Itzhak Zamir Moti Meironi -  Tomer Appelbaum - 07122011
Itzhak Zamir, left, and Moti Meironi. Photo by Tomer Appelbaum
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Medical residents at Ichilov Hospital refused on Tuesday to support a deal to end the crisis in the health system until they see a written draft of the agreement. They were expected to receive a copy late last night.

Residents have refused to accept a deal reached in August between the government and the Israel Medical Association.

Residents at Sheba Medical Center, Rambam Medical Center and Meir Hospital have voted to end the strike without seeing the draft.

The afternoon negotiations between the Finance Ministry and the residents broke down after the two court-appointed mediators, retired Supreme Court Justice Yitzhak Zamir and Prof. Mordechai Mironi told the Ichilov residents that the draft was still being drawn up. Mironi is president of the association of Israeli mediators.

A final draft was to be submitted to the residents last night, with the residents having until noon Wednesday to make their decision. If the Ichilov residents decide to support the deal, the agreement will be signed tonight, followed by a press conference at the offices of the Israel Tax Authority.

According to sources familiar with the draft, every resident will receive a grant of NIS 60,000 in two stages, and young residents will be paid more for evening and night shifts. These funds will be taken from NIS 30 million of surpluses stemming from the August agreement with the Israel Medical Association.

Also in the draft, residents who work on weekends will receive a weekly vacation day. Residents who work up to 20 hours extra time will receive compensation, and a higher sum will be given to those who accumulate up to 35 hours of extra time.

The draft also fines hospitals that demand that residents work more than six shifts per month, and the fines will grow according to the number of extra shifts required.

Another key clause in the draft agreement is to reexamine the August agreement in 2015, even though the original agreement was binding until 2019. A joint committee of doctors and treasury officials would examine the implementation of the agreement and if necessary launch further mediation. If that proves unsuccessful, the two sides would submit to binding arbitration.

Observers say that only after the deal is signed will the residents withdraw their letters of resignation. Still, in many hospitals senior doctors are trying to prevent the agreement from going through because the new agreement includes the obligation to punch a time clock, as agreed by the Israel Medical Association and treasury in August.

The new agreement would cost the treasury around NIS 150 million on top of the NIS 3.1 billion cost of the August agreement.

Deputy Health Minister Yaakov Litzman welcomed the principles drafted last night, as did his ministry's director-general, Dr. Ronni Gamzu. According to the ministry, "the goals have been achieved and the young residents now have a significant horizon. These are good achievements for the residents, the young doctors and the public health system." The IMA said the sides had reached an important agreement adding to the agreement signed in August.

Even if the current crisis is solved Wednesday, there will probably be many more struggles in the health system in the following months. The hospital doctors organization Arbel is determined to oust the chairman of the IMA, Dr. Leonid Eidelman and his supporters. Arbel claims that the IMA was wrong to sign the August agreement, which angered many doctors. Arbel is trying to bring forward the IMA's convention scheduled for September 2013, and to vote for a new leadership.

Also, several doctors organizations in various hospitals plan to continue challenging the legitimacy of the August agreement as part of a process underway in the Tel Aviv Labor Court. Recently there has also been an initiative to bring forward the elections for the doctors committee at Beilinson Hospital, where Eidelman is currently chairman. The clear aim here is to oust Eidelman.

Future moves debated

Last night several senior doctors at Arbel met to debate the strategy and future moves. Dr. Amnon Mosk, deputy head of the neurology department at Ichilov, said that "in the outline of the new agreement, the fate of the hospital doctors is determined between the IMA and the residents, and most hospital doctors don't feel they are part of this agreement. We must decide on our future steps." Mosk, one of the leaders of Arbel, added that "these agreements aren't satisfactory, and we can't readily declare the end of the struggle in the public health system."

More than 3,000 doctors have joined Arbel, especially from the center of Israel and Haifa; the organization aims to change the IMA from within, without leaving the association. "We're part of the IMA and we have the right to make our opinions known," Mosk said.

A senior IMA official reacted to Arbel's actions Tuesday, saying that "one hopes that the mood of defiance and heated words will make way for a serious debate of the agreement, a debate that will look seriously at the pros and cons without holding the IMA leadership at gunpoint."