Representatives of the country's medical residents walked out yesterday on negotiations involving their demands for amendments to the labor pact struck in August between the government and the Israel Medical Association. The National Labor Court in Jerusalem is expected to take decisive action in the case today unless a solution to the dispute is found. At least 495 residents who have submitted letters of resignation are expected to have their letters take effect at midnight tonight if the dispute is not settled and the court does not block the resignations.
In anticipation of the walkouts, the Health Ministry is expected to open a command center this morning to prepare for the staff shortages the resignations would cause. Representatives of the residents walked out of negotiations yesterday with officials from the Finance Ministry and the Israel Medical Association, claiming they had not been presented with the kind of proposal that could resolve the dispute. Sources at the meeting said the residents stormed out, saying finance officials had treated them with disdain.
A source closely associated with the residents said the treasury officials proposed reallocating funds that under the August agreement with the IMA were to be devoted to medical care in outlying areas of the country, and providing the money to hospitals in the center of the country instead. The source said the residents rejected the proposal on the spot and, from their perspective, there would be no further extensions of time on the effective dates of the resignation letters.
The IMA agreement with the government is slated to remain in effect for nine years, but the residents have demanded that the duration be reduced to three or four years. The residents have also made a preliminary demand for a NIS 7,000 monthly wage increase. With respect to the duration of the IMA pact, the parties have discussed the possibility of re-evaluating the situation after four years, along with other possible "exit points" over the nine years during which the state of the medical system and the need for possible additional funding could be weighed. The two sides have also discussed possible flexibility with regard to required on-call night shifts by young physician specialists.
Following the residents' walkout from talks yesterday, one resident spokesman called on Prime Minister Benjamin Netanyahu, who also holds the health minister portfolio, to intervene in the time remaining.
A Finance Ministry source expressed surprise that the residents' representatives walked out. "The residents threatened that premature babies in Israel would die [due to the resident shortage the resignations would cause] and they left the meeting shouting," the source said. He described the residents as "a band of guerrillas whose demands can no longer be surrendered to."
The disparity in the positions of the two sides remains wide. The residents are demanding provisions that would cost the government NIS 400 million, while the Finance Ministry has offered NIS 100 million, in addition to the NIS 2.5 billion that the agreement reached with the IMA in August provides in new funding for the health care system.
If an agreement is not struck with the residents, the government is expected to ask for an injunction against any resignations by the residents, or in the alternative that in essential hospital departments where over half of the residents are slated to resign, resignations be scheduled on a staggered basis to head off the prospect that patients' lives could be endangered. If injunctions are issued, it is not clear they would apply to hospitals owned by the Clalit health maintenance organization or to the Hadassah medical organization, neither of which is a party to the Labor Court case.
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