Emergency room at Soroka
Emergency room at Soroka: Private practice prevails. Photo by Eliyahu Hershkovitz
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Patient arriving at Soroka.
Patient arriving at Soroka Hospital for treatment.

Medical treatment is more readily available to Negev residents on a private basis from the very same doctors working morning shifts in the public health system, according to a report made public Tuesday by Physicians for Human Rights - Israel.

The study says this is because public service doctors working at Soroka Medical Center in Be'er Sheva and Barzilai Medical Center in Ashkelon moonlight dozens of hours a week at private medical clinics and institutes.

The report, which examined the effect of medical manpower shortages on southern residents, revealed that the problem does not actually lie with the scarcity of doctors, but with the fact that so many doctors employed in the public system devote long afternoon hours to private practice.

As a result, patients requiring consultations, treatment or surgery at Soroka are required to wait much longer for appointments than they would at private facilities located in Be'er Sheva. This obviously reflects a basic inequality: Patients with supplemental health insurance who can afford the required deductible portion of the cost for medical consultations or procedures have much quicker access to care.

The organization surveyed specialists in 13 medical fields, including ENT, gynecology and cardiology, finding at least 46 physicians who work mornings at the public hospitals - mostly at Soroka, but several at Barzilai too - while receiving patients at private clinics like Mediton, Beit Harofe and Assuta Be'er Sheva during the afternoon. A thumbnail calculation showed that the overall office hours provided by these doctors to the private system total about 175.5 hours a week, equivalent to 4.2 fulltime weekly positions.

"When it comes down to the issue of private versus public (health care ), there is much talk about Assuta Ramat Hahayal and the central region, but this time we wanted to check what is happening in the south, where doctors who want to work and live in the region wouldn't be thought of as greedy," explains Shlomit Avni of Physicians for Human Rights, one of the report's co-authors.

"But many devote much of their time to private work anyhow," she continues. "It is always said that the brain drain to the private market only occurs in the central region, but we discovered many private clinics operating in the south, too, with extensive private activity. We think this is a terrible mistake, because these resources and the need by doctors for additional income could have been utilized to keep them in the south and in the public system."

The NGO doesn't blame on the doctors or Soroka, but rather on government policy and the budgetary erosion in the public health system. "Good, well-paid doctors who aren't worn out by their workload will remain in the public system, while worn-out and poorer doctors will flee to the private sector," the report says.

"The erosion of public funding for public medical expenses and the lack of long-term planning for developing infrastructure - medical personnel, hospital beds and equipment - has led to hospital congestion," it concludes. "The use of supplemental insurance has become an 'escape route' for doctors and patients alike who've gotten fed up with the resulting erosion, along with the resulting contribution of supplemental insurance to unequal access for medical services on the basis of affordability, thereby undermining the stability and reputation of the public health system."