient personnel/bed ratio, positive economic results (with a
net profit of 2%, a much sought-after target for many private industrial Italian companies),
contained absenteeism, C-sections and acute myocardial infarction parameters within the target
ranges set by Agenas, as well as wide extra-regional attractiveness, great attention and human
approach to patients, easy access, consolidated online development – both in terms of electronic
health records and other services – as well as further excellent enhancement projects.
The Cancer Referral Centre of the Basilicata Region in Rionero del Vulture was awarded as a
virtuous example from southern Italy: a small, yet absolutely exemplary structure in terms of
efficiency, commitment and results. This institution is accredited by OECI as a clinical cancer
centre, and was awarded three “pink flags” over the past years, in recognition of the far-reaching
and responsible roles held by women. The centre boasts wide extra-regional attractiveness and
has an efficient personnel/bed ratio – similar to that of Sant'Orsola – indicating that southern Italy
can compare with the regions of northern Italy. Moreover, it features significant incidence of
researchers (approx. 15%), great and advanced attention to patients, efficient accessibility, good
communication systems offering telemedicine and tele-expertise services. The Crob was awarded
the Anac prize for transparency, and has a very, very low absenteeism rate. The Committee
dedicated its first Italiadecide “Administration, citizens, enterprises” award to healthcare, because
it believed that this service area, sometimes deeply injured by scandals, deserves greater
appreciation of its excellence, which is not sparse throughout the country.
I will conclude by highlighting that this result was made possible thanks to the active participation
of all Committee members, whom I personally thank, and who showed constant commitment and
factual contribution. A special thank you to the Italiadecide scientific direction and secretariat,
both of which offered precise and smart support to all steps of this initiative.
Vito Gamberale then invited the Minister of Health Beatrice Lorenzin and the Minister for Public
Administration Marianna Madia on stage to bestow the awards, which were received by Giuseppe
Cugno – General Manager of the Crob in Rionero in Vulture – and by Dr. Mario Cavalli – General
Manager of the Polyclinic Sant'Orsola Malpighi in Bologna, respectively.