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German waiting for committee findings before regulating medical tourism
By JUDY SIEGEL-ITZKOVICH
16/12/2013
Three surgeons at TA Sourasky Medical Center reject accusations by Channel 2 of improper handling of foreign patients.
 
Health Minister Yael German, who has not yet regulated the matter of medical tourism so it would bring in income without coming at the expense of Israeli patients, is waiting until the subcommittee of a professional body she appointed months ago issue its recommendations on the controversial issue.

The subcommittee, headed by Hebrew University economist Prof. Eugene Kandel (an expert in financial intermediation and market microstructure), is due to present its proposals in two months.

Pnina Shalev, German’s personal spokeswoman, said on Monday that “medical tourism is now being investigated by a special subcommittee of the German committee, to strengthen the public health system.

“The subcommittee will present its conclusions within about two months and the recommendations will serve as the basis for the ministry’s policy on medical tourism in Israel.”

The issue heated up yet again on Monday night when Channel 2’s investigatory program Uvda (Fact) hosted by Ilana Dayan focused on three very-senior and highly respected surgeons at Tel Aviv Sourasky Medical Center.

Dayan, who sent a woman to the surgeons, plays the role of a medical tourist agent seeking operations for foreigners and videoed conversations with Prof. Zvi Ram, Prof. Shlomo Constantini and Prof. Yossi Paz.

The program claimed that the surgeons, who work for the municipal-government medical center, asked for thousands of dollars for private operations.

Ram is head of the hospital’s neurosurgery department; Constantini heads the pediatric neurosurgery department at Sourasky’s Dana Children’s Hospital; while Paz is a leading cardiothoracic surgeon at Sourasky.

Asked to comment, the Sourasky spokesman said in the name of director-general Prof.

Gabi Barbash that the three surgeons “have a worldwide reputation, are devoted, and respected, and give their lives – day and night – without limit of work hours, to saving the lives of their patients.”

Sourasky’s “position is clear, there must be complete separation between a private practice and services – including medical tourism – given in the hospital.

It is forbidden to take payment from patients for services – including operations – in our hospital. This has been made clear to agents of medical tourism,” the spokesman said, without saying that the three had violated any of these internal hospital rules.

“From the moment that the contents of the TV program were brought to the attention of Sourasky, we reiterated what is permitted and not permitted and took action to prevent improper behavior by employees involved in medical tourism,” the Sourasky spokesman said.

Profs. Constantini and Ram issued their own statement, unequivocally rejecting the claims made by Uvda.

“We are senior physicians, sought-out widely in the private sector and work day and night for our patients. Never have such claims been made against us. We ensure absolute separation between our private practices and our public hospital work, and never personally accept any payment as surgeons – including from tourists – for surgery carried out at Sourasky.”

Constantini and Ram continued, “tourists come to us – not via the hospital – because of our international reputations, which we earned. “They are our private patients, and they pay for the private assistance and treatment we give them. Even though they are completely private patients and we are able to operate on them in any private medical center we choose, such as Assuta, we refer some of them for surgery at Sourasky’s Ichilov Hospital so that it benefits financially from this income.

“Its income from such medical tourists totals tens of millions of shekels yearly, and contributes much to the level of public medicine and improvement of services given to Israeli citizens.”

The senior neurosurgeons said that all patients operated on at Ichilov, whether they are public or private, Israeli or foreign, enjoy the same high quality and availability.

“The treatment of tourists does not come at the expense of foreigners, and there is no basis for the claims of preferential treatment,” said Constantini and Ram.

“Medical tourism is a practice that began to develop in recent years, and it is a very important source of income to the hospitals.

No rules and principles have been set down [by the Health Ministry] for it.”

Paz said that a person who presented herself as an independent medical tourism agent wanted a Russian tourist to undergo bypass surgery. “It was made to me personally and not via the hospital. It took place at Sourasky, but at that time I was not on duty as a Sourasky surgeon.

As best as I can remember, I advised the agent for the operation to take place at Ichilov, which itself charges foreign tourists, and the money is meant to improve services to Israeli patients.

“To the best of my knowledge, for additional medical services to the private patient [and not the operation itself], I said I would be paid.”

Paz continued, “because the patient was abroad and had to come here, the operation was to be scheduled 10 days to two weeks after the request, which is the usual amount of time Israeli patients wait for surgery in our department.”

Outside medical experts noted that there has, for some time, been a dispute between health ministers and professional ministry and hospital administrators. The latter want to regulate medical tourism and set down the rules and boundaries, while the politicians, who value the high reputation leading Israeli physicians enjoy abroad, have not wanted to limit it publicly.
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