The state comptroller devoted a vast section of his Wednesday report
to the Health Ministry and for the first time dedicated most of his criticism to shortcomings in the ministry’s failure to prevent disease and promote good health, rather than focus on faults in hospitals and clinics.
The Health Ministry responded on Tuesday evening to the criticism and denied most of the unfavorable judgments. It declared that some of the shortcomings in the report were in fields for which it lacked responsibility and authority and stated that it will be carrying out changes soon.
Shlomo Raz, the comptroller’s spokesman, however, told The Jerusalem Post that the State Comptroller’s Office “fully stands by its criticism” of the Health Ministry in its report and regards its shortcomings as “very serious. We wouldn’t have devoted 259 pages to the ministry if we did not feel that way,” he declared.
The first criticism raised was related to the ministry’s Public Health Division and blamed it for failing to lead the government and other public and private institutions in preventing melanoma. This dangerous type of skin cancer affects one out of 36 Israeli males and one out of 45 Israeli women. In addition, more than 10,000 Israelis a year are diagnosed with non-melanoma types of skin cancer, which are less likely to end in deaths but whose treatment is disfiguring and expensive. Israel is in 18th place in the world in prevalence of melanoma.
The Health Ministry fails in its job of spreading information on melanoma and how to avoid it, said the comptroller, leaving the task to the Israel Cancer Association, which gets no state funding.
Although it is vital to provide shade from the ultraviolet rays of the sun, which over time and can cause the malignant cancer, the report said the Health Ministry has not coordinated efforts of institutions under other ministries’ aegis, such as daycare centers, kindergartens, schools and military facilities, to require protection.
It did not, for example, make an effort to persuade the army to provide broad-brimmed hats for soldiers exposed for hours to the sun or ensure that workers in various professions, such as the police, suffer minimal exposure and are properly equipped with sunscreen lotion and protective clothing.
While the ministry could argue that this is not its job, public medical facilities would in turn have to spend large sums on treating victims of preventable skin cancer, implied the state comptroller.
Another charge against the Health Ministry was its failure to set down regulations limiting the use of artificial tanning beds, only ensuring that warning signs appear. The comptroller also pointed out that sunscreens are hugely expensive and sold by near-monopoly companies, adding that many families cannot afford them, thus exposing them to melanoma risks.
Furthermore, said the report, an “unnecessary” scanning procedure commonly used on melanoma patients continues to be offered because the ministry has not discouraged its use.
Turning to protective vaccinations for children and adults, the comptroller noted that such shots are a boon to public health. While some 95 percent of children receive all or most of the 14 different types of vaccinations required, tens of thousands of people, especially ultra-Orthodox Jews and Beduin, do not get the necessary shots.
The comptroller reported that mother and child care centers (“tipat halav”) owned by the government, the health funds and the Jerusalem and Tel Aviv municipalities do not always know when babies are born in hospitals; that they exist or if they are not brought in for shots. Information on babies’ immunization should be digitally transferred later on to schools and then to the IDF medical corps, but they aren’t, the comptroller wrote.
In addition, there is no central body that ensures that adults receive the vaccinations they need against diseases like tetanus, pneumonia and varicella zoster.
There is also criticism of the ministry for monopolizing all aspects of immunization and even assessing itself without bringing in independent experts to make suggestions.
In his criticism of ministry supervision of mother and child care centers, the comptroller found that they suffer from often-outdated equipment and inadequate manpower.
He called for the clinics to be open in the afternoons or early evenings so that more parents would be encouraged to bring their children in for vaccinations and examinations without missing work.
Again, little is done to make parents aware of screening tests that could catch medical problems early on, the controller said, adding that an in-depth examination of the possibility of reorganizing the centers’ services is needed.
Finally, in a section not related to disease prevention, the comptroller objected to the fact that the government decided 10 years to close the state-owned geriatric hospital in Rishon Lezion or transfer it to private ownership because it was outdated and inadequate but has not carried out its ruling. Although the hospital now has only 44 patients, the ministry employed 220 workers to take care of them.
The comptroller called on the ministry to implement the decision to close the facility immediately so that the elderly patients and their families, as well as the employees, no longer have to live in uncertainty about their future.