Medical residents
Medical residents demonstrating in Tel Aviv. Photo by Moti Milrod
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The letters of resignation submitted by more than 1,000 medical residents at government hospitals around the country are scheduled to go into effect on Sunday.

Health Ministry and hospital officials have become increasingly resigned to the likelihood that the residents will not reverse their resignations in the absence of amendments to the collective bargaining agreement that was recently signed between the state and the Israel Medical Association. Finance Ministry officials have not given any indication of their willingness to reopen the contract signed last week, which includes an average salary hike of 49 percent for the country's physicians over the lifetime of the wage agreement, which ends in 2019.

The State Prosecutors' Office yesterday declared the mass resignation illegal. The opinion was part of the state's response to a High Court of Justice petition submitted earlier this month by attorney David Forer in an effort to convince the court to order Prime Minister Benjamin Netanyahu to intervene in negotiations between the IMA and the treasury. That petition helped to accelerate the talks that eventually led to the collective bargaining agreement.

"Hundreds of residents, despite the signing of the agreement, have announced their intention to not report to work starting September 4," the Prosecutors' Office wrote the High Court. "In so doing, the residents are continuing an illegal and prohibited organized action that does not comply with the directives of the Israel Medical Association, their representative organization. The strike constitutes a violation of all the legitimate tools in the system of labor relations."

According to this legal opinion, the residents' actions also violate a National Labor Court order from July 21.

"Failure of the resident physicians to report to work would cause serious and illegitimate damage to patients, on top of the cumulative damage resulting from the labor sanction preceding the signing of the wage agreement," the legal opinion said.

Health Ministry officials had previously said that if the resignations were declared illegal, back-to-work orders could be issued against the residents.

Tal Keret, the labor lawyer hired by the organization representing the young physicians, has already stated that she may have to defend the legitimacy of the mass resignation in court.

"Each resignation is a personal step, and every resident considered the decision individually," said Dr. Yona Weissbuch, a resident at Beilinson Hospital who is the chairman of an advocacy organization for residents. Mirsham's motto is: "Residents for quality healthcare in Israel."

Hospitals gear up

The Health Ministry has begun issuing instructions to hospital administrators for dealing with the mass resignation of medical residents, should it go into effect.

Tel Aviv's Ichilov Hospital, where the largest number of resignation letters were submitted, has a plan in place.

"We are working intensively to prepare for this worrying situation, so that on Sunday we will be able to meet the needs of our patients," Deputy Director Dr. Gil Fire said. "Our main goal is to prevent any ill effects on our patients. It is a big challenge, because there is a lot of anger over the wage agreement being signed without the residents being consulted, and with the outcome, which in the eyes of our doctors is unsatisfactory. We don't want to hurt patient care, and on the other hand we must respond appropriately to the anger of our doctors."

Departments in Ichilov with the fewest resident resignations - such as urology; cardio-thoracic surgery; ear, nose and throat; and pediatric hemato-oncology - will operate normally. The remaining residents will pick up the slack.

In departments where most or nearly all of the residents submitted their resignations - chiefly the surgical wards - specialists will take the on-call shifts, with Health Ministry approval.

Sheba Hospital Tel Hashomer is considering having specialists take on 12-hour on-call shifts to make up for the absent residents.

Meanwhile, hospital and Clalit Health Services administrators yesterday continued to call on residents to withdraw their resignations, with little apparent success so far.