Rambam Medical Center in Haifa
Rambam Medical Center in Haifa Photo by Tomer Neuberg
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A malfunction several weeks ago at the Oncology Institute of Rambam Medical Center in Haifa, the only facility that provides radiation treatments to cancer patients in the North, forced the halt of some patients’ treatments for a week and raised harsh criticism of Deputy Health Minister Yaakov Litzman.

Six patients who were informed that the interruption could reduce the chances of the treatments’ success wrote an angry letter to the Rambam management, protesting the forced suspension of treatment.

The radiation unit at Rambam treats about 250 patients a day. It uses four linear accelerators, one of which is 17 years old and can provide only limited treatments at internationally acceptable standards.

The breakdown of one of the units, which forced the halt in treatments, generated renewed criticism of Litzman who, in contravention of professional advice, has been promoting the establishment of a new radiation treatment facility at the Rebecca Sieff Hospital in Safed, rather than upgrading the facility at Rambam.

The ministry, however, said it is drawing up a tender to buy new radiotherapy equipment for both institutes, in Safed and at Rambam, with each machine costing NIS 12 million to NIS 15 million.

“Most experts advised the ministry to upgrade the existing institutes that have accumulated experience in this field,” said a senior health system official. “But the deputy minister decided to invest in a new institute in Safed, while the veteran institute at Rambam suffered a malfunction whose ramifications are not known.

“Even if opening an institute in Safed will reduce the travel time of cancer patients for their radiation treatments, it’s safe to assume that most of those patients will continue to make a longer trip to be treated by more experienced personnel,” the official said.

Two different Health Ministry committees in recent years have advised that currently operating radiotherapy institutes be upgraded before new ones are opened. The first such recommendation was made in 2003 by a panel headed by Dr. Omer Ankol, of the IDF Medical Corps, while the second one came in 2009 from a committee headed by Prof. Eliezer Robinson, chairman of the Israel Cancer Association and former president of the Union for International Cancer Control.

Five of the six members of Robinson’s panel recommended upgrading the existing institutes before opening any new ones. From the data evaluated by the committee, it emerged that of the 14,000 Israeli cancer patients that need radiation therapy each year, 463 patients had to travel to Rambam from the Jezreel Valley, the Lake Kinneret area, the Upper Galilee and the Golan Heights, a trip of up to 75 kilometers. Another 400 had to come to Haifa from the Nahariya area, or up to 35 kilometers.

“But the health maintenance organizations generally provide accommodations near the radiotherapy institutes for the patients and their families from distant communities when they get treatment, as is customary all over the world,” said the senior health system official. “Therefore, the distance from home to the radiotherapy institute needn’t be a factor in deciding whether to set up a new institute.”

Litzman’s plan to set up a new institute in Safed has moved ahead in recent weeks, as agreements have been reached with three experts to work there. Sieff Hospital director Dr. Oscar Embon estimated the new radiotherapy institute would begin operating in about a year and a half, although the hospital is still waiting for the Safed municipality to issue a building permit for a new building to house it.

The Rambam Medical Center said that “like any device, the accelerators, the older one as well as the newest ones, break down from time to time, and are taken out of service for short periods to get spare parts and make repairs. Given the high volume [of patients], it’s clear that a malfunction in one of the accelerators will cause treatments to be postponed.

“As with any postponements, during the malfunction in question the medical staff made sure that no harm would be caused to patients. We are working with the Health Ministry to find funding sources to buy a fifth accelerator for Rambam, to benefit our patients in Haifa and the North.”

The Health Ministry responded by saying that “in accordance with the deputy health minister’s policy to enhance and streamline health services in outlying areas, it was decided to set up a radiotherapy center in Safed. There’s no reason that people who need treatment should have to travel long distances unnecessarily. The criticism is emanating from those in the healthcare system who would prefer to protect the medical activities at the existing centers.”