Nurses strike after failed negotiations with Finance Ministry on hospital overcrowding; court demands that the state produce relief plan

The breakdown of recent negotiations with the Finance Ministry on relieving the distressing state of Israel's congested hospitals has led the nurses union to announce that they will no longer admit new patients to internal medicine units once they have reached 100 percent capacity.

Bed shortages in Israel's hospitals continues to be a growing issue, leading to overcrowding and impeding hospital staff's ability to provide an acceptable standard of care to admitted patients.

An OECD survey of hospital beds places Israel almost last - ahead only of Mexico - with a ratio of 1.9 beds per 1,000 people. Some 90 of the state's hospitals have been reported to be operating above capacity.

Occupancy rates in the internal medicine departments at Ashkelon’s Barzilai Medical Center, which treat mostly the elderly and those with chronic diseases, have reached 200 percent. At Kaplan Medical Center in Rehovot, the internal medicine units are full and the emergency department is operating at 160% occupancy.

Pediatric wards at Wolfson Medical Center in Holon are at 200% capacity, and the pediatric emergency department is also full. At Petah Tikva’s Schneider Children’s Medical Center and Haifa’s Carmel Medical Center, all beds are full, and at Emek Medical Center in Afula, the departments are almost all at 200 percent capacity. The Health Ministry has denied the hospitals' requests to refuse new admissions but has allowed an increase in shifts with additional doctors and nurses.

Bed shortages are causing patients to be placed in corridors and other areas of the hospital not designated or properly equipped for patient care. These patients, many of whom are geriatric, are forced to receive medical care in places not conducive to privacy and confidentiality standards, and in areas not sufficiently weatherproofed for the winter.

The Israeli Medical Association (IMA) conjunctively petitioned the High Court of Justice on the state's failure to add hospital beds, seeking immediate relief of 100 extra beds in intensive care units and 500 additional beds in internal medicine units within the year. 

In response, the High Court has severely criticized the government for the hospital bed shortages and has instructed it to submit a plan for the distribution of more beds by the end of February. According to state representatives, the health and finance ministries have reached an agreement to add 960 beds to the country's hospitals over the next six years but refuse to say how these beds will be distributed among hospitals.

The IMA fears that most of these beds will be distributed to maternity and preemie wards, which are profitable due to payments from the National Insurance Institute. This would leave very few beds for the overcrowded intensive care and internal medicine wards.

The first day of the warning strike concludes

The first day of the warning strike (Tuesday 5^th April 2011) in hospitals and community health clinics has ended. 
  
During the day, staff at the IMA managed to maintain ongoing contact with the heads of committees in hospitals and HMOs, as well as with community physicians who were faced with questions and requests for clarifications. The public and patients turned to the IMA for information and assistance with troubleshooting. 
The IMA experienced excellent cooperation from the professional societies, doctors and public hospitals and despite the difficulties encountered during the strike, the justification for the doctors' struggle was recognized. 

Throughout the day, support teams visited various hospitals, including the Assaf Harofeh Medical Center, Shaare Zedek, Hadassah-Ein Kerem and Hadassah Mount Scopus. We have still not reached a solution to the disputes and yesterday (5.4) IMA representatives attended a negotiating session at the Ministry of Finance. Unfortunately, even this meeting ended without any progress; the Treasury and the employers repeated their offer to transfer the dispute to arbitration that would exclude several issues that are on the agenda of the IMA struggle.

The IMA repeated its position that it is not prepared to have arbitration with prior exclusions to acute issues such as private medical services and physician positions, and certainly not with a predefined cost framework, without giving flexibility to the arbitrator. In addition the IMA resents the arbitration proposal 8 months after the start of negotiations and after the Treasury stated its position that the previous arbitration agreement is invalid. 

Thousands of Doctors Attend Protest at Knesset

On Wednesday April 27^th approximately 2,500 physicians, medical students and advocates assembled in Jerusalem at the Wohl Rose Garden opposite the Knesset to protest the government's failure to effectively address Israel's collapsing public health system.

After reaching a stalemate in discussions with the Treasury, physicians staged what turned out to be the largest protest so far in the battle for higher wages and health care reform.

