Inadequate supervision of donations to hospitals; shortage of flying ambulance services; failure to curb obesity among children and adults; a lack of attention given to elderly patients.

These were among the shortcomings of the Health Ministry raised by State Comptroller Micha Lindenstrauss in a 61-chapter report to Knesset Chairman Reuven Rivlin on Tuesday.

The report tackles a wide-range of government activities, but two chapters on healthcare – one about the ministry and one about the elderly – were largely “welcomed” by the senior ministry officials.

The Israel Medical Association, which is in the midst of strikes and sanctions by doctors over wages, working conditions and other issues, said the comptroller’s criticism was “required reading” and a “wake-up call” for Treasury negotiators over IMA demands.

The IMA was especially incensed over the section on the shortage of hospital beds and manpower, which the Treasury has dismissed in its talks with the doctors.

The IMA maintained that the report was proof that their demands were legitimate and accurately characterized the public health system.

What the government has offered is “too late and too little,” IMA chairman Leonid Eidelman said. “The Treasury is disconnected from reality.”

The comptroller said the lack of proper hospitalization facilities and medical staffers was “very serious.” He praised doctors and nurses for working devotedly in the wards despite the obstacles of overcrowding and staff shortage.

Still, the implementation of ministry promises for improvements are taking too long, the comptroller said, and the country must adopt the health standards set by the Organization for Economic Cooperation and Development.

The ministry also came under attack for allegedly not supervising properly “donations” by patients, foundations, commercial firms and others to public hospitals.

The fact that some patients give financial gifts to voluntary organizations in the hospitals raised the possibility that those who donate receive preferred treatment, the comptroller said.

Even though the ministry issued an advisory that patients may not donate during hospitalization, the practice continues, Lindenstrauss said.

In addition, the ministry has failed to prevent these donating organizations from paying the salaries of some hospital staffers. They were permitted only to finance the work of researchers, the comptroller said.

Flying ambulance services have been intermittent and not equitable in all regions, Lindenstrauss said. Strict criteria and uniform standards for medical personnel and companies that provide the services must be established, he said.

Although the ministry established a team to promote “Healthy Israel 2020,” not enough is being done to ensure proper nutrition in schools and the IDF, the comptroller charged. The ministry does not monitor the obesity epidemic sufficiently, he added, and the government must discourage food companies from producing and selling food that is damaging to health.

Under the report’s section on the elderly, the comptroller said the inadequate supply of services for end-of-life palliative care at home was due to the severe shortage of medical institutions for this purpose. In addition, too little information is provided to families on what they are entitled to receive to care for their loved one at home.

The comptroller found that polypharmacy among the elderly – a system by which patients take a variety of different medications – is wasteful, often ineffective and dangerous.

The ministry must take specific action to deal with the phenomenon, he said.

The ministry’s supervision of the Council for Animal Experimentation – established in 1994 to protect animal rights while making in-vivo testing of animals to improve patients’ medical treatment – needs to be reorganized to reduce the number of superfluous animal experiments, the comptroller said.

More transparency in experiments is needed, he concluded.

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