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From tomorrow, hospital wards will be consolidated as doctors and nurses step up their sanctions over pay and employment conditions.

Based on collective agreements dating back to 2000 and practices dating back to 1977, the Israel Medical Association is prohibiting specialists from carrying out shifts (meaning shifts in wards, not their regular work ) at the affected government hospitals. Interns are being limited to six shifts a month.

The hospitals will set up "exceptions committees" that can provide specific solutions to the wards where only specialists can be on shift, for instance the intensive care unit at Assaf Harofe Hospital. Without exceptions, in such cases, the wards would have to shut down.

Until the issues are resolved and staff levels return to normal, there will be no choice but to consolidate wards, according to the IMA.

Today the National Labor Court will be hearing the state's appeal against a lower labor court's refusal to order the striking doctors to return to work. The IMA submitted its plan for escalating sanctions to the appellate court ahead of the hearing.

Meanwhile, the nurses' union has also decided to step up sanctions. Yesterday nurses abandoned three internal medicine wards at Assaf Harofe Hospital, leaving the wards manned by emergency staff only, including two nurses. The day before, nurses vacated two internal medicine wards at Sheba Medical Center.

Ilana Cohen, chairwoman of the nurses union, said similar measures will be taken at additional hospitals including Poriya in Tiberias, Soroka in Be'er Sheva, Wolfson in Holon, Meir in Kfar Saba, Bnei Zion in Haifa and Nahariya.

The nurses' main demand is for more positions at understaffed internal medicine wards, explains Cohen. Unless new positions are added, the nurses have warned that they will step up their sanctions, including strictly adhering to the rules governing nurse-patient ratios. This would involved transferring many patients to other wards. ( )