The national and regional ministries, which are responsible for upholding quality, ensure that LEA services are provided and waiting times are monitored. Several regions have introduced effective programs for prioritizing the delivery of care on the basis of clinical appropriateness of services prescribed and patient severity (France et al., 2005). All doctors under contract with the SSN must be certified, and all SSN staff participate in a compulsory continuing education program. The National Commission for Accreditation and Quality of Care is responsible for outlining the criteria used to select providers and for evaluating the accreditation models (including that of private hospitals), which are regionally determined and vary considerably across the system.
The National Health Plan for 1994–1996 led to the establishment of the National Oncology Commission; it was tasked with developing an intervention program to monitor and prevent cancer. Screening guidelines were then produced with the aim of reducing the heterogeneity of interventions and enhancing evidence-based program planning.