Cabinet to Mull Reform Trimming Hospital Bosses' Power

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Yael German.
MK Yael German.Credit: Michal Fattal

The cabinet is expected next Sunday to approve plans to overhaul the government hospital system and trim the power amassed by long-serving hospital officials.

Under the proposal, hospital department heads and service administrators – a group comprising some 1,000 people – will be limited to two terms totaling 12 years. Hospital directors will be limited to terms of 10 to 12 years. Today, hospital officials often serve until they retire, averaging 17 years in their jobs.

“Currently, doctors are appointed to management positions for extended periods, in most cases until they retire. This situation risks leading to stagnation, an absence of professional, personal and organizational development, burnout, brain-drain to the non-government sector for lack of opportunities to advance, the creation of power centers and discouraging excellence,” the proposal says. It is the work of the Civil Service Commission, the health and finance ministries and the Prime Minister’s Office.

The proposal also faulted the current system for preventing government hospitals from sharing organizational knowledge to improve services to patients. “The situation has widened the gaps in health services, for example between the center [of the country] and the periphery,” it said.

Health Minister Yael German said the reform also aimed to help doctors seeking career advancement.

“Good people look up and see a glass ceiling,” she told TheMarker. “How can they advance under these circumstance and what does this do to the system? A system that wants to move forward and offer horizons to its people need to encourage … conditions where management positions are attractive.”

In any case, managers forced out of their jobs will not leave empty-handed under the plan. They will keep the same salary and conditions as they had as managers and will have the opportunity to move to another management job. The committee that designed the reforms estimated that preserving managers’ compensation would cost the health system 24 million shekels ($7 million) annually.

Unlimited tenures for officials at government hospitals has long been an acknowledged problem. As far back as the year 2000, a government panel recognized it, but reforming the system met strong opposition from the Israel Medical Association,.

However, the proposals going to the cabinet Sunday aren’t final. They state that the changes won’t go into effect until the IMA has agreed to them in negotiations.

“It’s a declaration of intent,” German said. “We need to enter into negotiations, but I think we’ll be able to reach agreements on most of the key points.”

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