Cittadinanzattiva (Active Citizenship) and Corporate Social Responsibility

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1 Cittadinanzattiva (Active Citizenship) and Corporate Social Responsibility Rome, May 2003 A policy based on experience Cittadinanzattiva is a civic organization founded in It aims to expand the scope of public participation (beyond the traditional understanding, based on a system of rights and duties that characterize belonging to a national community, expressed mainly by the vote) to realize a new practice of citizenship, based on citizens exercise of powers and responsibilities in making public policy. It is particularly attuned to the effective protection of rights, both those proclaimed by law and those that are the legacy of the common conscience. Legally, Cittadinanzattiva is a non-profit and a consumers organization. It has some 50,000 members, organized in 180 local active citizenship assemblies, in issue-based networks and federated associations. More information can be found on our website at European and international activities are reported at We have undertaken many projects and initiatives over the years to promote civic participation for the protection of rights in the areas of health (the work of the Patients Rights Tribunal is well known), consumer protection, public services, schools and universities, the justice system, public safety and civil defense. We have successfully developed tools for the protection of rights, like monitoring, information, charters of rights, forms and protocols for stakeholder involvement, gathering and diffusion of good practices, conflict management, etc. Our efforts have led to the enactment of laws and administrative regulations. We have mobilized human, technological and financial resources; changed the behavior of social and collective actors; changed mass culture; defined new ways of social organization; introduced new models of administration and management of public services and changed the rules of the market. More generally, Cittadinanzattiva has worked to establish an active role for the citizen in public life, beyond political party mechanisms, voting and traditional forms of representation. After many years of work on the constitutional dimension of active citizenship, we achieved an important goal in 2001 with the reform of Article V of the Italian Constitution. Article 118, paragraph 4 of the new constitutional text embodies a specific proposal formulated by our movement: the State, Regions, Cities, Provinces and Towns shall favor the

2 autonomous initiative of citizens, whether individuals or associations, for the carrying out of public interest activities, on the basis of the principle of subsidiarity. Our interest in corporate social responsibility traces back to a practical origin: due to a financial crisis caused by dependence on the public administration in the mid-1990 s, we embarked on a strategy to raise funds from the private sector. Over the years, this became our main source of support (covering around 70% of our budget, which for some years has been around 3.5 million for our main activities, bringing in about one hundred of different contributors). This strategy has followed precise and rigorous rules: No unsecured financing, but only cooperation on specific projects; No product advertising; No profit-sharing relationships; Careful selection of partner businesses in relation to their market behavior; No restriction on justifiable disagreement, as was the case with AIDS drugs in Africa and the Lipobay case, for which many legal cases are being brought. In the course of this activity, we have developed relationships with many businesses deeper than just simple sponsorship. Rather, they were partnership relations: the businesses did not limit themselves to giving us money and asking to be acknowledged in our publications, but they got involved, usually through the top management, and often rethought their mission to focus on social responsibility programs. They faced internal conflicts over the role of business and the profitability of an investment in social responsibility, but chose to assume such responsibility nonetheless. At this point (around 1999), we noticed that an international debate emerged and global governance actors (the United Nations system, international financial organs, multinational corporations, non-governmental organizations, international media, scientific community, etc.) started to undertake corporate citizenship or corporate social responsibility initiatives. We decided to set up a restricted group of partner businesses, and analyzed common experiences in the Corporate Citizenship Manifesto, published in June Having ascertained interest in these issues, we decided to establish a unit dedicated to the promotion of corporate citizenship, which in our view implies forms of governance in which private actors can exercise responsibility for the public interest, and a strategy for the mobilization of resources for the protection of citizens rights. The initial steps of this program were: Realizing, in , a project co-financed by the European Commission and UniCredit, on the state of corporate social responsibility in four countries of Southern Europe and the UK, resulting in a proposal of guidelines for corporations pursuit of socially relevant activities; 2

