Annual WHO Report: |

Israel Far Behind West in Number of Nurses, Hospitals

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The number of nurses per capita in Israel is similar to the number in Oman, and less than half the number in Germany, according to the annual statistical report of the World Health Organization, published Thursday.

Other areas where Israel lags are in the number of hospitals per capita and the availability of radiation therapy units for cancer patients in hospitals, in addition to the shortage of inpatient beds. The Israel Medical Association said the findings reveal a sad and difficult picture of the Israeli hospitalization system.

Regretfully, we are familiar with these figures. The IMA has repeated for a number of years that the situation of the hospitalization system is deteriorating. A year and a half ago we even petitioned the High Court of Justice to require the state to install new [hospital] beds, but to our regret the process has been delayed.

The WHO report, which compares the 194 countries belonging to the group and is based on 2005-2012 data, finds that Israel has 49.7 nurses for every ten thousand residents, significantly lower than in Western countries, including France, with 93 per 10,000 people; Britain, 94.7; United States, 98.2; and Germany, 113.8. The number of nurses per capita in Israel is similar to countries such as Oman, 44.9; Egypt, 35.2; and Malaysia, 32.8 per 10,000 residents.

As to the number of hospital beds, the situation is a bit more complex: In Israel there are 3.4 inpatient beds for every 1,000 residents, similar to the United States, 3; Canada, 3.2; and China, 3.9. But it is considerably lower than in France, 6.6; and Germany, 8.2 per thousand residents.

The WHO figures are similar to the data available to the heads of the Israeli health system. They show on the one hand a high level of health care compared to the West in such measures as immunizations and mothers dying in childbirth (24 out 100,000 births). But on the other hand, the medical infrastructure is outdated, especially away from the center of the country, and is desperate for more investment, which in recent years has come mostly from donations. This shows in the low number of hospitals and radiotherapy units for cancer patients per capita.

The most recent budget proposal for 2013-2014 provides NIS 380 million for development over the next five years, and the Health Ministry says most of that will be used for improving psychiatric hospitals and psychiatric wards in regular hospitals. But it includes little money for improving the general hospitals, which will still have to rely mainly on donations. Such contributions are estimated at over NIS 500 million a year, and the state originally wanted to regulate them in the Economic Arrangements Law passed by the cabinet this week. The original bill included sections regulating such donations, such as banning donations from bodies that would place the hospitals in a conflict of interest, but these were removed from the final version to be sent to the Knesset.

In general, the report shows a reduction in gaps in health care between countries. The world has made a great leap forward in improving health care in poor countries and reducing the gaps between countries over the past two decades, the WHO report states. For example, the gap in child mortality between the top five nations and the bottom five decreased from 171 deaths per thousand births to 107 from 1990 to 2011. Countries such as Bangladesh, Rwanda, Nepal and Madagascar were at the bottom of the child mortality rankings 20 years ago, but have since improved.

More than a decade after world leaders adopted the Millennium Development Goals and associated targets, the report states, substantial progress has been made in reducing child and maternal mortality, improving nutrition, and reducing morbidity and mortality due to HIV infection, tuberculosis and malaria. Although progress has accelerated in recent years in many countries with the highest rates of mortality, large gaps persist both among and within countries. Nevertheless, current trends continue to provide a sound basis for intensified collective action and the expansion of successful approaches to overcome the challenges posed by multiple crises and large inequalities.  

Hadassah hospital in Jerusalem.Credit: Shiran Granot

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