Steinitz on medical residents: Nobody is above the law

Nearly nine-hour Labor Court hearing ends without results, no injunctions against residents' resignation; judge expected to make ruling.

Finance Minister Yuval Steinitz 311 (photo credit: Courtesy: Ministry of Finance spokesperson)
Finance Minister Yuval Steinitz 311
(photo credit: Courtesy: Ministry of Finance spokesperson)
Finance Minister Yuval Steinitz slammed demands being made by medical residents on Tuesday, saying that by going against the collective agreement reached last month and resigning, the residents are not respecting the law.
"I have a lot of appreciation for doctors and residents," he said, "but nobody is above the law and nobody is above the norms of legal agreements," speaking with Army radio.
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"To come one month after the agreement and say that we as an internal group are not satisfied with the agreement, that's anarchy," Steinitz added.
The finance minister also outlined starting wages of medical residents. Before the recently-signed agreement, he said, residents' starting wages were NIS 17,000 per month before taxes. In the new agreement, residents in the center of the country start at over NIS 21,000 and those in the periphery start at nearly NIS 26,000 before taxes.
The National Labor Court did not issue an injunction Monday overnight against the mass resignation of hundreds of medical residents throughout the country as the nearly nine-hour hearing ended with residents' representatives refusing to return to the negotiating table with the Finance Ministry.
The court is expected to reach a decision on Tuesday whether it will order residents to remain in the country's hospitals.
Prime Minister Binyamin Netanyahu – who is formally the health minister but has for many months left the medical system crisis to others – swung into action on Monday night as hundreds of medical residents made good on their promise to resign their posts.
In an effort to soften their resolve to quit permanently and find other work in Israel or abroad, Netanyahu told Finance Ministry negotiators to raise by thousands of shekels the monthly salaries of residents who agreed to devote all their work time to the public sector.
Netanyahu also asked the medical residents to hold back on resignations for another two weeks to find suitable solutions to the crisis. A statement put out by his office said he expected the medical residents to “demonstrate responsibility.”
Hospital wards in the center of the country were largely empty, as patients who did not need urgent care were discharged and sent home, while the Health Ministry evacuated those who couldn’t get adequate treatment due to the shortage of manpower to medical centers in the periphery.
At the same time, the public tried to get medical assistance in outpatient community facilities, and senior specialists were forced to take blood samples and do other elementary tasks that they hadn’t performed for years, if not decades.
But both the ministries and the hospital directors – waiting for a ruling late Monday by National Labor Court President Nili Arad – knew that such filling- in measures could not be managed for more than a few days or a week.
The session began at 5 p.m., when Arad ordered those physicians who had submitted resignation letters to respond to the state’s request for tie-down orders. Arad also called on hospital directors-general to establish their case for damages caused by residents’ resignations.
Never in the history of the state’s health system had young doctors – adamant about getting improved pay and conditions – not shown up at their lifesaving hospital jobs en masse, threatened with permanent dismissal.
More than half of the residents who submitted their resignation letters over a month ago decided on Monday that enough was enough. And, like birds of prey taking advantage of a tragedy, representatives of some foreign medical centers reportedly sent emissaries to Israel to offer medical jobs abroad to the doctors who had resigned.
The struggle was a conflict in which neither side wanted to blink first. Netanyahu realized the seriousness of the situation when the first residents announced they would not show up. He called Finance Minister Yuval Steinitz and Deputy Health Minister Ya’acov Litzman for an emergency meeting.
The state’s lawyers initiated a National Labor Court session aimed at winning “tiedown orders” that would prevent resignations that would endanger public health.
Although doctors have the right to resign individually, a simultaneous abandonment of the wards clearly puts health and life at risk.
Hospitals in the periphery, which ordinarily suffer from inadequate amounts of funding and manpower, suddenly became “kings” as patients were helicoptered and driven in to have their services. Residents in the periphery – which has been neglected medically compared to the better-off center – will harvest considerable financial gain from the nine-year agreement signed at the end of August between the employers and the Israel Medical Association. As a result, none of them signed letters of resignation.
Steinitz called an unusual press conference at the Treasury in the morning, saying the framework of the labor agreement could not be broken, but that he and wage officials were looking for “creative ways to improve certain things within the already-written agreement with doctors, including additional money.”
He said he was disappointed that despite ongoing negotiations in recent days, the young doctors decided to walk out and burn their bridges.
“Hold discussions with us,” he said.
A clearly angry Steinitz attacked the residents’ decision, saying that physicians were among the highest 10 percent of wage-earners in the country and accusing them of “of un-Jewish and unethical” behavior.
“Most doctors with more than 20 years of experience earn more than the prime minister – and that’s not including private work,” Steinitz said.
Earlier, Deputy Finance Minister Yitzhak Cohen (Shas) said the mass resignations were proof that the residents had “lost all morality.”
“The residents spurned every offer made to them by the state. They chose to use threats and extortion, and they took the sick hostage in order to obtain more money. During all the meetings with their representatives, they made no connection between their demands and the strengthening of the public medical system,” Cohen charged.
“The only thing that interests them is money, money, and more money, and therefore responsibility for the damage done to the hospitals lies with those who chose to desert in order to extract more money. Woe are we if they are the face of the new generation in our country,” he said furiously.
Announcing the resignation at a press conference in the morning, residents’ representative Dr. Gabi Haran called on the labor court not to order them back to work. “We respect the court far more than Finance Ministry wages supervisor Ilan Levin does. Today we will ask the court not to issue an injunction or tiedown. It is not the doctors who led us to this depressing situation,” he added. “It is the state that needs to take responsibility for its actions.”
Another resident, Dr. Oren Feldman, called on Netanyahu to intervene, as only his involvement could resolve the issues.
Hundreds of residents did not show up for their morning shifts. The biggest gaps were 105 at Tel Aviv Sourasky Medical Center, 71 at Meir Medical Center in Kfar Saba, 77 at Haifa’s Rambam Medical Center, 42 at Sheba Medical Center in Tel Hashomer, 20 at Holon’s Wolfson Medical Center and seven at Assaf Harofeh Medical Center in Tzrifin, according to the Health Ministry’s “situation room” in Jerusalem.
Health Ministry director-general Prof. Ronni Gamzu visited seven of the affected hospitals.
He said that hospital emergency rooms, as the hub of urgent care, were functioning properly.
The ministry is the only one to decide how Magen David Adom ambulances will distribute those who need urgent care among the hospitals, he said.
But the ministry worried that activity in gynecology, pediatrics, orthopedics and surgical departments will be the first to suffer.
Sourasky Medical Center director- general Prof. Gabi Barbash, who years ago was director-general of the Health Ministry, said that he strongly sympathized with the residents but opposed their act of resigning and leaving the premises. He guessed that his hospital could manage for a day and up to a week, but could not predict beyond that.
“I really fear that the health system could get used to the situation today,” he said, referring to the shortage of medical manpower and resultant lower level of medicine.
Barbash added that the public medical system was endangered by the competing private hospitals funded by supplementary health insurance. The hospital director-general is known to be a longtime advocate of private medical services (sharap) in the public hospitals to supply them with more funds.
Meanwhile, Kadima MK Rachel Adatto, a gynecologist and medical administrator by training, said the government had delivered the health system to a state of “anarchy and decline” and the worst situation in its history.
Adatto, chairman of the health lobby in the Knesset, claimed that the government failed hopelessly in managing the health crisis and ignored the situation for six months.
“The handwriting was on the wall,” she said.
“Prime Minister Netanyahu, who is health minister, is personally responsible for the current situation.”
Jerusalem Post staff contributed to this report.