Should Health Ministry probes of negligence be performed externally?

Families, ministry officials argue before Knesset panel.

(photo credit: MARC ISRAEL SELLEM)
Although some doctors accused of malpractice hide things they did and their fellow physicians may cover up for their friends, the Health Ministry’s public ombudsman argued that his office should not be transferred to an external body. Lev conceded that the issue was problematic, as doctors don’t want to incriminate themselves.
Speaking at a meeting of the Knesset State Control Committee on Thursday, Dr. Boaz Lev – a retired director-general and associate director-general of the ministry – said that a bill that would make the process more orderly will soon be presented in the Knesset.
A total of 14,000 complaints against doctors were filed in the past decade. Of these, 199 of the doctors were found guilty of improper conduct, and of those, 130 involved medical negligence. Only six doctors permanently lost their licenses to practice.
But arguing on the other side were families whose loved ones were harmed. They argued that an independent, exterior body should handle such investigations.
Committee chairwoman Karin Elharar said that the need for external investigations should be looked into as well as investigations inside the Health Ministry. “We will consider legislation if necessary,” she said.
The committee held a second discussion in two weeks of the case of Ofek Taub, an eight-yearold who sustained severe brain damage when doctors and other staff at Hadassah-University Medical Center, in Jerusalem’s Ein Kerem ignored prolonged warnings that an operating room (in which the boy was treated) had a carbon dioxide spigot that could be mistaken for the one for oxygen.
The boy’s father, Amiad Taub, said that “criminals with a medical degree” were protected by the system and their colleagues.”
He charged that doctors forged medical reports to avoid getting in trouble.
Dan Bental of the State Comptroller’s Office said that it published in 2012 a report on medical negligence. “It’s possible to save hundreds of millions of shekels for the health system, as 40% of the compensation paid goes to the court bureaucracy and not to the families. Little has been done since our report.
There is a list of what should be but has not been done.”
Lev said his office does not have professional investigatory powers. “We can only transfer our conclusions to disciplinary hearings, and the hospitals respond on what they have done to repair shortcomings that were discovered.” He admitted that the whole process takes a long time, even years, to adjudicate.
Doctors get warnings, reprimand, temporary suspension, but it is inadequate, continued Lev. “Sometimes we ask hospital directors purposely to halt the work of a doctor who endangers patients.”
However imperfect the current procedures, said Lev, taking the office outside the ministry “will lead to cover-ups. It will prevent rapid feedback into the system. The system should be headed by a physician who can understand this issue, the medical literature and the norms.
Otherwise it will look like a top engineer sitting at the head of the Bar Association.”
MK Yael German, a former health minister, said that while the ombudsman has made improvements in the last year, the office involving doctors should not investigate people who work in the same institution.
Aviva Milgelter, widow of Dr. Eli Milgelter who was a cardiologist at Hadassah-University Medical Center, told the MKs that he warned about many dangerous shortcomings there, “but the system swept them under the rug and caused him trouble. He was on duty when a case occurred six months after the Taub tragedy.
A baby arrived with a heart problem, but he [Dr. Milgelter] was not called by order of a doctor who was involved in the boy’s case. If they had informed him, my husband would have taken the baby to surgery, and he would now likely be alive. He also was not invited to testify at the investigatory committee.
He became an enemy of the system,” the widow said.
Elharar summed up that the health system can learn from other systems. “Perhaps we should consider a two-headed system, one in the ministry that investigates and considers how it can learn for the future, and an external system to look into individual complaints, letting the families speak out. We want people to feel that they face a truly neutral body.”