The Knesset Labor, Social Affairs and Health Committee will not approve the
proposed major reform in mental health services – first recommended two decades
ago and only recently endorsed by the Health Ministry – “if it is not good,”
said committee chairman MK Haim Katz (Likud) on Wednesday.
first proposed in 1990 by the Shoshana Netanyahu State Judicial Commission on
the Health System, would remove responsibility for psychiatric services from the
ministry and transfer it to the four public health funds. Thus, people with
psychiatric disorders would be regarded like any other patient with a physical
ailment and receive treatment from the basket of health services, rather than
from state services – when the ministry still has a budget for
The Israel Medical Association (IMA) and a selfstyled forum of
psychologists, psychiatrists and other professionals in the field have issued
strong statements against the proposal and were present at the committee
session. Meanwhile, ministry officials held a briefing to defend
Although Deputy Health Minister Ya’acov Litzman (UTJ) was strongly
opposed to the bill for various reasons when he was chairman of the Knesset
Finance Committee, a few months ago he came out saying he was in favor of it
now, even though he had some reservations.
His views were changed, he
said, by the realization that not making adjustments would only make the
situation worse. Many patients, especially children, have to wait months or even
more than a year to be received in a public psychiatric clinic.
director-general Dr. Ronni Gamzu warned opponents to the bill that “if the price
tag for implementing the reform becomes too expensive, the government will stop
He added that there are 100,000 Israelis with serious
mental health problems. One out of five residents will need mental health
treatment at some time in his lifetime.
“This bill underwent changes
since it was last discussed in 2007. It will get top priority from the ministry,
and we are working hard to make it possible,” Gamzu said. “[Now] the ministry
gives services, pays itself and supervises itself. This doesn’t work. The right
way is to separate between the service provider and the regulator, and that
means to give responsibility to the health funds.”
Asked by Katz what he
would still change in the bill, Gamzu said that “the existing rights of the
patient will not worsen. The ministry must carry out quality control, and the
reform would begin only when the four health funds feel comfortable with the
added budget for supplying the services.”
Katz said that his committee
would carefully examine all sections of the bill from all aspects to make sure
that it would be beneficial to the patients.
IMA chairman Dr. Leonid
Eidelman called on committee members not to allow the “defective bill” to be
passed, as “it is liable to come at the expense of patients and put extra
burdens on general practitioners, who would be trained to treat some emotional
He claimed that there would be quotas on the number of
sessions and treatments for psychiatric patients instead of according to need;
that the reform would “eat into” budgets for rehabilitation of patients in the
community; would lead to the closing of 50 existing state mental health clinics
around the country; that all patients would have to get a printed approval form
from their insurer before being allowed to get treatment; and that it would blur
the lines between the psychiatrists and general practitioners who would be
involved in patients’ care.
The IMA chairman also charged that patients’
medical files would have psychiatric care listed and that this would constitute
an invasion of privacy, since all physicians they consult would have access to
In addition, not enough money would be allocated by the
Treasury to cover the costs of psychiatric services, said Eidelman.
doctors’ association said it wanted “real mental health reform” without all of
Meanwhile, the “forum” of mental health professionals
opposed to the bill, headed by clinical psychologist Hanna Strum-Cohen, wrote a
letter to Prof. Mordechai Shani, a former ministry directorgeneral who is
volunteering to coordinate formulation of the bill, explaining that it strongly
opposes the current format.
She said she has headed the forum,
representing 1,000 people, for over 10 years. The bill, if passed, would “harm
the weakest elements in the population,” she wrote to Shani, who chairs the
Gertner Center for Health Policy Research of Tel Aviv University and Sheba
She said that even though the health funds are due to
implement the reform, “not all of them are in favor of it.”
has not explained why it did not wait to present the reform to the Knesset
committee until it had reached agreement with the bill’s
Kadima MK Rachel Adatto, a physician and lawyer by profession,
and MK Orly Levi-Abacassis of Israel Beiteinu said it was unfortunate that those
with eating disorders and those who had undergone sexual abuse would not be
included. Social workers at the session said that drug addicts would also not be
entitled to get psychiatric treatment.
Adatto added that while the
subject was very important, she did not think the Treasury would allocate enough
money for the bill’s implementation.