Israeli Doctors Have a Rare Opportunity

Doctors are now bearing the responsibility not only for the health system, but also for all workers who want to have a future here. All eyes are now on them.

"We don't want to wait for the agreement to be signed, when we'll face a done deal - like the social workers did in their time." This statement, coming from a medical school graduate who is supposed to begin his residency soon, embodies the great importance of the present doctors' struggle and all the reasons why it absolutely must not fail.

It is hard to blame the residents for losing their faith in the system. The social workers' strike, which was rare and received tremendous public support, and the state prosecutors' strike, which was the first in 30 years and was vital, both achieved meager and unsatisfactory results. The social workers were betrayed by the Histadrut labor federation and the Labor Court, and the prosecutors by the arbitration they agreed to.

The Israel Medical Association is not only a trade union. It is also the body that is responsible for the entire professional side of medicine and its purveyors. Through its scientific council, it is responsible for all aspects of residency and professional training. The IMA will celebrate its 100th anniversary in September, and it is one of the most stable and professional groups in Israel. Therefore the negotiations it is now conducting are not only over salary conditions, but involve many issues of vital import to the public health system.

The IMA is fighting against the growing shortage of beds and the increasingly grave shortage of doctors since 1995 - when the on going, consistent decline began in the number of young doctors, at a rate of 200 a year. And this is at a time when the population is growing in size and aging, and there is an increasing need to expand the system. The IMA is also fighting against a standardization that has already been deemed old and outdated by several committees and state comptroller's reports, which were shelved by the government.

The struggles of the IMA, and the power it grants the doctors, are inconvenient for the government. That is why the Finance Ministry is insisting on treating it like a trade union only, and in effect refusing to accept it as a valid partner to negotiations on the core issues that the IMA is responsible for, by dint of the powers granted it by law. Already in 2002 the government refused to accept the recommendation of the Amorai committee, to the effect that the Health Ministry and the IMA develop a new model for standardization, claiming that this is a right that should be granted to employers only.

And in fact now, too, when it comes to any subject that is not related to salaries, the treasury says, "Leave it to us." And that is after it failed to honor many of the stipulations of the previous agreement with the doctors.

Deputy Health Minister Yaakov Litzman would also be happy to dismantle the IMA and to transfer the powers of its scientific committee to his ministry, a step that would give him additional strength. After all, he still has a grudge against the IMA for its petitioning upon his appointment against the failure to appoint a health minister, and later concerning issues like hospitalization and the so-called health basket. The prime minister, who is not intervening, is apparently afraid of a confrontation with Litzman, an important coalition partner, and is also probably not in favor of large, strong public health system.

Precisely because of this, the interns must not leave the IMA. The treasury will eat the ideologically motivated young people alive. IMA chairman Leonid Eidelman diagnosed the situation correctly when he noted that the treasury is trying to adopt a policy of divide and conquer - just as the prime minister is trying to do with his handling of the various protests that we now see erupting.

The doctors have a rare opportunity. They are benefiting from a tailwind of civic awakening, and from the legacy of the strikes of the social workers and the state prosecutors. Alas, they are now bearing responsibility not only for the health system, but also for all workers who want to have a future here. All eyes are now on them. They must not under any circumstances surrender or lose this battle.