tipat halav 88.
(photo credit: (Jerusalem Post Archives) )
The Israel Medical Association petitioned the High Court of Justice on Sunday against the Finance and Health ministries decision to start a pilot project transferring responsibility for Tipat Halav (well-baby and family health) centers from the Health Ministry to the four health funds.
The IMA said such a transfer would endanger children's health by reducing immunization rates and wasting the vast experience of Tipat Halav doctors and nurses.
The IMA said the pilot program, due to start in Modi'in, Elad and a few other locations, violates the 1994 National Health Insurance Law, is regarded as disastrous by leading public health experts, and runs counter to public opinion.
IMA chairman Dr. Yoram Blachar said that with the government's gradual privatization of health services and reduction of funding for those that remain, the health funds already provide 20 percent of children with Tipat Halav services, but that most of the parents want them provided - for free - by the Health Ministry.
The municipalities of Jerusalem and Tel Aviv, rather than the Health Ministry, have historically supplied Tipat Halav services to local children. Jerusalem was to have been included in the Treasury's pilot program, but Mayor Uri Lupolianski said he wouldn't transfer responsibility to the health funds after a committee of experts recommended against the move. Public opinion was clearly against joining the program.
In their High Court petition, the IMA said that after failing to get the National Health Insurance Law changed to allow the transfer of the Tipat Halav programs, the Treasury has tried to sneak in the pilot program.
Blachar said the Finance Ministry had no proof that the transfer of responsibility to the health funds would save any money, and that governments around the world had concluded that governments, rather than private contractors, should provide well-baby and health promotion services to all, and for free.
The IMA asked the court to immediately issue a restraining order halting the pilot program and an intermediate order leaving the status quo in place until a final decision is made.
The IMA said Tipat Halav concept dates back 90 years ago, when the Hadassah Women's Zionist Organization of America brought public health nurses to perform examinations and to give health education, and a donkey cart to distribute milk to poor Jerusalem children. It has been praised by the World Health Organization and copied by several countries.
The IMA said it was concerned that sick children and healthy babies would be treated in the same places, posing a danger of infection to infants and toddlers who came for vaccinations, hearing tests, and to have their development monitored.
Since the health funds are forbidden to run a deficit, said Blachar, they would cut back on Tipat Halav services and fail to meet their commitments. For example, Kupat Holim Meuhedet committed itself to open a dedicated well-baby center in Modi'in, but instead it opened a facility inside its community clinic, which caters to sick people, he said. And Clalit Health Services in Bat Hefer near Hadera withdrew a commitment to provide Tipat Halav services to members of all the health funds, Blachar said.
The Treasury has allocated NIS 50 million to the pilot project, the IMA said, but there is no guarantee of additional money, and "no one has set criteria for success or failure of the pilot project."
The Health Ministry said on Sunday that it would "study the [IMA's] lawsuit." The ministry believes "that the quality of services provided by Tipat Halav centers has declined because the budgets and manpower slots have not been updated as the population and needs grew."
The ministry agreed to participate in the pilot project so that its budget would be covered by the health funds, leaving more money for the family health stations remaining under ministry ownership. "The pilot will be carried out under the supervision and control of the ministry's public health services and the Meyers-JDC-Brookdale Institute, the ministry spokeswoman said.