(photo credit: Associated Press)
After three decades of neglect and acknowledging the influence of The Jerusalem
Post in goading it to take action, the Health Ministry has decided to allocate
funds for establishing four dedicated burns units around the country. They will
be at Rambam Medical Center in Haifa, Sheba Medical Center at Tel Hashomer and
Soroka University Medical Center in Beersheba for adult burns victims and
Schneider Children’s Medical Center in Petah Tikva for children.
director-general Dr. Ronni Gamzu says that it was the Post’s investigation of
the problem that “accelerated” its decision to
set up proper burns units.
“It caused me to rethink the matter,” said
Gamzu, who two weeks before sent a terse, non-committal response to the Post
list of a dozen questions about burns treatment in the hospitals.
the country’s leading burns experts, National Union MK and former director of
plastic surgery and burns at Hadassah University Medical Center, Prof. Arye
Eldad, maintains that the chance of a person who has suffered serious burns
surviving is half what it is in the US, Britain, Canada, France and other
countries with proper units.
The State Comptroller wrote a scathing
section of his 2000 report on burns units and demanded that the ministry take
action, but nothing has been done since then.
A dedicated burns unit has
not only special beds with air mattresses, well-trained specialist physicians
and nurses, but also its own round-the-clock anesthesiologist to relieve the
horrendous pain of patients, an operating theater, intensive-care unit, the best
equipment and a facility for washing patients to reduce the constant risk of
Gamzu said that in addition to the Post’s constant
questioning about the issue, the Carmel Forest disaster (in which 44 died, four
of them burn survivors who died after a week or two at Rambam) and the
near-disaster of the Israel Railways fire (in which over 100 suffered from smoke
inhalation but were not burned) induced the ministry to take
After speaking to the Post
, Gamzu immediately called Eldad to consult on the burns unit problem and asked him if
he would participate in planning a solution.
Eldad had told this reporter
earlier that he had “given up” on the ministry ever taking the necessary action.
Eldad said he would be happy to be a formal adviser but could not, as a busy MK,
devote all his time to it.
Sheba and Schneider will be the first to get
the state funds for upgrading their burns treatment, while Rambam and Soroka
would follow at a later stage. The ministry will coordinate its plans with
Clalit Health Services, which own both Soroka and Schneider; Sheba and Rambam
are owned and run by the ministry.
The experts that the Post
all noted that the hospitals have no incentive to invest in burns units, as
every patient treated is a financial loss. It costs NIS 400,000 to treat a burns
patient – even without the extra costs of skin grafts – while the hospital is
compensated by only NIS 120,000.
Gamzu says the diagnostic-related group
(DRG) payment that hospitals will receive from the health funds for treating
each burns victim will have to rise. The experts said that the DRG for burns
victims should be tripled.
“It will be a realistic rate,” promised the
director-general, who has held several meetings on the issue with the ministry’s
medical branch and hospital directors.
Eldad told this reporter that it
was “unfortunate” mostly poor people are the majority of serious burns victims.
They are children in large haredi and Beduin families with inadequate
supervision and exposure to heat and hot water, and elderly with open-fire
heating, as well as soldiers during war. But they can also be ordinary victims
of mass catastrophes, like the Carmel fire or the Israel Railways fire.