Wednesday, October 12, 2011

Medical emergency

The health system in Israel is in an emergency situation. For about four months there was a doctor's strike in which the Israel Medical Association (IMA) demanded more pay and better conditions and the Health Minister, the Finance Minister and the Prime Minister pretended to negotiate. The Government was already facing enormous problems from the summer so-called "tent city" demonstrations, demanding more expenditure on cheaper housing as well as a range of social issues. The doctors became so disillusioned that their Head Leonid Eidelman went on a hunger strike. Finally after 137 days and intense negotiations with the Deputy Health Minister Jacob Litzman, the Finance Minister Yuval Steinitz and PM Netanyahu acting as Health Minister, an agreement was arrived at including large salary increases for doctor in hospitals, since their salaries are very low, a top doctor in a hosptial can only earn the equivalent of ca. $50,000 and must expand his salary through private practice in many clinics around the country. Provision was also made in the agreement for the peripheral areas where it is difficult to attract doctors.

However the young doctors, interns, who take the brunt of the difficult conditions in hospitals, decided that the IMA did not have their interests at heart and a large group of them broke off from the IMA and decided to take their own case to the Health Ministry. Of course, the response was we just finished negotiating a broad agreement and we can't do more, so too bad. This caused the interns to see red, and they decided to resign en masse, note not strike but resign, give up their jobs completely. At first the Supreme Court ruled that this was illegal, since they were acting as an unrecognized organization. So the interns reissued their letters of resignation each one personally. The only response was that PM Netanyahu, offered tens of thousands of Shekels to each doctor who commits him/herself to stay in the public sector and not subsidize their salary with private practice. But this cut little weight with the interns and as of today some 500 of them resiged, with another 200 due to stop work within a week.

Most hospitals have been put on an emergency basis, with the senior doctors doing the interns work, but there is no out patients clinics and only elective surgery. Only those already in hosptial and acute cases, such as accidents are being attended to. This is particularly true of the large city hospitals, such as Ichilov in Tel Aviv and Sheba Medical Center at Tel Hashomer. Such mass resignations can bring the whole health system to its knees. So far GPs and private hospitals such as Laniado in Netanya are unaffected.

On Tuesday also the Head of the Histadrut national union, Ofer Eini, announced at a press conference that they will be calling a general strike in two weeks time if the Government is not responsive to all the demands on the social issues (more competition for prices of food, cheaper housing) and the interns demands. They think they have caught the Government unprepared. But, the Government had set up the Trachtenberg Committee that last week submitted its conclusions and recommendations. Of course, the left are not prepared to wait for these recommendations to be implemented and the Report was only just received by the Government. The majority of Israelis would prefer that this be handled through Government negotiations and not through strikes and street protests. There will be difficult days ahead, because if Government spending increases significantly for these social issues, then we could find ourselves in Greece's shoes in a few years time, with a sovereign debt and bank crisis that was brought on by too much Government spending and not enough income.


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