hospital - Moti Milrod - Spetember 21 2011
Medical Residents at Ichilov Hospital in Tel Aviv handing in resignation letters earlier this year. Photo by Moti Milrod
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The health system is planning for the resignations of hundreds of residents, who submitted their resignations in protest of the new collective bargaining agreement signed between the state and the Israel Medical Association on August 25. So far at least 815 residents have submitted their resignations, which will start taking effect gradually starting on October 4, after the Rosh Hashanah holiday. About 20 specialists have also submitted their resignations in sympathy with the residents.

Hospitals are making plans on how to operate under emergency conditions after the resignations take effect. The residents resigned en masse earlier, but two and a half weeks ago the National Labor Court ruled these mass resignations were not valid, and the residents then resigned individually by submitting personal resignation letters to the hospitals. For now, the Health Ministry does not intend to return to court to try to stop the resignations, since the present round of resignations does not bear a clear sign of organized sanctions.

The representation of the young doctors within the IMA, which is leading their fight against the new contract, has has been careful not to make any official announcements on the resignations, but the resigning residents are expected to stage a demonstration tomorrow in the hospitals. The demonstration is being organized by activist residents in hospitals, and not any official organization.

The head of the Medical Administration in the Health Ministry, Dr. Hezi Levy, published instructions this week for preparing the health system for the mass resignations. Most of the resignations will take effect between October 4 and October 7, the ministry said. The hospitals fear that they will be unable to provide adequate service, especially during the holiday period during which they rely heavily on shifts from the young doctors.

"There are hospitals and departments where the resignations will cause problems in supplying medical services," wrote Levy wrote in the circular.

The Health Ministry instructed the hospital directors to provide the ministry with their plans for providing medical services after the resignations take effect. Among the steps under consideration are closing some wards and combining others, canceling surgery that is not urgent and canceling nonurgent treatments in outpatient clinics. The doctors freed up could then be sent to replace the residents who quit.

The hospitals were instructed to provide estimates of how long they could continue functioning under such emergency conditions. Levy also ordered the cancellation of all vacations and travel for the directors and department heads at the hospitals with the highest concentration of resignations.

Some hospitals, mostly in the center of the country, are encouraging the resignations, complained sources in the bureau of Deputy Health Minister Yaakov Litzman recently. Ministry sources said the hospitals have promised the resigning residents that they will be able to return to their jobs at the end of the protests. Litzman has already said that any decision on returning the residents to work in government hospitals will not be made by hospital directors, and every case will have to be examined on an individual basis.

None of these threats seem to have scared the residents, and they have not retreated from their resignations or protests. The present round of resignations was not accompanied by a list of demands - so as not to be considered an organized labor dispute - but the ministry assumes that only additional budgets over and above the agreement signed between the Finance Ministry and the IMA will suffice to solve the problem.

Despite the resignations and protests, the Health Ministry has started preparing to implement the new collective bargaining agreement. The ministry announced this week that it would allocate positions for residents in hospitals in the periphery, as agreed to in the agreement between the treasury and the IMA. The number of duty shifts for residents in the periphery will gradually drop to only six per month.