Israeli Children’s Hospital Charging for Psychological Services That Come for Free Under New Law

Petah Tikva’s Schneider Medical Center insists it operates according to Health Ministry guidelines.

Schneider Children’s Medical Center in Petah Tikva.
Nir Keidar

The Schneider Children’s Medical Center in Petah Tikva charges fees amounting to thousands of shekels for psychological services that are provided for free by the state, as stipulated by the reform in mental health services. These services include the treatment of attention deficit disorders and guidance for parents.

The reform was launched a year and a half ago. It involved the transfer of mental health services from the state to health maintenance organizations. The move obliged the HMOs to provide all services within a public framework and to cancel all services which had hitherto been provided for a fee, as part of patients’ extra health coverage plans. It now turns out that Schneider, which is owned by the Clalit HMO, is providing the public with various mental health services, given by psychologists and psychiatrists, for 250 shekels ($66) per session, with treatment courses lasting from four to 16 sessions.

Despite this, Schneider still imposes fees on mental health services. An example is a “clinic for improving parental authority.” Free guidance for parents is currently provided at public mental health clinics. Psychological treatment of parents is in fact a major part of treating children. The hospital claims that this is a course that aims to empower parents, but in fact this is a mental health service like all others, in which a team of trained psychologists provide parents with assistance during weekly sessions. According to the hospital’s website “the consultation is designed to help parents contend with children’s behavioral problems or violence, including refusal to attend school, quarrels and violence among siblings, over-use of computers and bullying behavior on social networks.”

In response, the Health Ministry stated that “parental guidance is included at no cost in the mental health basket for parents whose child is being treated at a mental health clinic. The hospital holds a course on parental authority which consists of an empowerment workshop for parents, unconnected to whether a child is being treated at the Schneider mental health clinic.”

In addition, the hospital operates a clinic for learning disabilities and attention deficit disorders. These diagnoses are now treated by the health and education systems at no cost. According to the hospital’s website, the clinic includes a team of trained psychologists and psychiatrists which “undertakes diagnosis and treatment for grade 1-12 pupils who are struggling with learning disabilities and attention problems.” The hospital’s administration claims that it doesn’t charge anyone entitled to these services as part of the health basket. The website doesn’t note if this service entails a charge.

The treatment of learning disabilities is not included in the health basket, and is carried out within the education system, through educational psychologists and remedial instruction. However, if mental health issues are involved the problem is meant to be treated by the health system. Schneider is treading a fine line: They claim that they deal with learning disabilities but provide standard mental health services. These are provided by psychologists, with the term “therapy” recurring on the website. It even notes that a new method called “the new authority” is used, based on psychologists rather than on learning specialists.

The hospital insists that these are services excluded from the health basket so that fees are permissible. The Health Ministry notes that “treatment of attention deficit is delivered as part of addressing the development of children under 6 years of age, and if this is done in mental health clinics no fees are allowed. Costs should be covered by the HMO, with some participation by the insured party.”

Schneider Hospital responded that it “operates according to the ministry’s guidelines, abiding by the mental health reform. Fees are charged only for services excluded from the health basket.”

The Health Ministry stated in turn that “the reform did not involve any changes in the health basket, so that eligibility for services remains unchanged. Services included in the basket are still provided. Claims of wrongful fees will be explored with the hospital and HMOs.”