Relief and hope expressed as long doctors’ dispute ends

Following 158 days of strikes, 9 days of negotiations, two sides agree on nine-year accord; PM: Negotiations proved real change possible.

REPRESENTATIVES OF the IMA and Treasury sign an agreement (photo credit: Assaf Shilo/Israel Sun)
REPRESENTATIVES OF the IMA and Treasury sign an agreement
(photo credit: Assaf Shilo/Israel Sun)
After a 158-day labor dispute that severely disrupted the health system – especially its hospitals – officials of the Israel Medical Association and the Treasury signed a new accord in Tel Aviv on Thursday evening aimed at making significant improvements in public medicine over the next eight years.
The nine-year agreement, during which no doctors’ strikes will be permitted, is retroactive for a year.
Sanctions to continue during mediation of doctors' dispute
Treasury wage chief Ilan Levin, who also represented heads of other doctors’ employers such as the Hadassah Medical Organization, Shaare Zedek Medical Center and Laniado Medical Center at the signing ceremony, said the accord “will bring about an improvement in the activity of the public health system while preserving the wage framework in the economy.”
Prime Minister Binyamin Netanyahu, formally health minister, praised the agreement, saying it will change the “world order” of medicine in Israel, and that it is good for doctors, the citizens and the periphery.
“The results of the negotiations proved that it is possible to bring about real and responsible change without breaking the budget and shaking up the economy,” Netanyahu said in a statement.
He said that the society’s “robustness is an integral part of the country’s national strength and is a high priority for this government.”
Finance Minister Yuval Steinitz called the agreement “an historic accord... it contributes significantly to improving the medical system, especially in the periphery...
The social strength, which is an inseparable part of national strength, has high priority.”
Deputy Finance Minister Yitzhak Cohen said the achievement was “unprecedented given the many difficulties encountered by the employers as a result of the undermining of the IMA’s status [by medical residents].”
“[The importance] is not only the agreement, but also a genuine change in the activity of the country’s public health system and the way the doctor will work. The accord is meant first and foremost to improve things for the patients.”
Treasury wage chief Levin also said that the final deal was based on the principle: “Give and you’ll get. The initiation of the time clock, as agreed, in addition to shift work by medical specialists and differential pay scales will make it possible to give better service while reducing the burden on the medical residents.”
The two sides were pulled together by Professor Yitzhak Peterburg, a former head of Clalit Health Services, who served as a mediator for over a week of intensive talks.
These include an additional NIS 2.5 billion to be spent on salaries, incentives and other benefits to the physicians, plus an additional 11 percent on incentive pay for working in the periphery and night and weekend shifts, grants, overtime and social benefits.
The doctors will receive an immediate 20% increase, while 70% of the cost of the agreement would be allocated over the next three years, with a mechanism to help protect the value of increases against inflation. Average doctors’ wages will increase by 49%, with the base pay to rise by 32% to which extra benefits would be added.
Doctors who work in fields in need of manpower will get significant increases, as will physicians working in the periphery. Residents and other young physicians will also get major boosts in salaries. In addition, the government has already committed itself to add 1,000 doctor slots to the system. Young physicians will do fewer shifts per month, and pay will be calculated according to a five-day, rather than the existing six-day week, with overtime. Senior physicians will work shifts in the hospitals until 11 p.m. a few times a month, rather than being on call from home.
Although over 1,000 residents and dozens of specialists signed and deposited letters of resignation almost three weeks ago, that would come into effect a week from now, it seems that despite a grinding of teeth, most of them will ask to take them back. Dozens of residents canceled their resignations even before the accord was signed, after they read the details in fine print.

The reason for the residents’ consent is that they have much to gain from the agreement, they do not want to leave their profession and the voluntary organization they elected to speak for them has no legal stature in the courts; only the IMA does.
The Health Ministry said in a statement prepared for release after the signing that the agreement “constitutes the greatest achievement in public medicine since the National Health Insurance Law [was passed in 1994 and took effect in 1995].
It is a more comprehensive and beneficial document than any other that has been signed in the past – even during the arbitration of the previous wage agreement and even in previous agreements under the aegis of the National Labor Court.”
The ministry added that the accord was signed in accordance with the professional views of Deputy Health Minister Ya’acov Litzman, “who praised both the IMA and the Treasury for their intensive discussions and good judgment,” and thanked Peterburg for his efforts.
Kadima MK Rachel Adatto, head of the Knesset Health Lobby, said that “where the government failed, the doctors succeeded. The IMA had no choice but to take on the role of the government and work to save the public-health system, which has been in a state of sickness for years. The IMA has struggled for and reached important achievements from which the health consumer will gain in the short and long term.”
Adatto, a physician and lawyer, said it was unfortunate that the government “was stubborn and left almost every possible stumbling block before the doctors, and thus dragged the health system into the longest strike in its history.”
“On the opposite side, the doctors stood and did not abandon for a moment their responsibility towards the public...
At least one can have consolation from the fact that the Israeli citizen is in the hands of an responsible adult – the physician.”

Herb Keinon contributed to this report.