MDA, Hatzalah battle over the nation's health

Emergency response teams fighting in court over who should treat the injured and sick.

A UNITED HATZALAH ambucycle is seen with Jerusalem in the background (photo credit: SHIRA HERSHKOPF/UNITED HATZALAH)
A UNITED HATZALAH ambucycle is seen with Jerusalem in the background
A legal battle between Hatzalah and Magen David Adom (MDA) has heated up to full fury.
Both organizations are dedicated to saving lives in emergency situations, but in recent years they have feuded over standards and levels of cooperation, with the dispute finally boiling over into court.
An indefinite lack of resolution between the sides could negatively impact the country’s rescue response services, as the legal war cannot be divorced from the broader battle between the two organizations.
Hatzalah, whose Israeli chapter started in 2006, services all persons in need. Founded in the ultra-Orthodox community, it continues to have a majority of haredi volunteers.
The organization claims that its volunteers are sometimes closer to where emergencies happen than some MDA officials, since nearly all of its personnel are already in the field when they respond to emergencies. They say this means that they often get to endangered persons at least several minutes faster than MDA, and that this time-lag can mean the difference between life and death.
In Hatzalah’s narrative, MDA has acted consistently to obstruct their involvement out of a misguided sense of competition and wanting to maintain monopolistic power on providing emergency care.
It says that with thousands of volunteers, it is clearly the next largest emergency care organization after MDA, and that MDA needs to get over its monopolistic tendencies to focus only on saving lives. Furthermore, Hatzalah says that it is not seeking to replace MDA, but only to hand over a more stabilized situation to it in those cases where Hatzalah can arrive to the scene first.
In contrast, MDA notes that it has been the sole organization recognized by the state since 1952 for providing emergency care. If Hatzalah has grown to several thousand, MDA says that with its 24,000 personnel, there is no comparison between the two.
MDA’s narrative is that there is no competition between the sides because Hatzalah is only one of 24 groups that at most supplement the job that only MDA can provide and is legally empowered to provide.
It disputes the claims by Hatzalah, saying its speed in reaching emergencies is up to standard, and accuses senior Hatzalah leadership of defaming its name to gain various advantages.
The Health Ministry has also been dragged into the public argument at times.
On one hand, it has issued regulations requiring MDA to integrate Hatzalah into a cellphone application so that Hatzalah’s responders can quickly get information to respond to a crisis.
On the other hand, MDA said that the Health Ministry sent a letter to Hatzalah in December requiring them to cease operating a competing emergency line to MDA’s emergency line.
Hatzalah has complained that it had stopped operating its emergency phone line in the past, but that MDA only integrated some of its volunteers into the system over an extended period. Accordingly, Hatzalah said it reactivated its own phone line after it appeared that MDA would only integrate some of its volunteers, while refusing to provide information to other volunteers – sometimes leading to tragedies.
Moreover, Hatzalah said that the issue is being litigated before the Communications Ministry, which makes the final call, such that there is nothing improper with continuing to operate the line.
After MDA sued Hatzalah for defamation for NIS 2.3 million in December, Hatzalah responded in March by denying the defamation claims, counter-suing MDA for defamation and defending its accusations against MDA as true.
According to Hatzalah’s court pleadings, in 2018, Hatzalah volunteer EMT Ariel Fahima received an alert in Beersheba regarding a medical incident on Chaviva Reik Street. Fahima himself was on the street at the time. He followed protocol by calling the MDA dispatch center to obtain the exact address of the incident so he could get to the location as soon as possible to provide medical care.
Allegedly, the MDA dispatcher and her supervisor said they could not pass on the information regarding the incident because Fahima was still not connected to the Health Ministry’s application. Fahima begged the dispatchers to give him the information, telling them he was on the street where the incident was occurring, but they allegedly rejected his pleas.
Hatzalah claims that the dispatchers acted against the Health Ministry’s set protocols for providing all pertinent information regarding an emergency. It claims that until all of the volunteers from Hatzalah were added to the ministry’s application, MDA was required to provide information, including by telephone.
Hatzalah’s legal pleadings also say that MDA exaggerates its average response time as eight to nine minutes, whereas it says the average times are longer and can even reach more than 20 minutes in peripheral regions.
“For years now, Magen David Adom has refused to cooperate with United Hatzalah in a manner that has literally risked the lives of Israelis,” Hatzalah lawyers Amit Hadad, Noa Milstein and Yair Leshem, from the office of Hadad Roth and partners, said in a statement. “Due to their refusal to pass on information, United Hatzalah volunteers have been prevented, numerous times, from arriving in due time to a medical emergency and to save lives. Instead of dealing with the practical criticism... MDA has chosen to submit a fruitless lawsuit.”
MDA countered with a case where it claimed Hatzalah attacked it for arriving 25 minutes late to a scene where a baby died from having eaten sand, though in fact MDA arrived within four minutes of being called. Rather, MDA said that Hatzalah delayed calling it for 21 minutes.
Sidestepping the specifics of the timing, Hatzalah said that if MDA was regularly sending out all emergency information to all ambulances, including those of Hatzalah, an ambulance that was never called might have arrived early enough to save the baby’s life.
MDA also said that there was insufficient quality control among Hatzalah volunteers, and that it had examples where it had doubts about certain volunteers’ qualifications and about whether they were actually the closest responders.
More generally, MDA responded that it “completely rejects the spurious and baseless claims which were already rejected by the Health Ministry” in a January 9 report.
“Going to the heart of the matter, we refer the media to our answer [to Hatzalah’s legal claims] filed in court, which speak for themselves,” said MDA.
Hatzalah said that the Health Ministry had mostly been a neutral arbiter between the sides, but that following the recent appointment of Avraham Manaleh to run MDA, the policy seemed to have shifted to trying to help MDA wipe out Hatzalah.
On April 10, MDA filed a response to Hatzalah’s denial.
MDA’s denial to Hatzalah’s counter-suit is the next expected point in the case, followed eventually by a trial to settle the conflict with no end in sight. Will the government ministries allow this to continue, or will they come together to find a resolution?
There are already indications that this struggle could be the difference between life and death.

Tags mda Hatzalah