The Public Forum for the Basket of Health Services voiced severe criticism Tuesday of the Health Ministry and the way its official Basket of Health Services Committee makes its decisions. The forum, appointed by the Israel Medical Association, chaired by former Supreme Court justice Dalia Dorner and comprised of leading doctors, academics, medical ethicists and legal experts, concluded at its final meeting that the updating of the basket must be significantly reformed. The forum said the way the process of adding new drugs and medical technologies supplied by the health funds at state subsidy violates the principles of the National Health Insurance Law and the Budget Law. As a result, "public health is damaged. In the long run, this is liable to cause harm to the level of medical care and Israel's health system, which has enjoyed the reputation of being one of the best in the world," the group said in its 24-page final report. The members recommended that the official basket committee meet throughout the year and not only during the last few months of the year, as the decision on what drugs to add always drags on beyond December 31, meaning that patients have to wait to receive the medications. The committee has not yet released its list of priorities for 2008, which is due to be worth NIS 450 million. The transfer of funds by the Treasury to the health funds for purchase of medications is "not run according to the principles of public budgeting," the forum charged, and the amount the health funds receive for the drugs and actually spend on members is not identical. The forum urged that an "exceptions committee" be set up to handle appeals from health fund members who are said not to meet the criteria for drugs they need, and that extra funding be made available beyond that allocated for the basket to deal with the needs of individual cases. In addition, the forum recommended that the power of the Health Ministry's Ombudsman of the Basket of Health Services should be strengthened so that the office can force the health funds to supply medications to patients it thinks should get them according to the law. The Health Ministry's "long delays" in approving medications for use in Israel (whether they are added to the basket or not) causes suffering, the forum said. The process should be sped up, and a solution must be found to add vital drugs to the basket even if they have not been registered yet by the ministry. In addition, "orphan drugs" (for diseases suffered by only a small number of patients) must be supplied more easily, with a special budget for those that meet criteria.