In Midst of COVID-19 Pandemic, an Alarming Exodus at Israel’s Health Ministry

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A protective mask dangling from a mirror inside an empty car.
A protective mask inside an empty car. Now of all times the ministry is gradually losing its senior professionals.Credit: Amir Cohen/Reuters
Ronny Linder
Ronny Linder

In the past eight months the Israeli Health Ministry’s agenda has been completely upended, and it has morphed into a kind of Coronavirus Ministry. Resources are devoted almost exclusively to handling the pandemic; the minister and the director general have been replaced along with their staffs; powerful organizations such as the Israel Defense Forces, the Mossad and the Shin Bet security service have received broad powers that in the past belonged to the ministry, and are now working with the ministry; and a “Shield of Israel” project has been established, headed by the coronavirus project manager, who has considerable authority and also works alongside the ministry.

Within this chaos, now of all times, the ministry is gradually losing its senior professionals. Most of these key figures have yet to be replaced, even though it’s been quite a while since they left.

Not everything is due to the coronavirus. The departures began even before the outbreak of the pandemic, but during this period the trend has become exacerbated. Most of the ministry’s top management has been replaced at best; other positions have been abandoned. In some instances there hasn’t even been a tender to replace the senior employee who left.

Edelstein’s power grows

Late last week Prof. Itamar Grotto, the deputy director-general of the Health Ministry and one of the prominent officials in the Health Ministry during the pandemic, announced his resignation after 13 years in the ministry, becoming the latest to join the wave of departures since the start of the crisis.

With his resignation, almost nobody from the original “beehive” that managed the crisis in the first wave remains. Health Minister Yuli Edelstein – who has been at the helm during this period of departures of ministry officials, many of whom have yet to be replaced – has thereby acquired tremendous political power and unchallenged control of the large professional ministry.

The latest key figure to leave his position: Prof. Itamar Grotto, the deputy director-general of the Health Ministry.Credit: Adina Valman / Knesset press office

Nir Kaidar, a senior deputy director general and head of the administration for strategy, economic planning, research and regulation in the Health Ministry, left in May 2019, after 13 years on the job, and is now a senior official in the Labor, Social Affairs and Social Services Ministry. Kaidar was a key figure in the ministry, one of the veteran officials who is thoroughly familiar with the system. He was involved in most of the decision-making processes, and in planning future strategy. Since he left, a year and a half ago, no successor has been appointed.

In September 2019 Revital Topper-Haver Tov, deputy director general for supervision of HMO’s (Kupot Holim), left the ministry due to particularly unpleasant relations with then-Minister Yaakov Litzman, and then-director general Moshe Bar Siman Tov. To date no successor has been appointed. The tender issued for replacing her has been stuck for over a year, and the candidates for the job have been assessed and are awaiting the final interviews – which are not taking place.

The next senior official to leave was director general Morris Dorfman, who had a great deal of authority and filled a combined position of head of regulation, digital Health and information systems division – three key fields. He announced his departure in April and left in June. He was recently appointed head of finances at the Maccabi HMO.

In August Dr. Erez Onn, head of the division of government medical centers, who served in the position for less than six months, resigned. Although no successor has been appointed, a tender was issued to replace him. Onn is returning to a management position in the Poriya Medical Center in Tiberias, where he originally worked. That same month his deputy, Shlomo Pashkos, also left, and became the chief financial officer of the Rambam Health Care campus in Haifa. Pashkos has been replaced for now by his deputy, Eran Hacohen. Only after Pashkos has been replaced can a permanent replacement for his deputy be chosen in a tender.

August also saw the resignation of another key figure in the handling of the coronavirus, Avi Ben Zaken, who held a variety of high­-level tasks including head of planning, development and construction of medical facilities. He has been appointed deputy director general of research and development at Ichilov Hospital (Tel Aviv Sourasky Medical Center).

The 2020 Mechitza: Men pray at a Jeruslaem synagogue with plastic sheets separating them to fight the spread of the coronavirus.Credit: Ohad Zwigenberg

The latest person to leave is Health Ministry spokesperson Eyal Basson, who reported this month that he is resigning to work as an adviser in the media and strategy department of the Tel Aviv Municipality. The tender for his successor has yet to be published.

Other senior officials are reportedly weighing their options and are expected to give notice in the near future.

Wanted: economists

Sources in the Health Ministry are calling the departure of these key people without the appointment of successors “destruction of the professional foundation on which the Health Ministry depends.” They say that this particular government ministry relies heavily on professionals with unique skills. “When a senior director in the Health Ministry leaves it not at all easy to find a suitable replacement; it’s not as though there are loads of people with this knowledge who are wandering around the market looking for work. It’s a matter of tremendous cumulative knowledge,” said one source.

According to another Health Ministry source: “When the managerial backbone is depleted, the ministry loses one of its most important assets – organizational memory. When one person leaves the ministry loses a lot of knowledge, when many leave together – projects that they sometimes worked on for a long time are likely to go down the drain, because there’s nobody who’s familiar with them and can continue to advance them in the ministry.”

Health Minister Yuli Edelstein.Credit: Emil Salman

Among those who have left are many of the ministry’s experienced economists and financial experts, whose departure has coincided with the challenging and sensitive period of the coronavirus. Within a few months almost all the economists left the complex and heavily budgeted ministry – Bar Siman Tov, Dorfman, Pashkos and Kaidar – leaving only one prominent economist: Vadim Perman, the deputy director general of planning, budgeting and pricing.

Due to the vacuum in the ministry’s professional leadership, the bureau of Minister Yuli Edelstein is stronger than ever, some say even stronger than in the days of Litzman and his personal assistant Mordechai Babchik. And at a time when Health Ministry administration is taking its time to conclude the tenders for the senior positions – some of which have been stuck for over a year already – the remaining directors are dealing with an onerous workload, which has only intensified during the pandemic.

“It’s hard to describe what the ministry is experiencing during this period,” says a senior official. “Meetings are scheduled in the datebook and evaporate, they’re simply postponed again and again. The coronavirus cabinet takes up the time of the most senior officials, with preparatory meetings and hours on end of meetings in the cabinet itself. Last week, for example, there were four cabinet meetings.

“And that’s the tip of the iceberg. Every morning there’s an hour and a half of situation assessment with all the senior officials in the ministry, and the professionals spend hours each week on endless sessions of the various Knesset committees. In such a situation it’s very hard to do anything beyond the ongoing work and it’s also hard to fill senior positions.”

The Health Ministry responded: “Naturally at a time of replacements and the end of tenures many senior officials want to resign. Some, due to professional advancement or a new job, and some, due to natural burnout in the ministry and the system. All the senior positions will be filled or are already in the process [of being filled]. Also, additional senior officials have joined the ministry.”

The organization that was supposed to accelerate the tender processes is the Civil Service Commission, which is in charge of appointments for senior government positions. But in response to a question by TheMarker on the subject, the commission referred us back to the Health Ministry. The commission also said that it “considers the filling of the senior civil service positions very important” and that “Due to the importance that the commission attaches to filling them, already in November 2019, in the wake of a directive by the Civil Service Commissioner, a report was prepared for all the vacant positions in the senior staff and in general.

“The report was sent to the directors general of the ministries and to the deputy directors general for administration and manpower, and they were instructed to accelerate the processes for filling the positions. The senior management administration in the Civil Service Commission turns from time to time to the administration of the ministries in order to follow up and monitor the filling of the vacant senior management positions.”

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