Tasks and responsibilities of the competent doctor 
The health care worker who is assigned the task of carrying out the workers' surveillance by the law is called “competent doctor” in the decree (article 16, section 2 and 17, section I, letter b)). 
This professional figure, that was already included in article 33 of the Presidential Decree 303/56 although did not clarify the real meaning of the specific adjectives, is laid down by the article 2 according to the specific obtaining of academic qualifications (specialisation, teaching or university teaching qualification in one of the subjects listed by numbers 1 and 2 of the letter d)) or the authorisation to practise the activity of competent doctor issued by the Health Town Councillorship having the territorial competence according to article 55 of the above-mentioned 277/91 Decree Law. The validity of this last requirement was recently confirmed also by the Constitutional Court (sentence n. 30/95). Furthermore, the future enlargement of the specialisation list considered to be eligible for the Ministry of Health along with the Ministry of the University and of scientific and technological research is likely to be made. 
With respect to the previous decree, the 626/94 decree law finally sheds light on the problems concerning the legal relationship with the employer. The doubts about the interpretation and the concrete enforcement of article 3, letter c) of the 277/911 Decree Law, in fact, seem to have finally been dispelled by sections 5 and 7 of article 17 where it is laid down that the competent doctor who does not carry out a control activity for a public facility can nevertheless work as: 
- the employee of a public or private external facility provided that there is no “agreement” with the company; 
- a professional; 
- the company's employee.
The role of doctors inside a company is presently more active and incisive: the general tasks laid down by article 17 for the competent doctor are in fact many and very complex and are divided into 11 points (letters a to m). 
Although many of such tasks had already been laid down in the 277/91 Decree Law and are then not a novelty, the new system of sanctions laid down by article 92 in case of their infringement (that also includes sentences of detention up to a two-month period) accounts for the need of an exhaustive, albeit schematic, comment. 

Infringement 
of the competent doctor 
When regulations are infringed, the competent doctor might be sanctioned in the following ways: 
a) imprisonment up to two months or fine from one to six million lira for infringement of articles 17, section 1, letters b), d), h) and l); 69, section 4; 86, section 2 bis; 
b) imprisonment up to one month or fine from five hundred thousand lira to three million lira for infringement of article 17, section 1, letters e), f), g) and i) and of section 3. 
As far as the clinical, diagnostic, medical and legal aspects are concerned, letters b) and c) of section 1 of article 17 explicitly refer to what the previous article 16 laid down concerning the general principles of sanitary surveillance. It essentially underlines that the basic goal of sanitary surveillance is to make sure that the worker is fit for working through: 
- preventive health controls aimed at detecting any possible contraindications to the kind of work the worker has to be assigned to; 
- periodical health controls aimed at controlling the health conditions of the worker using clinical examinations and diagnostic surveys the competent doctor believes necessary to carry out. If such controls are not carried out, sanctions will be filed. 
Doctors can be prosecuted with the same sentences if: 
- they do not carry out and/or update the worker's health and risk record (article 17 letter d)); 
- they do not inspect, along with the person in charge of the prevention and protection of risks, the workplaces at least twice a year (article 17 letter h)); 
- they do not co-operate with the employer to set up a first-aid service (article 17 letter l)). 
Doctors may be punished with an imprisonment sentence up to one month or a fine from five hundred thousand lira to three million lira if: 
- they do not provide workers with the necessary information about health controls and the need to undergo them even following the suspension of the activity in case they were exposed to long-term effect agents (article 17 letter e)); 
- they do not inform workers about the outcome of the preventive health controls as laid down in article 16 (article 17 letter f)). 
There is an imprisonment sentence up to two months or a fine from one to six million lira if: 
- the results and meaning of the collective anonymous controls are not communicated when meetings with the safety representatives take place (article 17 letter f)); 
- medical examinations requested by the worker when such request is linked to his/her professional risk are not carried out (article 17 letter i)); 
- the employer and the worker receive no written information in case of the worker's partial or temporary unsuitability decision (article 17, section 3). 
Without prejudice to the obligatory and propaedeutic nature of preventive medical examination (whose importance is rightfully underscored and well explained even in other parts of the decree involved: cf. article 55, section I for people working with computer screens), however, the 1994 decree did not substantially change any of the chronological terms concerning periodic medical examinations laid down by the current provisions in spite of what happened with the 277/91 Decree Law concerning workers exposed to lead and noise (cf. table accompanying the 303/56 Presidential Decree). 
To meet such need the competent doctor must make and update an individual health and risk record (article 17, section I, letter d)) to be kept by the employer with the protection of the professional secrecy.  
The competent doctor has complete professional autonomy when he has to carry out the above-mentioned controls as he can use the most suitable clinical and instrumental examinations according to the specific risk (article 3, section 1, letter l) and 16, section 3) and co-operate with experts chosen by the employer in case of justified clinical reasons (article 17, section 2) in order to formulate the required fitness judgement (article 17, section 1, letter c)).
                    (to be continued) 
 

Daria Pesce 
Avvocato Penalista