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