Analysis: Naveh ineffective in pushing reforms

By
January 15, 2006 23:45
4 minute read.

 
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There probably won't be many in the Health Ministry and the medical system shedding a tear over the departure of Dan Naveh as health minister. Most of them, who have seen a rapid turnover of health ministers - about 13 in the last two decades - much preferred Naveh's predecessor, Shas's Nissim Dahan, who had to leave when Shas abandoned the coalition. Although he had no medical expertise and is the member of a party not known for its deep involvement in medical issues, Dahan showed great intelligence, commitment and single-minded dedication to the issues as minister, and he continued to fight for patients as an MK, having formed a health lobby in the Knesset. At least one political reporter speculates that Dahan could return as health minister if Shas is brought into a Kadima-led government after the elections, and the health establishment will rejoice. Unlike Dahan, Naveh had his political ambitions at the forefront, making large numbers of political appointments in his office that aroused the attention - and investigation - of the State Comptroller's Office. Dahan, a rabbi with social issues at the top of his priorities, wanted to go no further than the health minister's old-fashioned Jerusalem office in a San Simon quarter apartment building. Naveh, who owes his political career to MK Binyamin Netanyahu, who made him cabinet secretary when he was prime minister, feared crossing swords with his patron when Netanyahu was finance minister. When angered by the Treasury's pinchpenny attitudes towards health care, Naveh was never willing to attack Netanyahu even indirectly; instead, he criticized "the Treasury boys" - senior budget division officials who recommend priorities and allocations to the minister. Naveh, however, did devote a lot of energy to the effort to promote organ donations, although the campaign did not result in significant increases in the willingness of Israelis to register as potential donors. In general, he devoted a large amount of time to the ministry, and was always prepared to hear people out on subjects related to it. While Naveh did manage to force the Treasury to expand the basket of health services by NIS 350 million last year, he was too weak to persuade the Finance Ministry "boys" to increase the basket automatically each year by, say, two percent, which would permanently make possible the inclusion of many more lifesaving medical technologies. He was also unsuccessful in bringing about a transfer of psychiatric care from the ministry, where services were inadequate, to the health funds. He boasted about preventing the Treasury-threatened closings of various general, psychiatric and geriatric hospitals, but it seems likely that the Treasury itself realized these plans were impractical due to the shrinking of per-capita hospital facilities and never really intended to close them down. Naveh also failed to bring about the turning of government hospitals, which the Health Ministry owns, into non-profit government corporations that would be only supervised by the ministry; the elimination of this conflict of interest has been demanded by numerous state commissions and committees but never implemented. Perhaps Naveh's greatest public health failure has been his refusal to take the initiative to reduce smoking by government-initiative legislation. The smoking rate and violation of no-smoking regulations could fall drastically if owners of premises where the laws are broken were fined painfully - and if enforcement of the laws were privatized rather than left in hands of apathetic municipalities and their inspectors. Coming under pressure from the Treasury that demanded reductions in the costs of over-the-counter drugs and from entrepreneurs, Naveh embraced a "reform" - against the recommendations of Health Ministry professionals - to allow the sale of numerous over-the-counter drugs at petrol stations and other outlets where a pharmacist is not available. These outlets did not really want to sell pain relievers and nose drops, but rather other products. The minister claimed this competition would lower prices, but in fact, the cost of OTCs in these outlets has risen by 25 percent, and most people still prefer to buy them at pharmacies - from open shelves or directly from the pharmacist who can easily be consulted about dosages and contraindications.

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