Israel's Health Chief Allows Employment of Unlicensed Optometrists

Deputy health minister says he’s merely providing a window for optometrists who practiced abroad and must pass Israel’s exam, but critics cite other motives

Yaakov Litzman at the weekly cabinet meeting in Jerusalem, May 12, 2019.
Emil Salman

Deputy Health Minister Yaakov Litzman has agreed to a request by the chain Optica Halperin and is allowing the employment of unlicensed optometrists for another year and a half, apparently breaching the law and the attorney general’s position on the matter.

Litzman met with executives of the chain three weeks ago, at their request, people at the meeting told Haaretz. The two sides sealed the compromise for optometrists who completed their studies abroad and have not yet taken or have failed the Israeli licensing exam. After the year and a half, the optometrists will have to take the exam.

The law regulating optometry forbids anyone without a license from practicing, otherwise risking imprisonment or a fine of 123,000 shekels ($34,000).

The Health Ministry did not respond to Haaretz's question on the minister’s authority to approve such a compromise. Optica Halperin says it has done nothing wrong and simply wants the terms for optometrists to be the same as for dentists and pharmacists.

Optica Halperin says it is Israel’s biggest optical chain. Between 2011 and 2015 the company donated millions of shekels to a nonprofit group headed by Rabbi Yaakov Alter. The rabbi, a patron of Litzman’s, is also known as the Ger rebbe, or the Gur rebbe, the head of a famed Hasidic dynasty.The nonprofit group once employed Chaim Yustman, who is now Litzman’s bureau chief.

Also, the year-and-a-half arrangement has particular significance for Optica Halperin because Litzman’s decision will help the chain defend itself against a class action suit claiming 71 million shekels due to its employment of unlicensed optometrists. The suit has been heard at the Tel Aviv District Court over the last few years.

A few days after Litzman was believed to have decided on the matter, Optica Halperin asked the court to amend its response to the suit. The chain says Litzman’s decision provides retroactive approval of the employment of unlicensed optometrists.

“The employment of these people undergoing specialization has been legal over the years, without violating any regulation, based on the very clear instruction from the health minister permitting their continued employment,” says the request for an amendment.

Cost cutting

The class action suit against Optica Halperin was filed in February 2015 by a customer of the chain, who was represented by attorneys Nimrod Geron and Shahar Skverer. The suit came after Channel 2 television, now Channel 12, reported that some of the chain’s optometrists were unlicensed.

“The chain regularly uses unauthorized and unlicensed practitioners who perform vision tests at several of its branches,” the suit states. “This is apparently done to cut costs, at the expense of customers and their health.”

The suit adds that Optica Halperin “conceals this deception, among other means, by forging seals and signatures, or by issuing prescriptions with the signature of a licensed optometrist at the chain who was not present during the test.”

The plaintiff alleges faulty diagnoses and the fitting of wrong lenses by an employee who presented himself as a veteran authorized optometrist but who was operating without a license.

In 2016 the two sides reached a compromise under which the chain would subsidize contact lenses for people treated by unlicensed optometrists over the seven years before the lawsuit. Attorney General Avichai Mendelblit opposed this because it did not include a correction of the overall situation.

“Someone without a Health Ministry license cannot present himself as an optometrist or work in optometry,” Mendelblit said in a brief. “The compromise does not include any commitment by Optica Halperin to cease its unlawful conduct of employing unlicensed optometrists who conduct unauthorized tests and are presented as licensed optometrists. This is sufficient reason to reject the compromise.”

Decent-sized donations

A similar suit was filed in 2011 but was closed under an agreement two years later. According to the registrar of nonprofit groups, in the year the first lawsuit was filed, Optica Halperin donated 1.5 million shekels to Ger institutions, the largest sum received from donors in Israel that year. In 2015, the chain donated again, this time 850,000 shekels.

A document summarizing the agreement between Litzman and Optica Halperin states that the chain aimed to equalize optometrists’ terms with those for dentists and pharmacists who study abroad: They can obtain exemption from exams based on their professional experience.

Litzman’s office says that all decisions have been taken based on professional advice, and that there is no link between any donations and professional decisions.

According to attorney Yigal Cohen, who is representing Optica Halperin and was present at a meeting with Litzman and other ministry officials, there is no connection between the meeting and the decision to extend the optometrists’ employment, or to donations to the Ger Hasidim.

Donations were given to other institutions as well, Cohen said. “This problem exists for other chains as well and for anyone who studied optometry abroad and wants to work in Israel,” he said.

Cohen said the rules for pharmacists and dentists should go for optometrists as well. “It’s not reasonable to ask a more mature person with a family, who has worked in this profession for years overseas, to take an exam,” he said.

Optica Halperin said: “Over the years the chain has taken steps ordered by the court attempting to get the health minister to regulate the employment of people specializing in optical health, something that is required for obtaining a license to practice optometry. These regulations have not been established and the chain considered petitioning the High Court of Justice so that it instructs the minister to set the guidelines.

“After discussions with professional teams at the ministry and the chain’s legal advisers, the professional team decided to equalize their situation with that of dentists and pharmacists who studied abroad, in order to ease the immigration of people who studied and worked overseas for years. The solution was to let them keep working for a year and a half and then take the exam.

“This solution was not meant only to solve Optica Halperin’s problem – the chain currently employs 10 optometrists who studied overseas. The solution also applies to hundreds of others who work at many other chains or private businesses. There is no connection between the professional decision and any donation to one institution or another. Optica Halperin donates to many institutions, religious and secular, and such claims will not weaken its resolve.”