Abstract Chapter 19

Chapter 19 discusses the theme of corruption in the INHS and the consequent policies aimed to tackle it. This article collects the different definitions of corruption in the literature; examines the Italian legislation on corruption, with a focus on the 190/2012 Law, which established a position, head of prevention of corruption (RPC), in each public entity; and explores the impact of this phenomenon on the current debate on NHS legality and efficiency, focusing on purchasing activities. The authors collected empirical evidence on the RPCs’ professional profile, the implementation of the anti-corruption normative and its consequent effects at the organizational level. Data were collected through a survey filled out by the RPCs from 83 Italian healthcare organizations, which represents 41% of the total number of healthcare organizations. According to the survey, 71% of RPCs have a juridical or political background. Moreover, 81% had worked only in the public sector. As stated by the normative, RPCs are mainly directors of clinical organizational units. On average, they spend 32% of their working time on anti-corruption activities. These activities are mainly the drafting of documents. Only 37% of them indicated the presence of a specific staff for anti-corruption. This can limit other activities that are perceived to be more effective, such as audit and training. RPCs consider their job slightly more urgent in the southern regions of Italy (4.3/7 compared to 3.9/7 for the northern regions). However, in the south weaker support between RPCs and Directors is perceived (3.1/7 in the south and 3.8/7 in the north). Nevertheless, throughout the country support of the RPCs is considered to be a key point to emphasize. The role of RPC is not yet fully accepted by both administrative and medical staff, due to the increasing administrative burdens introduced by the anti-corruption legislation. In conclusion, it seems fundamental to progressively integrate the oversight activities, both at an IT level and at the organizational level, through the integration of the RPC role with the internal audit function.