Health system praised for coping with war

Controversy arises over issue of second neurosurgery unit in North.

The war in Lebanon disclosed the need for the Health Ministry to allow another hospital in the North to offer neurosurgery, declared Prof. Shaul Shasha, director-general of Nahariya's Western Galilee Government Hospital, at a ministry-organized meeting on the medical implications of the conflict. Rambam Medical Center in Haifa is the only hospital in the North with a neurosurgery department, as the ministry has traditionally limited such facilities so surgeons would have enough cases to gain experience and achieve high success rates, as well as to save money on building additional facilities and hiring more staff. Shasha, who also serves as the ministry's northern district health officer, noted that if the neurosurgery unit at Rambam were to have been hit by a Hizbullah rocket or damaged in any other circumstances, there would be no facilities close enough to meet the needs of the wounded. The Jerusalem Post has learned that two-and-a-half weeks into the war in the North, neurosurgeons from around the country had a conference call to discuss whether there were inadequate brain surgery facilities and an inability to cope with head wounds. The conference call was mediated by Health Ministry associate director-general Dr. Boaz Lev, who did not voice his position. A senior neurosurgeon who took part in the conference call but did not want to be named said Monday that he and all his colleagues opposed opening a second neurosurgery unit in the North. "By then, there had been only six wounded who needed neurosurgery. This does not justify opening a new unit," he said. "If there aren't adequate volumes of patients, a new unit will not get highly qualified professionals. There are six neurosurgery units in the country, plus a very inadequate new one at Assaf Harofeh in Tzrifin that was a mistake to open; there are fewer per capita in other countries. Patients who need it can easily be helicoptered in minutes to a neurosurgery unit elsewhere in the country without any harm." He said he and his colleagues hoped the ministry would not bow to pressure and allow another neurosurgery department to open due to "reasons of prestige." The Monday meeting at Nahariya's hospital, attended by the heads of all relevant medical institutions and ministry officials, was the first of a series to look at how the health system functioned during the war. Ministry Director-General Prof. Avi Yisraeli heaped praise on the system, saying that all in all it did very well and that staff members remained at their posts despite the danger. "However, there are still many lessons that we can learn, and we intend to deal with all of these issues," he said. While many of the participants gave credit to hospitals, health funds and the ministry for their functioning during the conflict and for attending to the medical needs of the population when all were under rocket fire, there were some complaints about the lack of bomb-proof facilities in hospitals. There were also differences of opinion on whether all seriously hurt patients should have been transferred to Rambam Medical Center, which is a tertiary center with the highest-level trauma unit, or to other hospitals in the North or elsewhere. Yisraeli said that "all the points will be taken under consideration, and the ministry's executive will reach all the necessary conclusions to prepare the health system for future challenges."