POLITICAL DECENTRALISATION AND WORKER SAFETY IN ITALY

The “economic miracle” in postwar Italy was accompanied by a rapid increase in the industrial accident and illness rates. Italian workers demanded occupational safety and health enforcement mechanisms that would be more accessible to grass‐roots workers' groups and unions. In the early 1970s local “Occupational Medicine Services” were voluntarily established in many regions. The entire health care system was decentralised in 1978, giving regions exclusive authority to implement occupational safety and health standards within Local Health Units (USLs). The concrete results of these reforms are investigated and the validity of the assumptions of the calls for decentralisation. The difficulties encountered by leftist‐administered regions in attempting to translate their political commitments into significant health and safety improvements are documented. The track‐record of the USLs is examined. An ironic consequence of decentralisation has been that the concentration of all health care activities in the USL has swallowed up occupational safety and health. As a result it is less politically visible and less responsive to worker input.