Present at the demonstration were the dean of one medical school, numerous chairmen of major hospital departments and many young doctors worried about the future of their profession. No senior Health Ministry officials were present.

Many of those who attended the demonstration wore white medical jackets printed with the Israeli Medical Association emblem on the front and "Save Our Public Health System" on the back.

Dr. Leonid Eidelman, chairman of the Israeli Medical Association, said that the rally was organized to "protest the lack of progress [in talks with the state] and is another attempt to move the wheels of negotiations forward and to find solutions to save the imploding public health system."

As of now, the IMA is negotiating on behalf of 17,000 doctors employed in governmental hospitals, the Clalait, Leumit and now Meuhedet HMOs, as well as the Jerusalem NGO-owned hospitals such as Bikur Holim, Shaare Zedek Medical Center, and Hadassah University Hospital.

Medical students from all four medical schools in the country have also taken up the cause, with around a thousand students who were driven from their various universities to the capital in order to protest. The students have declared a strike and classes were canceled for the day.

“The public health system is collapsing,” warned Dr Eidelman during the protest. “It is the time for us to be heard. The population is expanding and aging. We have the know-how, but the lack of resources has weakened our ability to treat our patients. It is harder and harder to persuade a young resident to study unattractive medical specialties.”

Opposition head MK Tzipi Livni said she had come to support a “struggle of which there is none more worthy... Over 7.5 million Israelis have the right to decent healthcare, and not two medical systems, one for the rich and one for the poor.”MK Livni accused the government of “failing in this task” and called on the demonstrators to “roll up your sleeves.” 

According to Kadima MK Rachel Adatto, a gynecologist and lawyer by training, “In a well-run state, this demonstration would be unnecessary. There are not enough doctors, and the healthcare system is run by Treasury bureaucrats who do not understand it.”  She openly called onPrime Minister Binyamin Netanyahu to sit with IMA and Treasury officials and not leave until a solution is found to this crisis.
To this date, all meetings between the IMA and the Finance Ministry have ended without an agreement.

Doctors set to strike over next two weeks as negotiations remain unsuccessful

Despite an ongoing series of sanctions and protests launched by the Israeli Medical Association six weeks ago, negotiations with the government on public health reform and increased wages for physicians remain unsuccessful.

In an Army Radio interview last week, Treasury wage chief Ilan Levin said that doctors were performing "murder" by endangering patients during strikes and sanctions. Following the incident, the IMA suspended all negotiations until an apology was issued. 

Levin has since apologized, stating that while he opposes the doctors' actions and demands, he has much appreciation for the work and contributions of doctors to society and their professional level, and that the use of the word "murder" was out of context and does not represent his views.

The IMA welcomed the apology, adding that if it had been issued earlier during the last negotiating session, he would have saved "three days of needless strife."  IMA Chairman Dr. Leonid Eidelman stated that it is “unfortunate that Ilan Levin continues to question the legitimacy of the doctors’ struggle despite the fact that it is legitimate legally and morally.”

Throughout the strikes, the IMA’s “exception committees” have worked to ensure that all urgent medical needs are addressed. The committees have approved more than half of the 100 requests for treatment presented by patients and their doctors.

On Tuesday May 3^rd, another set of doctor strikes began, putting public hospitals and outpatient clinics throughout the country on a restricted schedule for the remainder of the week and part of the following week as well.

Sanctions were held on Wednesday in a number of the Clalit Health Services and Kupat Holim Leumit community clinics. Clalit clinics of the Sharon/Shomron District were closed in Ra'anana, Herzliya, Kfar Saba, Netanya, Hadera-South, Beersheba, Kiryat Gat, Netivot, Ashkelon and Sderot. Leumit Jerusalem District community health clinics were shut down as well.

On Thursday, outpatient clinics in hospitals south of Tel Aviv and the Tel Aviv Sourasky Medical Center will be closed.

On Sunday May 8^th, a majority of the country's pathologists will attend a pathology conference, which will significantly reduce operations scheduled to occur on that day which require the examination of biopsies for cancer and other diseases.

