An appointment with the Italian health system

Italians are a poorly bunch. The slightest breath of wind can lead to three days of bed rest, air conditioning can cause pneumonia and an overly-chilled drink can kill a man (no, really), and then you have weather systems to contend with. Low pressure is a disaster, but then when the weather changes… havoc.

It’s no surprise, therefore, that doctor’s surgeries here are pretty busy. Back in the UK, my wife and I were always relatively healthy; I think I saw a doctor once or twice a year at most, but since moving here, we’ve both been struck down with what can only be described as Italianitis. As a result, I’ve got to know the Italian health system pretty well…

It all starts with a call to the doctor. But you don’t speak to the receptionist, as there isn’t one, you speak to the doctor. He may be in the middle of a consultation, but he’ll take your call, talk to you about your symptoms and then give you an appointment. This is great when you’re on the end of the phone, but less great when you’re sat in front of the doctor describing your bowel movements in your finest Italian and he keeps answering the phone and interrupting your flow (if you’ll pardon the pun).

Most people don’t bother with appointments though, they just turn up, ask who’s last in the queue and take a seat. Again, no receptionist, there’s just a waiting room. The doctor then somehow combines those who have appointments with those who don’t and everyone magically gets seen.

If the doctor can’t put your symptoms down to a change in weather or an unruly draft (a doctor actually blamed the weather for my wife feeling ill a few months ago. It turned out she was pregnant. I guess you can’t be right all the time…) he’ll write you a prescription. They love to give drugs here. In fact, the only thing they enjoy more than giving drugs is taking blood. Every morning the local hospital has hundreds, if not thousands, of people queuing up with their doctor’s orders in hand, ready to part with a couple of test tubes’ worth of the stuff. Any ailment, it seems, can be cured simply by testing how many red or white blood cells you have.

Getting the results is exciting too. They don’t go to your doctor, you pick them up yourself. You get a couple of sheets of paper listing all the tests that were done, your score for each, and what your score should have been. If you’re out of the range, that probably means you’re about to die, so you run back to the doctor as fast as you can to find out if there’s anything that can be done to save you, only to have to sit in the waiting room for two hours while a succession of 80 year olds get treated for neck ache.

If the drugs and the blood tests can’t do anything for you, then it’s off to hospital to see a specialist. This is where things get really exciting. The first stop is always the CUP, which is kind of a waiting room crossed with Argos where you make and pay for appointments. You have to take a ticket to be served, much like the deli counter, but there are four options. You can pay privately, pay semi-privately, not pay at all, or something else, which I still haven’t worked out. I normally press all four, see what number comes up first, and then play the poor confused foreigner card once I get seen. To be fair, I am a poor, confused foreigner, so I’m not deceiving anyone.

Once you’ve either paid a lot, a bit or nothing, depending who you spoke to, it’s off to the specialist. These guys are good, and you get about half an hour of their time. If they want you to do more tests though, it’s back to the CUP, who’ll then send you to the department who will be doing your tests. There, you take another ticket, get sent back to the CUP and then back to the department again. Then, it’s back to the CUP to pay, before going back to the department to show them that you’ve paid.

Now, having read all this (you have read it all, right?), you might be thinking I’m not particularly enamoured with the Italian health system. But you’d be wrong. Yes it’s occasionally non-sensical, yes, one of the hospitals we had the displeasure of going to was dirtier than an Algerian public toilet, and yes, some of the people in the CUP are astoundingly, comedically unhelpful, but it also works. You get seen quickly, you get to speak to a specialist if you need, you keep your own results so they can disappear into your own filing system rather someone else’s, and some of the hospitals we’ve been to have been incredible; all shiny steel and glass, brand new equipment and even, occasionally, happy staff.

I still don’t entirely understand how it all works. I don’t think anyone does, including the people working at the hospitals, but one way or another everyone, even us foreigners brandishing EHIC cards, gets seen and everyone gets looked after. The Italian health system is really quite good. And that’s a conclusion I wasn’t expecting.

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