Failure to appoint health minister would harm services, experts warn

"Deputy minister won't have the political clout to fight for budgets."

By
March 30, 2009 21:16
4 minute read.
clalit hospital 88 224

clalit hospital 88 248. (photo credit: Ariel Jerozolimski)

 
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If Prime Minister-elect Binyamin Netanyahu does not appoint a health minister - but only a deputy minister from United Torah Judaism who cannot attend cabinet meetings unless specially invited - it will harm the level of health services in the country, according to disappointed health experts. Kadima MK Rahel Adatto - a gynecologist and lawyer who, if her party were in the coalition, would have gladly taken the post eschewed by prospective ministers - said on Monday that "it seems nobody in the Netanyahu government seems to want to be health minister. "There are always lots of problems, services to be provided and a shortage of money," she said. "The portfolio was hardly ever attractive. It deals with sick people lying in hospital corridors, cancer, life and death. Sadly, it has rarely gone to senior and powerful ministers. The weaker they are, the less money allocated for health by the Treasury." In addition, a health minister is not free to make political appointments, as doctors and other professionals fill most positions, experts say. Adatto said this attitude is unfortunate, as the Health Ministry is the country's third largest, with a NIS 24 billion budget and huge responsibilities and services that affect the entire population. "The public regard it as the third-most-important subject after security and education," she said. As the Ashkenazi haredi party United Torah Judaism avoids all ministerial posts, preferring to run things as deputy ministers or to chair important Knesset committees, the person chosen by Netanyahu will be absent at weekly cabinet meetings and not be a counterweight against the hugely powerful Finance Ministry, Adatto noted. Prof. Jonathan Halevy, director-general of Jerusalem's Shaare Zedek Medical Center for the last 21 years and former boss of Adatto, who was a deputy director-general of the hospital, said that the lack of a health minister "sadly demonstrates the meager amount of respect and interest given by politicians to health matters. They are deterred by the seemingly no-win situation" in providing and supervising health services, he added. Halevy himself does not dream of being health minister, as he has "no political aspirations, but some physicians in the system would regard it as a challenge. "There will always be sick and poor people, but for some reason, if you go into social welfare, you are a hero if you achieve something for such clients, while in health you deal with problems that seem to have no complete solution," Halevy told The Jerusalem Post. While some critics have expressed fear that a haredi deputy minister would make it more difficult to get a legal abortion or halt the small number of autopsies conducted today, Halevy said this was an exaggeration. The best health ministers in recent years, he suggested, were Nissim Dahan of Shas, Ehud Olmert, then of the Likud and Haim Ramon, then of the Labor Party. If the deputy health minister is a haredi MK, such as Moshe Gafni, Halevy said he would not be scared off, as Dahan was among the best. "He cared and went into every problem in depth," he said. But having no health minister for the first time in Israel's history is very disheartening, he concluded. Ben-Gurion University health economist Prof. Gabi Bin-Nun, who a year ago retired from the ministry after three decades as a deputy director-general in charge of health economics, said that the health system needs a minister "not for honor but for the political strength he offers. "He needs to make changes and progress, especially given the serious problems in the health funds and hospital infrastructure and the need for equity among patients. A minister must fight for health to be among the highest priorities." Prof. Avi Yisraeli, who has served as ministry director-general during the tenure of 83-year-old outgoing health minister Ya'acov Ben-Yizri of the defunct Gil Pensioners‚ Party, declined to discuss why politicians eschew the minister's post and what a deputy minister will mean. Yisraeli told the Post that the ministry's biggest achievement was getting a package of NIS 1.3 billion added to the basket of health services for the last three years instead of a smaller, one-year-at-a-time increment. "It is never enough, and an automatic two percent increase would have been preferable, but the package was an accomplishment," he said. "It provides the system with more stability. If it had been an annual increase, the system would probably have received much less due to the economic slump," said Yisraeli, who is likely to leave the ministry. Another achievement he listed was adding important vaccines to the basket, including free flu shots for all and the chicken pox vaccine for children. The establishment of comparative health measurements for the health funds and soon for the hospitals was also an important move towards minimizing differences in accessibility to health fund services around the country. The health system performed excellently during the Second Lebanon War and the war in Gaza, he stressed. In addition, Yisraeli said, because of higher discounts, fewer economically disadvantaged and elderly patients feel they must forgo the purchase of prescribed drugs for chronic illness. But he conceded that the enforcement of no-smoking laws has declined and that the ministry failed in overcoming Treasury opposition to increasing the number of hospital beds; did not manage to transfer responsibility for mental health to the health funds; was forced to transferred responsibility for school health services to a private body; was unable to get vitamin D and folic enrichment of basic foods and did not reduce obesity in the population.

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