WHO director Dr. Margaret Chan_311.
(photo credit: WHO)
After rapidly firing questions at local senior Health Ministry officials about
hospital occupancy rates, physician and nurse ratios per 1,000 residents and the
level of private expenditure on healthcare, World Health Organization
secretary-general Dr. Margaret Chan concluded on Monday: “Keep up the good
Chan, an expert in infectious diseases, displayed a high level of
expertise in the quantitative measurement of health systems during her 90-minute
visit to the ministry – and considerably higher English-language proficiency
than many of the Israeli experts she met.
A native of the People’s
Republic of China, she studied medicine at Canada’s University of Western
Ontario before joining the Hong Kong health department in 1978 and the UN
organization in 2003.
Chan is the first WHO secretary- general ever to
visit Israel, which is now part of its European Region rather than its Eastern
Mediterranean Region – due to the hostility of its neighbors.
director-general Prof. Ronni Gamzu specified that, “We consider ourselves
in-between regions. We [have much in common with the Europeans, but we are
locally and geographically in the Middle East, so we do our best to contribute
to the health of this region.”
Gamzu and associate director- general Dr.
Boaz Lev, who presented a recent film on the history of the country’s health
system since the mid-19th century, appeared both surprised and pleased by Chan’s
in-depth queries and her constant notetaking.
The WHO chief was taken
aback by Israel’s figures of 98 percent to 130% hospital occupancy – which
increases in winter.
“This is not good – a revolving door,” she
“The number of beds is controlled by the government, both public
and private,” Gamzu – a former hospital director – explained. The average
hospital stay here is less than four days – a record low for the OECD of which
Israel is a member.
“It’s an efficient, but deficient, system,” said Lev,
a former ministry director-general himself.
“We never have enough,” he
said, nodding his head when Chan said she was sure that the Israeli population
had high expectations and demands for top-notch healthcare.
patient aspires to Rolls Royce treatment, but it’s not sustainable,” she
When Chan suggested more community healthcare to reduce the burden
on the hospitals, Lev said that was “exactly what we are aiming at – more
community care and emedicine, but we still need more infrastructure and hospital
beds, we think nurses can be specialists dealing with chronic diseases in
Chan congratulated the health system for controlling expenses
and planning an increase in physicians and nurses, after learning that many
medical professionals who arrived during the 1990s immigrant wave from the
former Soviet Union union were reaching retirement age.
officials said they are looking at ways of stretching professional care by
recognizing that physician’s assistants and nurse practitioners can take over
some of the tasks of doctors and nurses without lowering medical
When the ministry official hinted that the Treasury is the
main force that limits the health system, Chan noted: “It is true all over the
Health and finance ministers really don’t talk to each
There is a disconnect. The health minister asks for more money and
the finance minister says there is no more. You live in two worlds. But the WHO
organized four meetings of national health and finance ministers and after they
started talking, I could see that the Treasury people realized that health is
not a bottomless hole, but an investment.”
When Chan noted that in
Africa, the average health minister “lasts for a year or two because their
political systems do not have stability” and that it was good that Israeli
health ministers last longer and are able to promote long-term planning, the
They did not tell her that except for the four-year-term
of the previous (deputy) health minister, Israel has had 16 health ministers in
the past 28 years.
After hearing that 38% of medical costs are paid for
outof- pocket by the taxpayer and that the state’s contribution to healthcare
has been declining over the last two decades, Chan said this could not continue
“Almost 40% of Israelis buy private insurance, in addition to the 75% who buy
supplementary health insurance through their public health fund. It’s a
challenge to us to combat that,” said the official.
“Make sure you don’t
go the way of the US,” suggested the WHO chief.