How Israel Founded the Adelson Medical School: In Haste and Against All Advice

The minutes of the committee meeting where the facility was approved reveal how the gatekeepers were moved aside with political pressure, leaving the hurriedly approved plan with critical questions unanswered

Or Kashti
Or Kashti
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The Adelsons, Bennett, Litzman and Rivlin at the inauguration ceremony, August 2018
The Adelsons, Bennett, Litzman and Rivlin at the inauguration ceremony, August 2018Credit: Meged Gozani
Or Kashti
Or Kashti

In a festive ceremony held last Sunday, an inauguration ceremony for the medical school at Ariel University in the West Bank Jewish settlement was held. On the stage were Miriam and Sheldon Adelson, the primary donors, alongside Education Minister Naftali Bennett.

“A year and a half ago, we said a medical school would be established and today it has been established,” the minister said proudly.

The minutes of the decisive meeting of the Council of Higher Education’s Planning and Budgeting Committee reveal that approval for the new school in the West Bank settlement of Ariel was granted in an expedited manner, without waiting for answers to tough questions about budgeting and academic standards, and before essential data were received about the training process. The protests expressed by the Committee of University Heads was rejected by the budget committee’s chairwoman, Prof. Yaffa Zilbershats, whose term as chairwoman had been extended by Bennett a few weeks earlier. The gatekeepers were moved aside; political pressure prevailed.

>> Israeli university heads challenge decision to open medical school in West Bank settlement

The Planning and Budgeting Committee, considered the most important committee of the Council for Higher Education, is responsible for allocating the government’s 11 billion shekel ($3 billion) higher education budget among the various universities and colleges. Because of the sensitivity of its work and its powers, it was founded as an “independent body,” not directly under the government or the academic institutions. But that was during a different period, when academic independence meant something.

On July 18, the subcommittee approved Ariel University’s request to open a medical school. The minutes of the meeting, revealed here for the first time, show that as far as Bennett and Zilbershats are concerned, proper procedure means nothing when it comes to examining proposals and making decisions. All means are kosher when it comes to legitimizing Ariel.

About two weeks before it received the sought-after approval from the budgetary committee, the university announced that in order to plan properly, the medical school’s opening would be postponed until the following school year. People familiar with the details say that the announcement came as a complete surprise: Nothing remained of the urgency with which the decision to open the school was made. The postponement was swallowed up by a joint photo-op of Bennett and Adelson, at an opening ceremony that was held before its time.

The budgetary committee meeting was opened by the council’s deputy director for planning and policy, Merav Shaviv. She reported that the university’s plan, which Bennett had already approved, is now under examination, while “surveying” would be conducted in order to “assess the potential for 'clinical fields.'”

Bennett and the Adelsons at the inauguration ceremony at Ariel UniversityCredit: Meged Gozani

This is a key term, referring to the number of places where medical students could do residency. Shaviv stated the obvious: “A condition for the increase in the number of doctors is an increase in the number of residency slots by the health ministry,” and “it is very important to work toward arranging the use of clinical fields, which are a limited national resource.” In other words, if no slots are added for residencies, the new medical school at Ariel might to not be able to make a dent in the shortage of doctors, which was the main justification that Bennett and his emissaries had bandied about.

In fact, some other medical schools have already announced that they were taking fewer students. “No one is enlarging the sized of the cake; it’s only being cut into smaller pieces,” said one medical school official.

According to Shaviv, the committee examined the university’s plan and “a number of questions were raised and a number of mistakes identified.” These included, for example, relying on hospitals already working with other medical schools and "presenting letters of commitment from hospitals for clinical training, some of which lacked details and others were subject to conditions.” Shaviv explained that at a certain point, Ariel university was asked to submit clarifications, but “the letter of response was received only a few days ago.” Consideration of the letter was not completed before the meeting, which Prof. Zilbershats announced with only a week’s notice.

Shaviv’s bottom line: “First of all, the number of students at existing [medical schools] should be increased and their clinical training arranged” and “only if there is a need to increase the number of students would it be possible to plan the establishment of a new school.” Bennett had claimed that the opposition to the Ariel medical school was organized by a “cartel of universities,” but Shaviv's recommendation comes from the official responsible for planning the required programs in higher education. But facts don't seem to matter.

Shaviv wasn’t the only one to find deficiencies in Ariel University’s plan. “The institution only presented the teaching budget and not the research budget,” Shira Navon, the planning and budgeting committee’s budgeting director, noted. “So not all of the required data exist. The research expenses are very significant, and there is no reference to them at all in the documents that have been presented.” In addition, when one compares the plan submitted by the university and the budget of the existing medical schools, Ariel’s budget is described as “lean” and “many components have not been budgeted for.” One source described the plan submitted by Ariel University as “a medical school at a bargain price, which is clearly not realistic.”

The decision to approve the establishment of a medical school at Ariel University was supported by four committee members with two voting against and one abstaining. A short time later, Education Minister Bennett issued a press release in which he declared: “We have made history today,” without mentioning criticism of the decision by the planning and budgeting committee’s professional staff.

A week later, in an unusual move, three university representatives who sit on the committee read a letter of protest decrying what they said was political interference by Education Minister Naftali Bennett in the committee’s work. When the Committee of University Heads demanded new deliberations on the decision to allow the establishment of the medical school in Ariel, Bennett tweeted in response: “The demand is rejected. The decision was taken in a professional manner and it is final.”

In response to a report in Haaretz on the criticism of the decision, Zilbershats, the chairwoman of the Council for Higher Education, responded that “the planning and budgeting committee’s professional staff had provided all of the necessary material to the committee members for the hearing.”

The minutes, which are being reported here for the first time, show, however, that this was not exactly the case. The chairwoman of the committee had refused to refer to a recommendation from the committee’s professional staff suggesting that the survey of the clinical fields be completed before planning for the new medical school begins. As for the questions regarding the proposed budget, the response from Zilbershats was that “sometimes you need to begin in the midst of the work.”

In response for this article, the Planning and Budgeting Committee said: “In total contradiction to what has been claimed, the decision-making process regarding the Ariel medical school was thorough, deep and flawless. The first decision on the matter was adopted in November 2017. The plan was examined by a committee of experts ... that unequivocally recommended establishing the school at a meeting that lasted about three hours and that was devoted only to the subject, and which was conducted according to procedure."

The claims of partial information are not correct, said the statement. "Prof. Zilbershats is determined to act with full force to solve the doctor training crisis and no background noise will deter her from that important goal.”

The statement added that the planning and budgeting committee “is working with the Health Ministry to arrange the matter of clinical fields as soon as possible.”

Ariel University said in response: “The establishment of the [medical] school constitutes a historic step. The final approvals were issued in July so that towards the end of 2018 and the beginning of 2019 registration and student admission will be carried out in the run-up to the first academic year in October 2019.”

With regard to the plan submitted to the Planning and Budgeting Committee, the university stated that it had been “examined academically, organizationally and budgetary-wise by a committee composed of senior scientists and physicians” and that the committee report “explicitly states that the data submitted by Ariel are reliable and provide a realistic picture of the clinical training possibilities.”

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