ITALIAN LAW. - According to the Italian legal system, the hospital is a public institution intended for the free health care of the sick and the injured, through admission, maintenance and medical-surgical treatment. The element of gratuitousness must never be lacking, even if limited to a certain number of beds, otherwise it would be a private nursing home with a speculative purpose. The free service, which may be limited to certain categories of patients, may be owed not only for purposes of public charity but also by virtue of a social insurance relationship.
Depending on the subject to which hospitals belong, they are distinguished into public and private; public are those administered by public bodies, private those maintained by private individuals, natural or legal persons; to this second category belong the hospitals run by religious orders or congregations. The majority of existing public hospitals belong to charitable institutions; there are then the hospitals proper to many municipalities, the civil and military hospitals of the State, those of the Sovereign Military Order of Malta, of the Mauritian Order and of many assistance and welfare bodies.
From this distinction it follows, in the first place, that the relations between the body and the employed personnel fall, in the first case, under those of public employment, in the second under those of private employment with all the effects of a substantive, formal and procedural legal nature. In the second place, even the relationship between the body and the patient must be distinguished into a relationship of public law, with the consequent application of the principles relating to public-law contracts, and a relationship of private law, with the application of the principles of contracts between private parties. Finally, public hospitals are subject, in addition to the ordinary administrative controls, to those of the central and provincial health authorities. Private ones undergo only an extrinsic police control with regard to compliance with the rules of public health safety (art. 193 T. U. 27 July 1934, no. 1265).
All hospitals managed by public bodies must observe a body of common rules regarding the technique of constructing buildings and their installations, the internal organization of services and the legal status of personnel. The rules on the construction of hospitals are contained in a decree of the Head of Government of 20 July 1939. The organization of services is the subject of a specific regulation issued by R. D. 30 Sept. 1938, no. 1631, to which art. 192 of the T. U. of the Health Law refers. By the same regulation the legal status of the personnel assigned to hospitals is governed, which was previously regulated in various ways according to the various administrations by the