No sanctions will be held on Memorial Day for the Fallen or on Independence Day.

On Thursday May 12^th, outpatient clinics will be closed in all public hospitals north of Tel Aviv and at Sheba Medical Center at Tel Hashomer.

As usual, physicians will continue to treat all patients in life-threatening situations, even on days of serious sanctions.

IMA conference on the Physician shortage: How we got to this situation?

The shortage of thousands of doctors in Israel: the situation, exchange of ideas and possible solutions.

At a conference held in Tel Aviv on the 18^th May on the shortage of physicians in Israel, Dr Eidelman, Israeli Medical Association President, stated that the physician shortage is worsening, and that this phenomenon is affecting the work in all hospital departments. "Hour after hour patients pay the price for this shortage." The IMA has placed the issue of the physician shortage as a top priority in the negotiations with the Treasury.

Representatives from the Ministry of Finance were invited to take part in the conference, however they refused to participate.

During the conference Dr. Eidelman stated that "Doctors feel the impact of a drying health system every day. The shortage is at our expense and at the expense of patients: patients die due to the shortage of doctors. They die because the doctor was tired from doing 10 shifts a month, and because the doctor does not have time to examine them sufficiently. Clinic physicians have five minutes for each patient: to review the patient's medical file, identify the illness, decide on a treatment and to explain this to the patient. "

Member of Knesset Dr. Rachel Adato, also spoke at the conference, she said that "the current governments claims to add 960 beds in six years, in order to save the public health - is like pouring sand in our eyes.  At the end of the day, the Ministry of Finance are the ones who run the health system, and for them Health is always the last priority.”  MK Dr. Adato demanded that the Prime Minister, Benjamin Netanyahu, intervene immediately to resolve the crisis.

Director General of the Ministry of Health, Prof. Ronni Gamzucalled on a system to plan for the next 10-15 years.  Prof Gamzu reported that the country has grown every year by about 130 thousand inhabitants, and in order to maintain the current rate of doctors per thousand inhabitants, it is necessary to increase the number of new doctors entering the profession.  
 
Prof Gamzu stated that in order to resolve the immediate crisis and the shortage of doctors, we require more students in the existing medical schools, the addition of the new medical school and at the same time we must also embrace students from abroad to enable them to complete their studies in Israel.

Michael Schonstein, Health labour market specialist, from the OECD, presented the international data indicating a need to redefine the image of the health workforce. According to this data, the health sector is a growing field in OECD countries, responsible on average for 9% of GDP and 10% of employment in these countries. In Israel, however, health expenditure is about 7.8% of GDP, which is lower than the Western world. According to the data presented, between 2000- 2008 Israel recorded a very low growth in the number of doctors relative to the population and significantly less than the OECD average.
 
Mr. Schonstein warned that the age of the physician workforce compared to and the rate of training is not sufficient. According to the analysis presented, we must ensure that the number of medical students coincide with the number of doctors aged 55 and above. Israel now stands on the brink of the need to replace a large population of physicians, who joined the system during the great immigration wave from the former Soviet Union. However, there are not enough new medical students to replace the ones leaving the profession. Countries facing a similar situation, examine the possibility of postponing the retirement age for physicians.

Dr. Matthias Wismar, Senior Health Policy Analyst from the WHO Observatory predicted that the labor market will continue to open allowing doctors to work and study in different countries. Certain countries rely much more than others on health professionals coming from abroad to address the growing shortages in the health workforce and meet increasing needs. 25% of U.S. physicians, 23% in Switzerland, 36% UK and 39% New Zealand - have been trained in other countries. Dr Wismar identified the most influential factors on the emigration of doctors to be wage gaps, followed by career opportunities, and working conditions.  

Lag B’Omer Rally - Doctors unwilling to continue to put out fires

On lag B’Omer the IMA held a rally in protest of the lack of progress in the negotiations with the Mministry of Finance. Two months after the IMA declared a labour dispute, approximately 1,500 doctors, interns and medical students attended the rally threatening to upgrade the protest.