3 Organizing an international seminar (Frascati, May 2001) to discuss the results of the above project, which has been repeated every year since (October 2002, October 2003); Supporting the Frascati Group, which brings together corporations engaged in promoting corporate social responsibility (the corporations are Abb, Ancst-Legacoop, Day Medical, Barilla, UniCredit, Unipol, Ethicon Johnson & Johnson, Formenti, Pfizer, Apindustria di Vicenza, Pharmacia, Merck Sharp & Dhome); Working with the European Commission on the text of the Green Paper on Corporate Social Responsibility, which brings together some our specific recommendations (above all, the social audit and citizens participation in the promotion and oversight of corporate social responsibility); Participating in the work of the European Commission unit charged with planning the follow-up phases to the Green Paper, and developing Community policy on corporate social responsibility; Organizing the Italian presentation of the Global Compact, proposed by the United Nations Secretary General (February 2002), and helping to put together the network for implementing and overseeing corporate compliance with the Global Compact; Becoming members of the UN Global Compact; Working with individual corporations to develop social responsibility programs and related educational and training activities; Working with UniCredit to develop a social responsibility strategy, with particular focus on the bank s relationship with its customers. This led to the revision of all the contractual documents submitted by the bank to its clients. The main partnership projects with private corporations: Social Audit Project, promoted by civic organizations, aimed at sharpening a method of critical and systematic analysis of the behavior of health care corporations. The method used is a survey conducted by groups of citizens in collaboration with health care related corporations. The program is in its third year. In the course of 2001, 12 social audits were carried out in Piemont, Liguria, Trentino-Alto Adige, Veneto, Emilia Romagna, Toscana, Marche, Abruzzo, Campania, Puglia and Sardegna; the same number were carried out in The project is run with the help of Astra Zeneca. Informed Consent Campaign promoted in order to draw the attention of health care workers and the public to the need for informed patient consent to medical and surgical treatments. Informed consent is 3

4 quite rare in practice, and not the key moment of interaction between the individual and the doctor that it should be. The campaign is in its third year, and is supported by Ethicon-Endo Surgery. Pain Management Pain is a prison from which patients need to know that they can escape. This is the main thrust of the informational campaign for pain medication. In 2001, 100,000 leaflets and 5,000 posters were distributed. In 2002, the campaign was carried out in over 40 cities on the same day; the results of a survey conducted in 43 hospitals were presented and discussed. The campaign is supported by Grunenthal-Formenti. Good Practices For some years now Cittadinanzattiva has been advancing a policy of good practices in the public service sector, including health care and public utilities. The goal is to recognize the positive measures taken to improve the accessibility and quality of these public services. We hold an annual competition, in which we evaluate the various projects submitted to us and give a symbolic, monetary award in a public ceremony. All the submitted projects go into a database, and the workers that run them become part of a network. This project is carried out with the help of Pfizer and the Pfizer Foundation in the area of health care; Italgas, Poste Italiane, Omnitel support the project in the area of public utilities. Protection from Medical and Insurance Malpractice Since 1999, a program has been in place to monitor the main causes of medical errors, as well as recommendations and requests to intervene on behalf of the public. The monitoring was carried out in a number of hospitals and health clinics, and was followed up by the proclamation of a Charter of Protection from Medical and Insurance Malpractice, which includes the criteria to be respected in order to reduce and/or eliminate the main causes of error. To implement the Charter, we put together a test group of 30 hospitals. The program aims at facing up to the serious problem of the high number of medical errors, which almost never lead to the attribution of medical responsibility or actions to prevent such errors from recurring. It is supported by Pharmacia. Government Contracts and Public Participation Since 1998, Cittadinanzattiva and Ancst (National Association of Cooperatives, Services and Tourism, a member of Legacoop) have carried out a partnership program on Government Contracts and Public Participation. This is based on the idea that the public ought to be directly involved in the planning, production and evaluation of private contractors in public services, in order to avoid harms associated with the pressure to award such contracts to the lowest bidder. On the basis of the conclusions of a research project and some experimentation, we decided to widen the number of participating actors as much as possible, in order to set up a permanent observatory on this issue. By now, a protocol of understanding has been signed between Cittadinanzattiva and umbrella organizations representing 90% of the interested businesses. Open Railway Stations This program was launched in 2000 in order to realize a day devoted to meetings and discussion between the various actors operating in railway stations, like the railroads, the public, the owners of other public utilities and organizations for the protection of citizens rights. The project partner is FS-Trenitalia. 4

