“The future of the Hadassah Medical Organization is in the hands of its 6,000 employees and hundreds of creditors,” HMO director-general Avigdor Kaplan said on Friday. The organization on Tuesday is to vote on an agreement reached close to midnight Thursday between HMO and the government.
Kaplan, a businessman and former head of Clal Insurance who took over a desperate HMO a year ago, told The Jerusalem Post he could not say he was optimistic or pessimistic about the vote, which will be decided by a simple majority of the employees and creditors rather than giving veto power to any of the workers unions.
No one is enthusiastic about the agreement, as it is painful to carry out, but it will mean the HMO’s debts can be wiped out, the creditors will be paid off, and the two Hadassah medical centers in Jerusalem will be able to work hard to restore their previous high status, said Kaplan, who presented the agreement to the Jerusalem District Court.
Dr. Leonid Eidelman, chairman of the Israel Medical Association that represents most of the country’s public doctors, said his legal and medical experts will study the agreement and decide by Tuesday whether to recommend its acceptance to HMO doctors.
“We read the agreement and we are still studying it. We regret that there are significant gaps, subjects that weren’t raised at all in the negotiations [but that are in the proposal], such as closing psychiatric beds, shutting down the osteoporosis unit, the dismissals of physicians and more. As is, we cannot accept it,” the IMA head said. “It is clear that without the consent of the doctors, there can be no recovery agreement for HMO.”
Eidelman said that on the plus side, important issues were resolved. These included strengthening doctors’ malpractice insurance; preserving the principles of the agreement between the state and the IMA that ended the major strike in 2011; acceptance of the principle that NIS 300 million to NIS 500m. taken from Hadassah doctors will be returned; the principle of academic staffs in HMO’s medical faculty will be protected; and the principle that HMO doctors will not have to give grants but only loans to support the hospitals financially has been kept.
Eidelman called on the court-appointed trustees of Hadassah to “alter the agreement by Tuesday and bridge over the gaps so the IMA can recommend that the doctors vote for it. We have only a few precious days for improvements to be made that would prevent the dismantling of this vital and exquisite institution called Hadassah.”
Kaplan said the agreement presented to the court, which has been approved by all sides except for the doctors and creditors (who include HMO employees), is “balanced. No one is really enthusiastic, but look at the alternative. Every side will contribute significantly to cover the deficit.
The administrative and maintenance workers have contributed; the nurses, who did not receive excess benefits and of which there is already a shortage, will have only a minimal burden on them. The government is helping significantly by giving hundreds of millions of shekels in onetime grants and over a period of time.”
The HMO director-general added that the Hadassah Women’s Zionist Organization of America, which owns HMO, will provide NIS 19m. per year over seven years (this is the same financial support it has given annually for several years), plus a $25m. onetime grant. In addition, the 19-story, $360m. hospitalization tower on the Ein Kerem campus, which opened in March 2012 but which has not yet been fully occupied, will be in two or three months, except for a few facilities that will have to wait to move.
Internal medicine departments, intensive care units and surgery theaters will be housed in the tower rather in the old facilities in Ein Kerem.
The Hadassah University Medical Center on Mount Scopus will continue to function. HWZOA will transfer a number of its Jerusalem properties – land and real estate – to the state, for which it will pay NIS 150m. This money will be transferred to HMO to eliminate the debt.
Among the HWZOA assets will be the “Little Hadassah” clinic, rented to other interests, in the capital’s Kiryat Hayovel neighborhood. The state will decide what to do with it. Senior doctors who provide private medical services (Sharap) will hand over 30 percent of their fees to HMO, an increase from the past.
Thirty senior Hadassah physicians will be dismissed or go on early pension, Kaplan said. “They are doctors we can manage without. Another 275 administrative and maintenance workers and paraprofessionals will be fired and get compensation or go on pension. Despite this, HMO will function well. What we have to do now is bring back the customers we had before. If the agreement is not approved on Tuesday, the matter will have to return to the district court, but I really hope it is approved,” he said.
Although some surgical theater nurses did leave HMO recently because of bonuses offered by another hospital, Kaplan said he had heard that “some of them say they want to come back. We are making efforts to persuade doctors and nurses not to leave. Hadassah is a very good workplace,” even though paychecks arrived late for months and have been reduced.
Kaplan, who is in his 70s, said he was “not sorry” that he took the job.
“I saw it as a mission. I will continue to do it as long as I see a chance to change things for the better. If not, I will not stick to my chair. I think I can continue to contribute; this past year has been an impossible situation.”
The HMO financial crisis, which has been going on for several years but was ignored until the beginning of 2014 by the government and others, should have been resolved a long time ago, said Kaplan, “so the damage to HMO would not have been severe.
All sides should have been willing to reach an agreement, because the longer it takes to do this, the more expensive it becomes.”
Kaplan was unwilling to comment on the involvement of Prime Minister Binyamin Netanyahu, Finance Minister Yair Lapid and Health Minister Yael German, all of whom have been criticized during the negotiations.
“I will not criticize,” he said.
But he did praise Jerusalem Mayor Nir Barkat for “doing excellent work to bridge the gaps behind the scenes.”
Meanwhile, the Treasury said that the agreement reached will significantly change the corporate management that existed until now at HMO. The chairman of the board, the director-general and the financial officer will be appointed, and their terms in office will be renewed, only after approval by the government.
Seven of the nine board members will be Israelis, with only two representatives of HWZOA, and four of the Israelis will be public representatives, the Treasury said.
The board will meet once a month in Israel and will have significant authority. All major decisions of the hospitals will have to be approved by the board; until now, HWZOA decided nearly everything.