Resources for health system like ‘water in the desert’, more is needed

Top physicians expressed support for the government’s plan to strengthen the Israeli health system while stressing its bad conditions and highlighting how much more help it needs.

ENTERING THE emergency room at Ichilov Hospital in Tel Aviv.   (photo credit: MARC ISRAEL SELLEM)
ENTERING THE emergency room at Ichilov Hospital in Tel Aviv.
(photo credit: MARC ISRAEL SELLEM)

Several top doctors welcomed the government plan to strengthen the country’s health system, but strongly denied reports about a secret deal between the government and medical centers that would provide additional funds conditional on lowering the standard of care to be able to accept more patients, or to avoid reporting to the public problems regarding the care for corona patients.

A statement from the Prime Minister’s Office also called the published rumors “false and unfounded.”

“No such thing was demanded from the hospital directors, neither officially nor implicitly, neither in writing nor orally,” the statement said. “The hospitals in Israel are headed by top managers and doctors, excellent and honest professionals who save lives every day. Any attempt to impeach their professional integrity belittles the best of our doctors, who are at the forefront of the fight against the virus day and night.”

Bennett announced a plan on Wednesday to strengthen the Israeli health system by providing an additional NIS 2.5 billion. According to the plan, 770 hospital beds and 800 new positions – doctors, nurses and paramedical staff – are set to be funded, as well as the training of 3,000 in the healthcare field. In addition, another 1,000 beds in geriatric hospitals and 1,400 beds in the home hospitalization network will be added to the system.

Israel Hayom claimed that the government asked the physicians to avoid reporting insufficient resources to treat patients, citing conversations with five hospital heads, some of whom were involved in negotiations with the government. No names were mentioned.

The Walla website reported that Bennett asked the doctors to meet certain standards in terms of the number of patients they can receive.

However, several top physicians expressed support for the government’s plan, while at the same time pointing out that the Israeli health system is in need of much more resources, considering that it already reached the pandemic understaffed and underfunded.

“On the one hand, the health system in Israel is excellent, with excellent human resources, but on the other hand, it is characterized by a continued lack of resources, and this was way before the pandemic hit” said Prof. Yaniv Sharar, deputy director of the Barzilai Medical Center in Ashkelon.

Among OECD countries, Israel is among those with the lowest numbers of physicians, nurses and hospital beds compared with the population, he noted.

“Even without COVID-19, even just considering the population growth and its older age, the system needed more resources, which have not arrived in years,” Sharar said, adding that the situation has impacted the quality of care.

“For this reason, adding resources to the system is like giving water to someone in the middle of the desert,” said Sharar. “This is a very important step toward making the health system stronger.”

Sharar also noted that the system needs much more than what has been promised so far, regardless of the pandemic.

“We need all these new physicians, nurses, staff, and hospital beds, but this is just the beginning,” he said. “There should be a program for this purpose over the next 10 years.”

There are currently 420 serious corona patients – at the peak of the pandemic they reached 1,200 - but Sharar said that the hospitals are full with other patients as well.

The doctor expressed hope that thanks to the vaccination campaign and other measures to contain the outbreak, serious morbidity will be reduced, but he said that the hospitals will always be ready to accept and treat patients as needed.

“It is out mission,” Sharar said. “Collapsing is not an option in my view. We went through the first three waves, we will do the same in the fourth.”

Asking to comment on the reports about an alleged agreement to remain silent in exchange for resources, Sharar said that “as you can see, I am very open to talk about all the problems we have. I am not aware of such a thing, I think it is just fake news.”

Dr. Zeev Feldman, chairman of the Israeli Medical Association and director of the department of pediatric neurosurgery at Sheba Medical Center, said the health system and authorities work with transparency.

“We are living in a democracy, and I cannot imagine that anyone will try to deny the right of hospital directors or any others to talk about issues of concern,” he said.

Feldman also said that hospitals will never turn down patients.

“Not many months ago we treated more than 1,200 corona patients,” he remarked. “Right now, we are gearing up for more patients and to give them the best treatment we can. If the number increased dramatically, we will need to decide what other medical system will need to be limited.”

Feldman said that it is important to make sure that the additional staff promised by the government will be added to the system permanently and not just temporarily.

“However, we will benefit from them mostly in the next wave, not this one, because after new staff is hired there is a learning curve before they become an effective member of the team,” he said.

According to Prof. Jonathan Halevy, president of Shaare Zedek Medical Center in Jerusalem, the plan rolled out is good news, provided that it is effectively executed.

“The prime minister’s offer is very generous, and it was a must even before Covid as the Israeli hospital system is in a state of insufficiency for a long time now,” he said. “However, the prime minister’s promise will be judged by its implementation. History proves that the Treasury does not always fulfill these promises.”

Several hospital heads and physicians expressed their support for the plan – even as just a limited solution – and denied reports about any backroom deal.

“Hospitals want to deal with the corona crisis while increasing the absorption capacity of the entire health system, health funds and hospitals, all for the benefit of the citizens,” said Prof. Ronni Gamzu, director of Ichilov Hospital and former corona commissioner, according to a statement by the hospital. Gamzu took part in the unveiling of the plan with Bennett.

“I reject the reports about a clause ‘resources in exchange for silence’,” he added. “It was never said, by the prime minister or by anybody else. It is a complete lie.”