doctors - Nir Kafri - July 20 2011
Residents who walked off the job yesterday outside Kfar Sava’s Meir Hospital. Photo by Nir Kafri
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Negotiations to end to the 16-week-long doctors' strike continued late Tuesday night at the National Labor Court. The court president, Judge Nili Arad, urged the parties to keep negotiating in a bid to reach an agreement before midnight. If that fails, the sides were to meet in her office after midnight, and Arad will consider the state's request for a back-to-work injunction forcing physicians to return to work. The court's summer break begins tomorrow morning. If neither an agreement nor an injunction materializes, the physicians are expected to escalate their strike.

Twists and turns in the negotiations were reported throughout yesterday. The gap between the parties is estimated at NIS 125 million per year for an eight-year period, while the overall cost of the agreement is already estimated at over NIS 1 billion. Calls increased yesterday for Prime Minister Benjamin Netanyahu to intervene and bring about a breakthrough in the talks.

The current draft agreement, distributed yesterday to physicians across the country for consultation, would see a pay rise of 19.8 to 20.4 percent per hour per physician, a 23.25 percent pay rise for physicians in the periphery, and an NIS 1,200 pay rise for medical fields in particular distress, including internal medicine, surgery, rehabilitative medicine, geriatrics, emergency medicine, pathology and pediatric psychiatry.

Sixteen percent of the pay rise physicians received in the last agreement with the treasury, 11 years ago, will be relocated to their basic salaries. Over all, the total pay rise will come up to 47 percent in eight to 10 years' time. The agreement also sees the work week shortened to five days - or 40 hours, with Friday recognized as a holiday on which private practice will be allowed. The physicians, for their part, agree to stamp time clock cards with GPS satellite technology, with the details of their exact whereabouts to be made available to employers only if there is an inquiry.

As for overnight shifts, the draft agreement suggested reducing the number of overnight shifts to six a month for residents (at 120 percent the normal pay ), and one to two a month for specialists under the age of 47 (at 140 percent the normal pay ), over the course of three to five years. The residents would receive four training days and one professional conference a year, while specialists will receive eight training days, and department heads will receive up to 22 training days in Israel and abroad.

An extra 10 holiday days a year was promised for medical professionals exposed to radiation as part of their work.

The agreement also suggests creating a new position of "service administrators" alongside department heads as a promotion level for senior physicians. The agreement is meant to be valid for eight years, but yesterday the treasury was trying to extend it to 10 years, while the physicians would only agree to extend it to eight and a half years.

The draft was met yesterday with an unprecedented, spontaneous walk-out protest by medical residents, who abandoned hospitals throughout the country to rally against the agreement. Hundreds of physicians walked out from the hospitals of Meir, Rambam, Ichilov, Kaplan, Beilinson and Shalvata. The protest began at Meir Hospital in Kfar Sava, with residents expressing anger at a clause in the agreement suggesting the addition of 650 new medical positions over three years, a number the residents said fell far below their estimate of the necessary and urgent minimum of a thousand positions now. One of the negotiators told Haaretz yesterday the information the residents received on that clause was not entirely accurate.

Mirsham, the medical residents' non-profit organization, promised to continue protest actions today even if an agreement is signed. It aims to expand its membership to at least 900 out of the 2,700 residents working in the country and be acknowledged as a representative workers organization, which would allow it to take more significant protest actions and negotiate separately on the working conditions and salaries of medical residents. To date, the organization has enlisted only about 500 residents.

The residents plan informational assemblies at the Meir and Naharia hospitals, and a protest action at the Sheba Medical Center in Tel Hashomer. They also consider working on weekend schedules throughout the week, while residents not on duty will hold protest rallies at the hospitals. A group of medical students in their sixth year started a Facebook petition yesterday in support of the residents' demands.

Senior physicians on the ground have also criticized the draft agreement, with physician committees in Wolfson and Rambam hospitals voting against the agreement. Senior surgeon Dr. Haim Toledano, chairman of the physician's committee at Rambam Medical Center in Haifa, said that "there's no need to get stressed out and rush for a quick agreement just because of the summer break. Ther are still plenty of problems." Toledano added: "I tend to tell our representatives at the talks to continue patiently working to improve the agreement, and I send them my support."

A senior official at the Israel Medical Association said that "the physicians are criticizing before they learned the full details of the agreement."