Waiting for Dr. Godot

One of the most serious findings in the State Comptroller report speaks of government hospitals where patients have to wait for months, sometimes more than a year, for vital operations - such as the removal of tonsils and ear operations for children, and operations to remove urinary tract growths.

While these are not defined as "urgent" operations, the comptroller said, waiting for the operation can lead to health problems and in some cases can even be life-threatening. The ministry's figures show that there are hundreds of people in line for operations of this type.

The comptroller pointed out that the ministry does not have any significant kind of supervision of these waiting lists, nor does it have information about how long the wait is and how many patients are involved.

The ministry has also not fixed regulations about how long it is permitted to keep the patients waiting and therefore cannot make significant checks of the situation in the various hospitals. The comptroller pointed out that there is not even equality in wait times since patients with means or those who have supplementary insurance can undergo the operations privately and avoid the lines.

The wait for ear, nose and throat surgery is very long, the comptroller pointed out, and at Sheba Medical Center at Tel Hashomer, for example, patients, including children, were waiting as long as six or seven months. At Nahariya's Western Galilee Hospital, it was even longer - up to 13 months - while at Ichilov Hospital in Tel Aviv, the waiting time for surgery for a deviated septum was more than a year.

Also at Ichilov, the wait for surgery on the urinary tract, or for correction of Peyronie's Disease, was three months. At Sheba Hospital, it was a two or three month wait to have a cancerous growth removed from the kidney. The waiting period there for a knee operation was seven to eight months.

The comptroller's examination of the lack of doctors revealed that, at Soroka Medical Center in Be'er Sheva, the central hospital for the south, there are seven operating theaters but because of the shortage of surgeons, anesthetists and trained nurses - some of which is the result of a lack of job slots - only five of them are in use. That is why patients there have to wait a year to undergo surgery for a hernia or to have a gall bladder removed.

The wait for cataract surgery there is also a year, and there are operations, like removing polyps from the nose, where patients are referred to other hospitals because there is such a long wait.

Based on expert medical opinion, the comptroller stated that in some cases waiting for an operation, such as surgery for the removal of tonsils in children, could be life-threatening since the child could die of apnea or suffer a drop in oxygen in his blood.

A long wait for an ear operation in a child can cause chronic ear infections and an infection to the ear-drum, the report said.

The findings on the long, and unsupervised, wait for surgery emerged in the investigation that the comptroller's office carried out about funds for research programs in 11 government hospitals. As part of these programs, operations are supposed to be performed in the afternoons in an attempt to shorten the lines and so the hospital staff can earn more money.

For various reasons - including the unrealistic wage fixed for these operations, which does not make it attractive for hospital staff to work the extra hours - there are no real incentives to do the surgery in the afternoons and shorten the waiting time, the comptroller found.

"Economic and administrative considerations dictate decision making with regard to performing surgery and shortening the waiting time," the comptroller stated.

Among the other reasons that led to the long lines were the countrywide shortage of anesthesiologists and qualified nurses for operating theaters, and the lack of suitable remuneration for doctors who wished to operate in the afternoons within the framework of the research programs, the comptroller found.