Israelis needing to see medical specialists in the community often have to wait an inordinate amount of time - up to three months - according to a first-of-its-kind report issued by Physicians for Human Rights-Israel (PHR) released for publication on Thursday morning. The authors found that there is a long queue for specialists not only in the periphery, but in the main cities as well. PHR criticized the Health Ministry for "failing to supervise" services and the health funds for allowing "huge gaps in waiting times" among the various districts. The study is based on data provided by three of the four health funds - Clalit Health Services, Maccabi Health Services and Kupat Holim Meuhedet - at the request of PHR. The fourth and smallest public health insurer, Kupat Holim Leumit, claimed it could not supply any data because Leumit itself did "not have data about queues for specialists according to specialties and districts that include all fund members, and we have no ability to collect such data using the existing systems." The amount of time considered reasonable for seeing a specialist was set by PHR as four weeks. The longest wait was for a gastroenterologist - 100 days for Clalit members in the center of the country, compared to only 18 days for health fund members in Haifa. Next was an 88-day wait for a rheumatologist in the southern district of Maccabi, compared to a national average of 34 days. In general, the longest and most "unreasonable" waits were in Clalit and, surprisingly, Maccabi, which is widely regarded as the "best" public health fund. Meuhedet, the third-largest health fund, was found to have the shortest waiting times in all the geographical areas and specialties. There were big differences in waits within the same health fund, with 36 days in the queue for Clalit members in the south and only 10 days in Haifa. A health fund may have enough experts in a specific specialty, but they may not be well distributed around the country. Shulamit Avni, head of PHR's residents department, called on the ministry to fill its obligations as a regulator and take immediate measures to find a temporary solution, followed by a long-term solution. Rahel Peretz of PHR's Beersheba group urged the health funds to allocate money among the districts so that, for example, residents of Beersheba would be able to see a specialist in a reasonable amount of time. Asked to comment, the ministry spokeswoman told The Jerusalem Post that according to the National Health Insurance Law of 1994, doctors must be available within a reasonable distance and within a reasonable time. She maintained that a JDC-Brookdale-Myers Institute survey on waiting times - apparently based on subjective reports by health fund members asked to remember how long they waited to see specialists - showed waiting times for health fund specialists were "reasonable." The ministry added that Israelis tended to consult with specialists more often than people in Western countries, where patients depended more on the general practitioner or family physician. If someone has an urgent need for specialist consultation, he can go to a hospital emergency room and be hospitalized as needed, said the ministry spokeswoman. She added that it was "complicated" to compare waiting times, due to demand for specific specialists, health fund agreements with independent doctors, and the difficulty of getting specialists to live and work in the country's peripheral areas, among other things. Clalit commented that it was constantly working to shorten queues and that its target was a maximum 14-day wait for doctors in five major specialties - orthopedics, gynecology, dermatology, ophthalmology and ear-nose-and-throat. When members had an urgent problem, they were able to be seen earlier, it said. There are also urgent medical care centers that patients can go to in emergencies, it added. It also maintained that systems used by the health funds to measure waiting times were not uniform, so the results could not easily be compared. Maccabi responded that it welcomed the comparison, although it was not certain that the various funds provided data based on the same methodology. It conceded that it was weaker in the south and was monitoring itself regularly and taking initiatives such as providing mobile medical services to various parts of the country. Meuhedet was pleased in general but added that some specialty clinics were hard to fill because there were shortages of doctors in these fields.