The cabinet approved on Sunday a major Health Ministry proposal to establish a separate authority that will bring about the ministry’s multiple and conflicting roles of running and supervising the state-owned general hospitals.
One of the recommendations of the German Committee to Promote the Public Health System, headed by Health Minister Yael German, which has not yet formally presented all its findings, was to establish a separate state authority to run the 11 medical centers. Such an idea has been bounced around for several decades but met opposition from the Finance Ministry and others.
The head of that authority will be a manager and administrator who is not necessarily a physician, and who will answer to the health minister. Some of the proposals have included turning the government medical centers into independent hospital corporations, but as that would mean state employees would lose some of their job security and beneficial conditions, the workers have strongly objected to the idea.
This time, German managed to persuade Prime Minister Binyamin Netanyahu and Finance Minister Yair Lapid, the Civil Service Commission, the four public health funds, the Israel Medical Association and senior administrators to go along with the idea, which she raised last March. She said on Sunday that she will work to bring about the state-hospital authority “as soon as possible.”
The psychiatric and geriatric hospitals that the Health Ministry owns will not be under the new authority’s control at present, and other frameworks may be necessary for those hospitals.
The shift will give the new ministry director-general, Prof. Arnon Afek – who is due to take over on Sunday from Prof. Ronni Gamzu – more time to deal with other issues. Afek, currently head of the ministry’s medical administration, has spent much of his time supervising state-owned hospitals.
Some of the employees who have dealt with supervision of state hospitals could be transferred to the new authority, but as the ministry has had little time or energy for running these medical centers, which have therefore mostly been run by their sometimes highly independent directors- general, major personnel changes are not expected in the ministry.
Government hospital doctors, nurses and administrative, maintenance and paramedical personnel will become employees of the new state authority rather than directly of the ministry. Steering committees will set policy for the authority and be responsible for budgets.
Heading the German Committee’s subcommittee on the ministry’s “multiple hats” was Ronit Ken, formerly a Treasury official in charge of monopolies.
“The mandate I gave the subcommittee was to suggest how to deal with the ministry’s three hats, because [having] too many tasks significantly weakens the ministry’s status and harms the public health system,” German said.
“The hospitals are not capable today of running the activity for which they are responsible in a optimal way – among other reasons, due to the lack of flexibility,” she said.
The new authority will also supervise all the research funds, friends associations and additional bodies that have been part of the state hospitals.
Advisory committees for running the hospitals will be set up to help each hospital’s administration, and there will be internal comptrollers appointed as well.
The hospitals’ directors-general will get more flexibility, as well as more responsibility in running their medical centers, according to Ken.