Just a remission for the health system
The decisions made by the cabinet - transferring NIS 100 million to cover some of the deficit, subject to organizational and structural changes - may have temporarily solved the crisis, but they have not taken even a single step toward a solution of the basic problems of the health system.
A week ago, a senior official in the health system called Nes Tziona Psychiatric Hospital and said that a quick calculation of the hospital's capacity showed it could be closed almost immediately and its 120 patients dispersed to other hospitals. Apparently the senior official was not up to date, because currently there are plans being made by a joint management team from the Nes Tziona hospital and Be'er Ya'acov Psychiatric Hospital to merge them into one facility at the Nes Tziona campus.
Ultimately, the proposal to close the Nes Tziona hospital, like the treasury demand to close the Tirat Hacarmel Psychiatric Hospital, was not brought to the social-economic cabinet, headed by Finance Minister Benjamin Netanyahu, that dealt with the hospital crisis on Tuesday.
But the manner in which it came up and was examined, represents the level of seriousness with which the entire solution to the health crisis was conceived.
The decisions made by the cabinet - transferring NIS 100 million to cover some of the deficit, subject to organizational and structural changes - may have temporarily solved the crisis, but they have not taken even a single step toward a solution of the basic problems of the health system, nor do they bear any tidings at all on the urgently needed improvements in the quality of medical service and treatment in Israel.
The manner with which the Health Ministry management handled the crisis was also problematic, characterized as it was by panicking the public, presenting it with misleading and inflated information. For example, the Health Ministry's announced last Saturday that Ichilov Hospital in Tel Aviv was running out of medicine; the next day the director of the hospital, Dr. Gabi Barbash, said there was no such depletion of supplies.
In the last two weeks the Health Ministry, eagerly joined by Clalit HMO, has made sure to keep the public informed daily about ongoing harm to medical treatment as a result of the financial deficits in state hospitals, as they do every year.
The financial crisis in some of the hospitals, particularly in the outlying towns, is indeed genuine, and the demand to transfer additional budgets to them is justified. So is the duty of the Health Ministry to notify the public of difficulties in the functioning of the health system. But the ministry's announcements and the media reports were tainted with exaggerations, some deliberate, because the ministry knew that headlines about a patient's crisis would force Netanyahu to transfer the extra money.
For that reason they did not try to reduce the harm done to patients, even though they could have. Why, for example, didn't Minister Dan Naveh and his director-general Dr. Boaz Lev, think before they announced to the public that Ziv Hospital in Safed was ceasing to take new patients that they could transfer the necessary equipment from hospitals in the Tel Aviv area? And why did the Health Ministry announce some medical treatments at Nahariya and Assaf Harofeh hospitals were being reduced, when they would eventually announce that the deficits would be covered by the profits from research funds?
The health minister and his ministry's officials did not manage to force the hospitals (especially the strong ones, including Ichilov, Sheba, Rambam and Assaf Harofeh) to respond positively to the treasury's justified demand to make more use of their profits from research funds and leases of state land to the health maintenance organizations. As a result, the treasury imposed decisions on the Health Ministry that could harm the public (like privatizing state geriatric hospitals even though the ministry has a difficult enough time regulating and supervising existing old-age homes that are in a dreadful state) and some of the decisions could be delayed for years, like merging the Bnei Zion Hospital with Rambam Hospital and transferring Wolfson Hospital to the Maccabi HMO management. (Did the ministry first conduct a full-scale examination of the medical functioning of the hospitals already under Maccabi management - Assouta and Ramat Marpeh?)
Yet there was one bit of refreshing news from the cabinet: The health minister announced he supports the return of private medical services to state hospitals. Such services operated illegally through research funds, without any supervision by the ministry (though it backed the service up with its silence) and while harming patients - until the Supreme Court ordered an end to the scandal.
It is highly possible Naveh wanted to remind the public that it is always preferable to be rich and sick and to make the public forget that the most important demand he made was not accepted by the cabinet - to conduct a comprehensive examination of the charge that the health system is discriminated against in the state budget.
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