# San Marino healthcare system governance and service delays

> Live situation record from CLSTR: https://clstr.news/situations/san-marino-healthcare-system-governance-and-service-delays
> Updated: 2026-10-12T15:51:32.000Z. Sources: 8. Developments: 3.

The healthcare system in San Marino is facing challenges regarding service delivery and governance. Data from the Istituto per la Sicurezza Sociale (ISS) indicates that 17 out of 47 monitored services, including 10 specialist visits and 7 diagnostic examinations, are exceeding established waiting time standards.

In response to these delays, health officials have implemented additional services in gastroenterology, radiology, and orthopedics. Alessandro Bertolini, director of health activities, noted that increasing available slots is the primary method for reducing waiting lists. Specific improvements include the addition of specialists in Otorhinolaryngology, which reduced wait times to approximately four days, and the introduction of home pediatric visits for fragile patients up to 14 years of age starting October 1.

Management of the ISS is now facing scrutiny following a dispute regarding the early return of surgeon Giovanni Landolfo from leave. The political opposition, led by Repubblica Futura, has accused the government and the ISS Executive Committee of “political interference and bureaucratic mismanagement” concerning the movement of medical department heads. Critics have pointed to previous difficulties in the orthopedics department and raised broader concerns regarding staff shortages and potential new medical fees.

Secretary of State Massimo Andrea Ugolini has defended the administration, characterizing the dispute as a “purely administrative issue” that should be resolved by the ISS general management and executive committee to ensure service continuity. Concurrently, the PSD political party has proposed new governance models to address the increasing complexity of the system and the trend of citizens turning to private healthcare.

## Timeline

### 2026-10-12: San Marino ISS faces scrutiny over medical personnel management

San Marino's healthcare management is under fire as political opposition accuses the ISS of mismanagement and interference regarding the return of surgeon Giovanni Landolfo from leave.

6 sources. https://clstr.news/cluster/torrette-hospital-suspends-urgent-histological-exams-due-to-equipment-failure

### 2026-09-30: San Marino healthcare services exceed waiting time standards

San Marino's ISS reports that 17 out of 47 healthcare services, including specialist visits and diagnostics, are exceeding standard waiting times, prompting increased service slots in several departments.

3 sources. https://clstr.news/cluster/san-marino-healthcare-services-exceed-waiting-time-standards

### 2026-09-30: San Marino PSD proposes new governance for healthcare system

The PSD in San Marino advocates for reforming the public healthcare system to better govern the increasing use of private medical services and prevent fragmented patient care.

2 sources. https://clstr.news/cluster/san-marino-psd-proposes-new-governance-for-healthcare-system

---
Cite as: San Marino healthcare system governance and service delays. CLSTR, https://clstr.news/situations/san-marino-healthcare-system-governance-and-service-delays