The return of Dr. Landolfo to the San Marino hospital is not a political matter but an administrative one. It is up to the ISS leadership to decide the timing and manner of his reinstatement.
This was the position reiterated today, Wednesday 14 October, by the Secretary of State for Health, Massimo Andrea Ugolini, who spoke during the joint session of the second and fourth Council Committees.
The debate focused not only on the matter of the chief physician but also on the conditions of healthcare staff, prevention programmes and the new hospital project. Ugolini responded to concerns raised by several committee members, firmly rejecting accusations of possible political interference and of reduced investment in screening programmes.
On the Landolfo case, the Secretary urged a distinction between the doctor’s professional standing and the procedures required for his return to service.
“The return of a professional of Dr. Landolfo’s calibre would be most welcome: it will be up to the executive committee to determine how this should happen, based on timing and procedure,” he said in his reply.
Ugolini recalled that the chief physician had independently requested a period of leave, and that the ISS general management and executive committee now have to deal with the organisational consequences of a prolonged absence.
“It is not for politics to weigh in on the voluntary choices made by individual professionals,” he stressed, noting that it is often political forces themselves that denounce interference in healthcare decisions.
According to the Secretary, the real issue lies mainly in the rules governing leave of absence for chief physicians and their replacement.
Legislation dating back to 1991 allows for leave periods of up to two years, whereas the 2024 organisational act establishes that temporary replacement at the head of a complex operating unit can only occur in extraordinary circumstances and for a maximum of twelve months.
This can create difficulties when a chief physician is absent for a long period, leaving a position of responsibility vacant.
“Perhaps, from a political standpoint, in future we will need to assess whether the combination of these rules on chief physicians’ leave creates problems — and figure out how to manage not so much the return, but the departure,” Ugolini explained.
The Secretary then raised the need for a broader reflection on how lengthy absences are authorised, particularly when they are not linked to health issues or serious family reasons. However, he made clear that, for now, managing the Landolfo case remains the responsibility of the ISS’s administrative structure.
Ugolini also dismissed what he considers unfounded accounts of the affair, urging against fuelling speculation.
Another topic addressed was healthcare staffing. The Secretary said he had no evidence of alleged departures of doctors or other professionals from the San Marino hospital.
“As for doctors or healthcare staff leaving, I have no indication of that,” he said, pointing to recent union agreements and measures introduced to recognise the work of ISS staff.
On the prevention front, Ugolini announced that new screening programmes for the male population will be introduced in the coming months, with particular attention to prostate health and other conditions.
The Secretary also responded to criticism concerning the frequency of screenings and any possible revision of the intervals between check-ups.
According to Ugolini, the matter must be approached on the basis of scientific evidence and international guidelines. If San Marino intends to maintain more frequent check-ups than those recommended by the guidelines, he explained, it would be appropriate to support that choice with studies demonstrating its effectiveness.
There is therefore no intention of cutting screening programmes to save resources, the Secretary assured, rejecting the interpretation put forward by the opposition.
“Any scientific studies are not aimed at saving money,” he clarified. The goal, he added, is to verify and confirm through scientific data the validity of the prevention activities already carried out by San Marino’s healthcare system.
Finally, the new hospital. Responding to remarks from committee member Troina, Ugolini recalled that the fourth Committee has already approved a motion calling for a comprehensive review of the future facility.
The discussion will cover the design, the healthcare services to be included in the new complex, and the financing methods, including the possible use of project financing.
“As soon as we have a complete and finalised dossier ready, we will reconvene in the fourth committee to examine it in depth and receive a clear political mandate on this important issue,” he stated.
For now, there is no definitive indication regarding timelines or the financing model. The project will return to the Committee’s attention once the Government has prepared a full overview of the planned interventions and their associated costs.
