Health care in Rome

It's difficult to make generalisations about the Italian healthcare system. For one thing it's run at a regional level and an experience in Bolzano will be entirely different from an experience in Sicily. Now that I've experienced the trifecta of childbirth, open heart surgery and a major allergy attack at Roman public hospitals I do feel more qualified than most to comment on the system in Rome at least.

At first glance, Rome's public hospitals are pretty forbidding places. It's not uncommon to turn up for your appointment to find no information desk, no signs and have no idea where to go for your appointment, as has happenned to me a few times at various places. In this situation, it's customary to poke your head into office doors and accost people passing by in white coats in order to finally make it to the correct place (often late - in which case you'll usually find that your doctor has left to treat patients in his/her private practice). Doesn't seem like the most logical system but somehow this seems logical to many Italian hospital administrators. In addition, I've learnt the hard way that you need to get to the hospital much earlier than your appointment time so that you can pay your 'ticket' (a wildly varying fee you need to pay for health visits and tests) ahead of time.

The hospitals also have a forbidding air due to the fact that they are usually run down, depressing places, with peeling paint, broken chairs, dirty bathrooms (toilet paper and soap are both rare) and a general feeling of decay. At the hospital where I had my open heart surgery, someone had written things like floor numbers and directions to the mammogram clinic on the wall in felt tip pen as (I assume) getting a proper sign made would have been too expensive. This type of thing does not give the nervous patient a feeling of calm.

However, I found that when I was really, really sick, the hospital was there for me. I had a great team of cardiologists treating me at the public hospital and had life saving surgery by skilled surgeons (so i assume - on the other hand it may have been dumb luck!) When I was in intensive care and semi intensive care it was pretty similar to what you'd probably experience in other Western countries (caveat - I've never been in hospital anywhere but Rome).

Where things fell down was when I was feeling a lot better but was still in hospital (say week 3-4 of my 7 week stay) when I was moved to a tiny 6 person room with dirty bathroom down the hall, shared by 18 people plus visitors, and cleaned only once a day. Sharing a room with that many other women (no curtains), many of whom were suffering from dementia or Alzheimer's, I learnt a lot - but not all of it things I really want to know already in my 30s (I'll spare my readers the details). It was very hard to sleep and the 'healthier' patients spent a lot of time keeping tabs on the 'less healthy' patients (I'm thinking particularly of a woman with profound memory loss/dementia who kept trying to climb out of bed to 'go upstairs').

It was ok for me by this stage as I was feeling a bit better after my surgery but there was a young woman with advanced breast cancer on the next bed to mine for several weeks who was unable to sleep because of the racket these women made day and night. I'm no expert but I'm sure that this was not good for a person fighting advanced cancer and, in fact, she looked worse and worse (and more tired) as the days wore on. I'd also like to know the rates of post-op infection at Roman hospitals as those bathrooms were filthy, there was no soap and the nurses weren't available to help us bathe (apart from the occasional quick bidet).

I've also heard lots of heart wrenching stories about giving birth in Rome. Most of it seems to be due to lack of organisation but also lack of caring about a woman giving birth feeling excessive pain or discomfort. I was lucky when I gave birth because the hospital I chose offered rooming-in with the baby post birth, had an anaesthesiologogist available when I wanted an epidural and has a relatively low rate of c-sections (around 40% rather than 80% of births as at some private clinics in Rome). I did a lot of research ahead of time to find a hospital which offered (more or less) what I wanted. Well actually I would have liked a water birth but since that's not available at any Rome hospital I gave up on that idea and worked with what was available.

Many Italians say "the hospitals here aren't very 'bello' but the doctors are great." I'd agree with that assessment with one caveat. The fact that the hospitals are run down and underfunded is indeed largely an aesthetic problem but when it comes to lack of toilet paper, soap or clenliness it's actually very serious. Hospitals must (at the very least) be clean and there must be soap in the bathroom.