Ministers launch reform of psychiatric care

Ministers in the social-economic cabinet approved proposals for psychiatric reform on Tuesday. The cabinet, headed by Finance Minister Yaakov Neeman, authorized the completion of action on the controversial proposals, which were presented by Deputy Health Minister Ya’acov Litzman (United Torah Judaism).

The reform, which was not sent to the Knesset, has been 17 years in the making by several health ministers, and will transfer responsibility for psychiatric treatment from the ministry to the four public health funds. The additional cost of providing these services – beyond what the ministry spent – is NIS 300 million a year, with the total state expenditure set at NIS 1.5 billion.

Litzman said the reform is an accomplishment that will improve the quality of treatment of psychiatric conditions.

“We are making history in the health system today in a very important and sensitive field after many years of delays. The reforms reflect the understanding that body and mind are linked,” he said.

The 1994 National Health Insurance Law intended to put psychiatry and geriatric care in the basket of health services provided by the health funds, but only general medical care have been fully included so far.

The reform is expected to minimize the stigma of mental illness, as patients will go to their health provider for treatment just as they would for any medical condition. Agreement was reached in the government, the health funds and various professional organizations.

To give the insurers time to prepare, it was decided that the health funds will, from now on, receive state financing and offer psychiatric treatment gradually until responsibility for it is formally transferred to the health funds in July 2015.

But not everybody was happy with the changes. Hadash MK Dov Henin attacked the reform, saying it was improper that the government should bypass the Knesset by issuing orders. The MK, who chairs the joint committee for environment and health, said this body had held numerous sessions on the government bill to “privatize the psychiatric system by transferring it to the health funds. We showed the many shortcomings of the bill, which allows the government to shed responsibility for treatment and supporting the mentally ill.”

He continued that over the years, the government “forced the mental health system to undergo a severe diet, a well-known technique to create a crisis so services can be privatized.

It even reduced funding for the law for rehabilitation of the mentally disabled in the community, an impressive legislative and social achievement of my predecessor, former MK Tamar Gozansky,” Henin said.

“Instead of using the conventional legislative process, the government has taken unilateral action to force the reform on the health system and the public.
This is another example how this government is fighting society and destroying democracy.”

He asked Knesset Speaker Reuven Rivlin (Likud) and the Knesset legal adviser to investigate whether the procedure was legal.

The union of government workers in the social sciences and humanities, which represents public psychologists working in mental health services, said Litzman had “kidnapped” psychiatric services. It noted that Litzman had been opposed to the reform for years but then changed his mind and make the change before the elections using a state order.

The union claimed that existing mental health services will be limited and some completely cancelled. In recent years, budgets and manpower have been reduced to make the service ripe for privatization.

Kadima MK Rachel Adatto, who is a physician, said it was a scandal that the Knesset was not allowed to vote on the reform.

“It is divide and rule. The process must include an open discussion with all the professional bodies involved,” she said.

“The weakest sectors in the society are involved, thus the debate must be fully transparent, without such a shortcut. The condition of patients and their families who have waited a long time for reform will worsen.”