Health Ministry Director General Ronny Gamzu on Sunday instructed senior ministry officials to come up with a plan by the end of this week to move all patients in private mental health care facilities to public hospitals by the end of 2013, Haaretz has learned.
The move followed the revelations last week of allegations of abuse at the Neveh Yaakov psychiatric hospital in Petah Tikva. Gamzu's instructions to Prof. Arnon Afeq, head of the medical administration, and Dr. Gadi Lubin, chief of mental health services, have turned the case into a watershed in residential mental health care in Israel.
In a letter to Afeq and Lubin, Gamzu wrote: "After revelations of the incident at Neveh Yaakov and our inability to supervise what goes on in private facilities, I have resolved to take therapeutic responsibility for these patients in public institutions only." Gamzu wants the plan launched as soon as possible and for the process to be completed during 2013.
Some 70 staff members, administrators and owners of the Neveh Yaakov facility were arrested last week after a year-long undercover operation. They are under suspicion of assault on helpless individuals, abuse, neglect, sexual abuse and failure to report these crimes. The day after the arrest, the Health Ministry announced it was closing down the institution, in which 150 severely disturbed or developmentally delayed patients are hospitalized. Two other private institutions care for patients with severe psychiatric disorders or retardation, Ilanit and Neveh Shalva, both in Pardes Hannah-Karkur. All told, there are 250 such patients in private institutions in Israel. Some of these patients, Gamzu told Haaretz on Sunday, "cannot always be stabilized by usual treatments and some are both psychiatrically ill and suffer from retardation. I think that precisely these patients, whose treatment sometimes might involve violence, just as some of the illnesses express themselves in violence, must be more closely monitored."
It will not be easy to find alternative beds, Gamzu told Haaretz. "But if there is a chance for change, it is in such a crisis, because now everyone is aware and listening."
Gamzu said that one of his greatest difficulties was to find a new location for the 36 most severely ill patients from Neveh Yaakov. "At first I thought I would divide them among 10 or 11 hospitals, but I very quickly realized that we do not have a good solution within the public system for these patients," said Gamzu, adding that this disturbed him. Such a solution must be provided "especially after we see a case like this in which the things happened despite very thorough monitoring."
Gamzu compared the situation to that of Holocaust survivors living in residential care facilities, whose care has recently returned to direct state hands. "Don't put the most severe cases in private facilities. The moment you as a government ministry come face to face with a private institution, then even without noticing it the fee will not be the highest and even when the fee is sufficient the interests of some of the private institutions are felt, to hire the cheapest labor, and how much monitoring can you do? Sometimes we think we're doing the best monitoring, but in the end there's no way to know everything," he told Haaretz.
Gamzu said that supervisors can monitor hospitals medically "but are not trained to discern situations from a criminal point of view - to discover cases of intimidation and threats. That is not their job. This shows that the current system of monitoring is of low effectiveness in this area," he said.
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