Betrayed by the Unions

Residents must must be permited fair representation in negotiations to improve conditions.

Late Wednesday night, after more than 100 days of labor sanctions and work stoppages, the negotiations between physicians and the state broke down and the National Labor Court issued a back-to-work order. The Israel Medical Association, which operates as a trade union, announced the suspension of all labor sanctions through Sunday.

The negotiations broke down over demands by residents. The trainee physicians, arguing that they would not be getting their fare share in the agreement taking shape between the IMA and the Finance Ministry, demonstrated against the contract in the making. President Shimon Peres asked the residents yesterday to end their protest on the ground that it harmed the patients, "first and foremost." But the truth is that the residents were betrayed at the negotiating table.

The IMA waged a two-faced battle: In public it presented the difficult conditions faced by residents, describing their too-long and too-frequent on-call shifts. It demanded higher wages and an increase in the number of job positions for residents, coupled with a reduction in their on-call burden, as well as pay rises for physicians in remote areas of the country.

But during the negotiations, behind closed doors, a different voice was heard: There, senior physicians and specialists joined forces with hospital management in an effort to obtain an agreement that was good for them - and not for the residents, who are the future of public medicine.

After all, the doctors sitting around the negotiating table are senior physicians, hospital department heads, who naturally represent themselves. As one said: "At the end of the day, residency lasts for four or five years - a moment in the career of a physician."

This attitude, and conduct, is typical of Israeli trade unions. It happened with the faculty unions, where professors initially talked about stemming the "brain drain" of young academics and demanded higher wages for junior faculty members but at the last minute demanded that seniority be factored into the salary hike. As a result, the more senior faculty members received much more than their younger colleagues, and the "brain drain" was forgotten.

The residents must not be left to the same fate. They must be permited fair representation in the negotiations. That is the only way to guarantee that the doctors who carry the burden of on-call hospital shifts receive appropriate compensation, and that additional residents are hired to share that burden. That is the only way to guarantee better medical care for the public.