Doctors Warn of Painful Cutbacks in Services Come July

Israel Medical Association's chairman says doctors to substantially reduce presence in hospitals starting July, unless demands are met.

Doctors will substantially reduce their presence in hospitals to the minimum standard required starting July, unless their demands are met, the Israel Medical Association's chairman, Dr. Leonid Eidelman, warned yesterday.

The minimum standard has barely been amended since it was established in 1977.

doctor protest
Moti Milrod

The IMA also decided that from now on, doctors will work under terms set in the last collective wage agreement signed in 2000, according to which residents do no more than six evening and night shifts a month, and specialists, except for surgeons, are not allowed to do night shifts at all but only to be on call.

Meanwhile, some 1,300 doctors and medical students staged a protest rally yesterday at Reading Park in north Tel Aviv yesterday.

According to senior IMA officials, the steps planned for July will mean that some wards will have to close or combine with others so that all patients will be under a doctor's supervision at night. "We're giving the system a chance to organize. If there is no agreement, and the system does not organize, wards and outpatient clinics will close," Eidelman said.

The IMA said the sanctions of the past seven weeks would continue until July. Today, outpatient hospitalization units will be closed in hospitals from Tel Aviv and southward.

Tomorrow, outpatient units will be closed from Tel Aviv northward.

Disruptions are expected Thursday in scheduled surgeries as well as outpatient units because of a conference being held by physicians who are exposed to radiation in the course of their work, including cardiologists, urologists, anesthesiologists and gastroenterologists.

"Negotiations are stuck, and in fact there has been no progress since they started 10 months ago," Eidelman told protesters yesterday.

"The willingness of the Finance Ministry to invest in health is negligible and insulting, and patients are paying the price in their health and with their lives. We will continue the struggle, even for an extended period, and we will not stop until we bring new tidings to the people of Israel," Eidelman said.

Noting that yesterday's protest fell on Lag Ba'omer, which traditionally celebrates the end of a plague during the time of Rabbi Akiva, Eidelman said: "We are asking today to end the plague that is happening before our very eyes, in which we cannot save lives and the government is saving on funding to the health care system.

Eidelman called on Prime Minister Benjamin Netanyahu to intervene to end the strike, recalling that the last prolonged strike ended after Prime Minister Menachem Begin intervened. Netanyahu "can act no differently than Begin did in 1983," Eidelman said.

The IMA has so far acted cautiously and has not taken harsher steps out of concern that it would alienate the public. But in light of the lack of progress in talks with the treasure, it decided to issue the early-July ultimatum. "Even if the public that supports us now grows tired, we the doctors will not tire and can continue the fight for many months, until we reach our goal," Eidelman said.

Medad Gisin, chairman of Zvi, the umbrella group of patients' rights advocates, said: "We oppose any sort of strike that harms patients but we decided to join the fight - not for salary conditions, but on the subject of saving public health in Israel"

At a meeting two weeks ago with senior Health Ministry officials, the group demanded the standardization of rehabilitation units in all health maintenance organizations, a reduction in insurance deductables for public medical services, and limitations on medical tourism in public hospitals.

MK Dov Khenin (Hadash ) said at the rally: "Instead of accepting justified claims, the government continues its spin campaign to divide the residents... and the young doctors from the veteran ones. I call on the public to stand behind the doctors."

Negotiations resumed last night between the IMA and the treasury after a five-day hiatus. One issue discussed during the meeting involved shortening the residents' shifts to 18 hours. The IMA said this was not practical because it would mean that the residents arrive for their evening and night shift in the afternoon and miss the mornings, during which most of the teaching goes on in the wards.

Only limited talks are planned on specific issues on Tuesday and Thursday.

Yesterday doctors struck at public hospitals, and unnecessary surgery and treatments were postponed. This was the first time sanctions were applied on a Sunday, typically a busier day for in hospitals.

Rebecca Sieff Hospital in Safed was given special permission to work yesterday because of the Lag Ba'omer celebrations on nearby Mount Meron. The hospital treated about 40 patients, mostly for dehydration and heat exposure following the traditional bonfires.

Deputy Finance Minister Rabbi Itzhak Cohen said yesterday in response to the strike and the rally: "The IMA leadership does not want or is unable to reach an agreement. Just last week the Finance Ministry concluded complex agreements with the teachers, the Israel Lands Administration and other bodies, involving structural reforms and changes. In contrast, it seems to me that with the doctors there is no real partner for an agreement."

Cohen said the IMA "could not make the necessary decisions for the benefit of the public health system in Israel and prefers to continue harming patients with unnecessary and illegitimate strikes."

Cohen said the treasury had offered what he called "generous solutions to the real problems of the health care system" - outlying regions, the residents, and specialties that do not attract enough students, but, he said, "the doctors continue to barricade themselves in their positions demanding more wages that will benefit mainly senior doctors..."