5 Public Health Laboratory The goal of this project is to create a permanent laboratory for training our own local leadership as well as the leaders of other civic organizations active in the health sector. In 2001 a series of training sessions were organized in the areas of: 1) federalism in the area of health care; 2) management of a non-profit organization; 3) committees on ethics. In 2002 the topics were monitoring methods and the protection of citizens rights. Over 150 civic leaders are involved in the program. The project is supported by Pharmacia. Safe Hospitals The aim is to promote a shared culture of safety in the hospitals and thus public policies for risk management. The methods employed are the distribution and taking of surveys in health service institutions, the development of cultural and educational activities directed at health care workers and the public, and the implementation of discussion forums in order to arouse the interest of the Health Minister and the regional governments. The program is in its sixth year (5 reports have been published) and is supported by Assobiomedica, Anie Associazione Componenti e Sistemi per Impianti, IMQ-CSQ. Integrated Protection Health Project - National Since 1996, our central office has provided information, assistance and counseling to citizens with problems regarding access to or quality of health care, whether public or private. The integrated project is a kind of front line, reachable by telephone, fax and , as well as a back office, staffed by civic activists and medical and legal consultants. Any citizen who contacts this service may get answers aimed to help solve real problems. The database in which the cases undertaken by the integrated project are recorded (an average of 10,000 a year) is used to produce an annual report on Citizens and the Health Services, which is a kind of barometer of the Italian health system from the standpoint of the public, and is used as a point of reference by all health policy makers. It was created with a grant from Bayer (for the first three years) and is currently supported by private donations. The service which is completely free to the public has never received public financing. Integrated Protection Services Project - National Like the integrated project for the protection of health care rights, described above, the integrated project in the field of public services has been active since 1999, focusing in particular on transportation, telecommunications, energy, the postal service, administrative services, financial services and insurance, in particular. It was created with an initial grant by the European Commission, but is sustained with funds from private service providers (along the same lines as the integrated health project), it is free and it receives no public financing. The Minister of Productive Activities is, however, financing the establishment of 10 integrated services projects at the local level, as part of a policy of supporting consumers organizations. Integrated Protection Health Project - Local This program was created in 2001, motivated by the need to transfer the successful experience of the national integrated health project to the local level, giving citizens the closest possible point of reference, and more accessible in terms of time and expenses. The ultimate goal is to establish 35 local integrated protection health projects; 30 are already in service. The project is carried out in partnership with Ethicon Endo-Surgery. 5

6 Water for Everyone Cittadinanzattiva launched an informational and training campaign on the rational use of water resources, aimed not only at the public and consumers, but also at farmers who, more than anyone, use this public good. The campaign was carried out by means of an educational handbook on the rational and responsible use of water and a section of the Cittadinanzattiva website completely devoted to the campaign. The project is supported by Syngenta. Informational Campaign on the New Electricity Meters The campaign seeks to inform the public on the functioning and the advantages of the new electricity meters. The campaign plans to undertake activities of public awareness, aimed at families, on the rational and responsible use of electrical energy, to be facilitated by the new meters that enable anyone to monitor such use. Twenty informational seminars have been realized throughout the country, directed at the public, in collaboration with the National Union of Consumers. This program was realized with the contribution of ENEL Distribuzione. Health Information, Awareness and Protection Campaign The Patients Rights Tribunal promotes a series of campaigns to raise the public s awareness of a number of generally misunderstood illnesses. All the campaigns follow the same format, which foresees the production and distribution of informational materials to the public, and the realization of national and local events in which the chosen issue is examined. Some examples: the oncology campaign, supported by Astra Zeneca; the infertility campaign, supported by Serono; the osteoporosis campaign, supported by Procter & Gamble; the incontinence campaign, supported by SCA; the obesity campaign, supported by Ethicon, the campaign for the prevention of cardiovascular diseases, supported by Ratiopharm. Objective: Barriers Campaign In 2003, European Year for People with Disabilities, Cittadinanzattiva promoted a project to raise the public awareness of physical barriers to mobility, and to remove at least 118 of them (this number refers to Article 118 of the Italian constitution which introduced the principle of horizontal subsidiarity). The project unfolds through a series of activities: a national advertising campaign, with the professional partnership of Ethico at J. W. Thompson; a survey to bring out the data regarding physical barriers to and within public buildings; a traveling protest in a camper, stopping in 20 cities in Italy, with the goal of removing at least one physical barrier in each city; a collection of good and bad practices thanks to the information provided by citizens to Cittadinanzattiva. The project is supported by the Johnson & Johnson Foundation, Coop Nord-Est, Hewlett Packard, Microsoft and Tim. Citizens for the New Europe This is a project undertaken by the European branch of Cittadinanzattiva, Active Citizenship Network ( Its main element was a survey, carried out by civic organizations in the 28 countries of the New Europe on the public policies regarding civic activism and at the European Union level. The survey results the first of its kind will be discussed at the end of this year at a conference in Warsaw. This discussion will help us define future projects and proposals to improve public institutions treatment of civic organizations. In addition to the European Commission, UniCredit, Bank Pekao, General Electric made this project possible. The project is operationally supported by 35 national-based citizens organizations. 6

7 European Charter of Patients Rights Active Citizenship Network was also engaged in drafting a European Charter of Patients Rights, which set forth 14 rights currently under threat in all the European countries for political and economic reasons. This Charter grew out of the Italian experience, as filtered through the 15 or so associations working in the area of health care at the national level that participated in drafting. These rights are grounded in the fundamental rights recognized by the European Union and thus fall under the responsibility of the Union, even though providing health services is an exclusive competence of the national governments. The Charter was presented in Brussels in November, 2002, and is currently the means for gathering information in the countries of the Union on the state of the implementation of these rights. This information will appear in a report to be presented in The program is supported by Merck Sharp & Dhome. For further information: a.gaudioso@cittadinanzattiva.it b.dalessio@cittadinanzattiva.it 7