After years of strongly opposing a 20-year-old proposal for reforming psychiatric care, Deputy Health Minister Ya’acov Litzman on Thursday changed his mind.
He told participants at a conference of the National Institute for Health Policy Research at the Dead Sea that he now favors transferring responsibility for providing psychiatric care from the ministry to the four public health funds – meaning the inclusion of mental health services in the basket of health services.
However, the deputy minister set several strict conditions that could mean years could pass before the the proposal is implemented.
He said he would ask for “continuity status” for the government bill for the reform that was presented to the previous Knesset, so it could pass in its second reading.
“There is no reason why treating psychiatric problems should be different from physical conditions,” said Litzman, who opposed the reform as chairman of the Knesset Finance Committee but did not voice his opinion formally in the past year and a quarter as deputy minister. However, despite pleas from experts inside and outside the ministry to push through the reform immediately, he took no action, saying he would study it.
A week ago, he told a conference on psychiatry that he would decide within two weeks, and on Wednesday night at the conference at the Royal Hotel in Ein Bokek, his incoming director-general, Dr. Ronni Gamzu, warmly embraced the reform.
“It is no secret that previously I opposed it strongly,” Litzman said. “I won’t hide it. I still have doubts. But what has existed so far is not good. There is a catastrophe in psychiatric services,” he said, referring to woefully inadequate ministry budgets for outpatient and inpatient care and long queues, especially for psychiatric treatment of children and teenagers.
“But the lack of certainty has caused chaos in psychiatric services. The alternative would be to spend years investigating it. I know there will be a lot of criticism of me for zigzaging in my views, but I don’t care,” the deputy minister said. “I hope it will succeed and will make every effort to make it succeed.”
His first condition was that patients in the periphery get suitable psychiatric care as well as those in the center of the country. “I want doctors to get more pay for working there,” Litzman said.
He added that he wanted specialists to work in hospitals on weekends and holidays. “I am a haredi, but I want experienced doctors to be on duty rather than recent medical school graduates.”
Another condition he set for passage of the reform was that psychiatric hospitals have to be renovated in a multi-year program.
His last condition was boosting rehabilitation of recovering
psychiatric patients. Litzman promised that existing psychiatric
clinics run by the government would not be closed. And for the first
time, psychiatric hospitals will get paid for taking care of patients
in their emergency rooms. But he added that ministry supervision of
implementation would be a must.
The inclusion of psychiatric treatment by the health funds in the
basket of health services was proposed by the Shoshana Netanyahu State
Judicial Commission to Reform the Health System 20 years ago, which led
to the 1994 National Health Insurance Law, which stipulated the same
thing. But psychiatric reform was never implemented.
As for his plan to provide subsidized dental treatments for children up
to the age of eight, which has been stymied by the High Court of
Justice, Litzman said it was only a “technical problem” of failing to
get approval in advance from a Knesset committee for taking NIS 65
million for it from the basket of medical technologies. The deputy
minister said he was “already in intensive negotiations” with MK Haim
Katz, chairman of the Labor, Social Affairs and Health Committee, about
getting approval for this.