Dr. Eidelman, president of the IMA stated: "We are in the midst of a struggle over the future of medicine in Israel. Lag B'Omer is not only a day of bonfires, we are gathered on this day to bring an end to the epidemic occurring before our eyes, when we cannot save lives because the government saves the expense of public health. We have to stop the epidemic of the neglect of the public health system.
 
“We shall continue our struggle until we have brought news, to the residents of Israel, of a true reform in the health system. We will continue to struggle for months if necessary.

"Prime Minister Benjamin Netanyahu, it's time for the public health system reform, it is time to change priorities for increased investment in the health system. It is time to relate to life and save lives.” 

During the rally fires were lit under the slogan "Doctors unwilling to continue to put out fires." The protestors stated that by July they will only work to rule and without extra hours, which the doctors claim they are not being paid for. 

Government appeals to the labour court to set an injunction against any further stoppages by the IMA and doctors

At the end of May, the Ministries of Health and Finance appealed to the Tel Aviv District Labour Court requesting that they issue an injunction banning the Israeli Medical Association and doctors working in public hospitals from any further work stoppages. 

The IMA stated that the only reason for submitting an application to the court by the Treasury is an attempt to thwart the resolution of the doctors conflict and avoid solving the main issues. The IMA is taking moderate steps in the sanctions out of responsibility to the public.

The Ministries appeal stated that the IMA is taking advantage of its power to advance the interests of its members and added that they would offer the doctors accelerated negotiations, monitored by the court or arbitration.

On the 2^nd June, the Tel Aviv district Court rejected the petition by the state. The court accepted a compromise proposed by the IMA, under which the doctors will limit their labor sanctions. The court also ordered the parties to conduct intensive negotiations for two weeks, after which they will notify the court of the progress in the talks.

Judge Michael Spitzer told the Ministry of Finance, there is no case for an injunction because the doctors had not completely shut down the health system, and were only taking "measured" steps.

Both the IMA and the Ministries expressed satisfaction with the ruling.

Court Ruling on IMA Additional Beds Petition

In January 2011 the IMA filed a petition demanding the court to order the immediate addition of 100 beds in intensive care units and 500 beds in internal medicine departments in hospitals across the country, in addition to a long-term plan for extra beds in the public health system.
 
On the 16^th June the Supreme Court published their ruling rejecting the petition. The verdict by Judge Miriam Maor, and was joined by Justices Edna Arbel and Salim Joubran.

The reason for rejecting the petition was based on the government's decision at the end of February, which among other things, confirmed the addition of 960 beds in six years, and the state's response to the petition that there should be an intention to add 120 beds in intensive care wards in 3 years (40 beds per year). The High Court ruled that in light of this decision and the present disposition of the court not to interfere too much in priorities of national economics, restrained the judicial intervention, and will allow the state to implement the solution to the plight of hospitalization which they declared (together with other solutions as substitutes for the inpatient and outpatient community).

Judge Arbel and Justice Joubran noted that if the plans for additional beds will not be implemented, the court will not hesitate to intervene in the future.

Petition Judge Arbel said that "the plight of hospitalization as presented to us, paints a dismal and disturbing picture."The judge noted that 'if any further delays in implementing the plans presented occur, the court is most likely to find itself less restrained, and ready to intervene.'"
 
Justice Joubran stated that we cannot accept a situation in which a patient, at precisely their most vulnerable moments, was forced to sleep in the hospital corridor and to receive medical treatments exposed to every passerby. This severely harms the human dignity and privacy of patients. The judge agreed with Judge Arbel and noted that nothing lasts forever; the future may result in less court restraint.

IMA World Fellowship Grants

Since its establishment, the Israeli Medical Association (IMA) has actively been operating on various levels to promote and advance the status of physicians and medicine in Israel. The IMA - World Fellowship was founded to create and enhance mutual bonds between Israeli doctors and their colleagues from around the world who express an interest in and identification with Israel and its medical system. As part of practice, the IMA-World Fellowship provides grants and assistance to young Israeli doctors partaking in fellowship programs abroad.

