Oncology: screening carried out outside working hours does not entitle staff to additional remuneration
A senior medical officer has been ordered to repay the local health authority the sum of approximately 113,000 euros, as the activity falls within the scope of his “official duties”
The screening for cancer falls within the ‘duties of office’ of the medical director, which is why the remuneration received for this activity must be repaid. This was ruled by the Court of Cassation (Order No. 17304 of 2026), which upheld the ruling by which the Naples Court of Appeal had ordered an oncologist to repay the local health authority (ASL) the sum of approximately 113,000 paid “for cervical cancer screening activities”.
The Supreme Court’s ruling
In his appeal to the Court of Cassation, the oncologist had argued that the work had been carried out outside normal working hours and whilst understaffed. This argument failed to hold water. The Supreme Court, on the one hand, referred to the principle of the all-encompassing nature of the remuneration of senior managers as provided for in Article 60 of the National Collective Labour Agreement– Healthcare Management Sector – and Articles 24(3) and 27(1) of Legislative Decree No. 165 of 2001, according to which: a) the basic and supplementary remuneration covers all the functions and duties assigned to managers, as well as any role conferred by the relevant administration or upon its designation; b) remuneration due from third parties is paid directly to the relevant administration and is incorporated into the resources allocated to the supplementary remuneration of managers; c) any additional remuneration due under special provisions is to be regarded as already included in the remuneration established by contract.
Guidance on overtime
On the other hand, the Court referred to the established case-law according to which:
- A senior medical officer is not entitled to any additional remuneration by way of compensation for overtime, except for services specifically provided for by law or by collective bargaining agreements, such as intra-hospital private practice, on-call duties or standby duty (Court of Cassation, Labour Section Labour, Order No. 32264 of 10 December 2019);
- the medical director’s overtime is compensated through performance-related pay, without it being possible to distinguish between hours worked in excess of the normal working hours to achieve the assigned target and those required by the needs of the ordinary service (Court of Cassation, Labour Division, judgment no. 7921 of 28 March 2017).
