Unhealthy report

It was a dubious honor. The Health Ministry was the single most mentioned of all government offices in the latest State Comptroller’s Report. Over two-thirds of the report was devoted solely to this ministry’s many shortcomings. As The Jerusalem Post’s health and science editor Judy Siegel pointed out, never before in recent memory has a State Comptroller’s Report devoted so many pages of criticism to the Health Ministry.

Though it is difficult to generalize, many of the faults the state comptroller raised seem to have stemmed from the inherent conflict of interests in a ministry that runs state hospitals and clinics while at the same time being responsible for licensing and supervising both public and private healthcare. This conflict of interests creates untenable situations in which the ministry is tempted to work in direct contradiction to citizens’ express medical needs.

One glaring example was the serious shortage of rehabilitation facilities and personnel for elderly people who suffer strokes or hip fractures. As a result, many elderly people remain hospitalized in general hospitals’ internal medicine departments without proper treatment. This further exacerbates crowding in these departments. It also endangers the lives of these elderly patients by indefinitely postponing their desperately needed physiotherapy.

This quickest way to solve this bottleneck is to license more private institutions to engage in rehabilitation of the elderly. But since the state owns and runs geriatric hospitals, it has an interest in monopolizing the market and preventing private competition.

It should come as no surprise that though the demand for geriatric rehabilitation has grown as our population ages, the number of licensed beds in private facilities has actually declined.

Malpractice insurance is another area in which there is a clash between the public and private sectors. Average payments to patients and their families to settle malpractice suits have risen by 260 percent in the last six years, while insurance premiums paid by doctors’ employers – in particular, the state – rose by 30% between 2008 and 2010. Meanwhile, doctors employed at public institutions have their malpractice insurance funded by taxpayers’ money, and this insurance also covers them for the private work they do. As a result, taxpayers have to foot the bill for malpractice that took place in the private sector.

In yet another example of a conflict of interests, Sheba Medical Center director-general Prof. Zev Rotstein and Tel Aviv Sourasky Medical Center directorgeneral Prof. Gabi Barbash were found to be moonlighting for five or six different medical companies each. What happens when the interests of one of these private companies clashes with that of Sheba or Sourasky? And the state comptroller found other, lifethreatening faults, such as the poor treatment of those suffering from kidney problems (Israel has the highest mortality rate for kidney patients among 21 Western countries) and the ongoing territorial disputes between Magen David Adom and other volunteer first aid organizations that the Healthy Ministry has left unresolved.

UNFORTUNATELY THE ministry does not seem to be taking the state comptroller’s report seriously. Its written response was unsatisfactory, and the ministry refused to supply the Post with a broad overview to explain why it had been caught with so many shortcomings.

Once upon a time, a given in this Jewish state was that no Israeli citizen would be left without proper medical care. But in recent decades, we have drifted away from this ideal, as evidenced by the State Comptroller’s Report, and other crises that have rocked our health system. Leadership is needed to return the health system to its past greatness. And it just so happens that while Deputy Health Minister Ya’acov Litzman (United Torah Judaism) is responsible for the Health Ministry’s day-to-day management, Prime Minister Binyamin Netanyahu technically holds the Health portfolio and is, therefore, ultimately responsible for its faults. The time has come for Netanyahu to face up to this responsibility.