Abstract

Analysis of the profiles of the accountability of medical directors most closely tied to functions related to the organisation and management of the sanitary structure has been performed concentrating attention on administrative accountability for damages and managerial accountability for the failure to observe directives and for the failure to reach assigned objectives, respectively. The first matter dealt with is the problems relating to the structure and functions of the two different forms of accountability in light of the general normative discipline, of the evolution of jurisprudence and of scholarly thought. As for administrative accountability, emphasis has been placed on jurispruden-ce's recent pronouncements aimed at turning to account, within the framework of administrative oversight concerning the adoption of discretionary measures, aspects tied to the different level of professionalism possessed in relation to the functions performed. As for managerial accountability, stress has been placed on the debate that still seems to divide scholarly thought regarding the characteristics of such accountability, and on the solutions that seem to allow making the most of the professional skills of the manager while at the same time guaranteeing the efficiency and effectiveness of administrative activity. A second area investigated concerns the specific aspects of the administrative and managerial accountability of the medical manager as they appear in recent reforms involving the health sector and in contractual provisions which, following privatisation, have come to discipline the professional status of medical management. In particular, the intent here is to verify the compatibility, including as regards medical management, of the conclusions reached in the first part of the work, above all with reference to the possibility of modulating the power of oversight concerning the adoption of discretionary measures as a function of the specific functions of the organisation and management of sanitary structures, taking into account the inevitable intermingling of managerial competencies and technical/professional competencies which in this area characterise all management positions.