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The Leumit Health Maintenance Organization has knowingly provided sub-standard services to patients in the South Tel Aviv clinic, according to a scathing report submitted recently to top officials at the Health Ministry.

The report charges that Leumit assigned a problematic physician to treat patients in the clinic, knowing well the doctor's shortcomings and hoping that a work overload in a low-income area would force him to quit. Altogether the HMO put a medical staff in the South Tel Aviv clinic that lacked the training and expertise needed to provide adequate care for patients, the report says.

The panel that reviewed Leumit's activities was established after the death of Rafael Ben Yeshai, 69, in Leumit's South Tel Aviv clinic (on Har Tzion Boulevard) on March 13 this year. The panel sharply criticized the clinic's treatment of its 3000 Leumit members. It charges Leumit with acting recklessly when it appointed Dr. Yoram Vaktel to work in the South Tel Aviv clinic, hoping the work would force his resignation.

A number of complaints about Vaktel's professional competence had been made raised before his appointment to the clinic and his dismissal had been prevented bt the intervention of the Israel Medical Association. Dr. Vaktel worked from 1987 as a family doctor and pediatrician for Leumit, although he had never specialized in these disciplines.

The panel charges the physician with failing to administer life-saving procedures to his patient Ben-Yeshai, even ignoring the entreaties of clinic staff.

The committee also alleges that health professionals at the clinic have not had supplementary professional training in emergency medical procedures for years. The panel added that Leumit's apparatus for supervising health care at problematic clinics like South Tel Aviv is flawed and ineffectual.

Top Health Ministry officials, including director general Prof. Boaz Lev, are inclined to favor unprecedent punitive measures against Leumit, one senior ministry source told Ha'aretz. Leumit is likely to be heavily censured for its failure to address the sub-standard level of its services, and the dubious ethics of some HMO staff, the source says.

Disciplinary measures against Dr. Vaktel are also likely. Dr. Lev, the director general, says the ministry is considering whether to submit the report's findings to the police.