2011 Grants Ceremony

This year 14 scholarships were awarded by the IMA–World Fellowship in collaboration with physicians groups, and the following medical institutions: Sourasky, Hadassah, Sheba and the IMA-World Fellowship Chapter in Switzerland.

The scholarships were awarded to:

Dr. Avriel Avital (Soroka), Dr. Kasim Eyas (Hillel Yaffe), Dr. Shachar Tal (Sourasky), Dr. Chamzney Yaniv (Rabin), Dr. Scholochov Galina (Barzilai), Dr. Reyes Gustavo (Sheba), Dr Tomkins Netzer Oren (Bnai Zion), Dr. Bar Assaf (Wolfson), Dr. Sheni Ilon (Soroka), Dr. Price Michal (Rabin & Machon Dan, Clalit Health Services), Dr. Rozobosky Uri (Sourasky), Dr. Greipner Gabriel (Hadassah), Dr. Armon Yaron (Hadassah), Dr. Jacobson Siton Ariella (Sheba)

An additional 10 grants were awarded to physicians travelling to Canada and the United States in a collaboration between the IMA-World Fellowship and the American Physicians Fellowship (APF).

These scholarships were awarded to:

Dr. Margalit Ofer (Sheba), Dr. Berger Gidon (Rambam), Dr. Cialic Ron (Hadassah), Dr. Youngster Ilan (Assaf Harofeh), Dr. Ben-Ishay Offir (Rambam), Dr. Haberman Ziv Yael (Sheba), Dr. Arkadir David (Hadassah), Dr. Steinberg- Shemer Orna (Schneider), Dr. Oron Amir (Kaplan), Dr. Kerner Miryam (Emek)

A scholarship Award Ceremony was held on Thursday, 09 June 2011 at the IMA Offices.

We wish all the successful fellows a fruitful experience and a safe return.

Israeli physicians increase strike action

 

Hospitals to go on strike after late-night talks fail.

The Israeli Medical Association has declared a series of new, harsher protest moves following the failure of its negotiations with Health Ministry and Treasury officials regarding physicians’ employment conditions, starting with a general strike on Monday 20^th June.  It was suggested that so far the sanctions have not been harsh, so they were hardly felt by the public.

The talks began on the evening of Sunday 19^th June and lasted until early Monday morning.  The negotiations ended with no progress resulting in strikes in hospitals and Clalit Health Clinics.  Negotiations were scheduled to resume on Monday evening.

Doctors ‘work to rule’

After 10 months of negotiations conducted by the Israeli Medical Association (IMA) to save the public health system and given the lack of progress in negotiations with employers, it has been decided that doctors will work ‘by the book’. The IMA gave employers and the Treasury 6 weeks notice, stating that if an agreement was not reached, starting in July the health care system will start to work according to their current contracts and in accordance with collective agreements only. Work according to their contracts and Health Ministry regulations are rarely carried out due to the lack of medical manpower.
   
Out of responsibility to patients the IMA will continue to run the exceptions committees who deal with appeals from patients who require urgent care. According to the  ‘work to rule’ residents will only work 6 shifts per month instead of up to 14 which some currently work; residents will work shorter shifts and will complete their shift after completing the handover of department. Specialists who are not listed for shift work will not be in hospitals after 16:00 (except during a medical emergency) and will not take on more work without remuneration. In fact, hospital wards and operating rooms in hospitals around the country, at some point during the month, will likely not be on duty after 16:00. Hospital administrators and the state will have to find a solution to the created shortage of doctors after 16:00. Clalit Health Services Community Clinic physicians (Kupat Holim Clalit) will not provide services where no direct contact exists between patient and doctor outside of work hours, but will issue a final list of medical certificates (certificates of illness, student medical certificates, etc). 

The Israeli Medical Association expressed surprise that despite the fact that doctors had warned six weeks ago their intention to work according to rule, the Ministry of Finance and Employers have made no effort to prepare in advance and negotiate matters that will end the crisis. 
   Dr. Leonid Eidelman, president of the IMA said that "we are conducting a fierce struggle to save the public health care system. We were disappointed with the conduct of the Treasury, who refuses to reach an agreement that will bring about health care reform. Now everyone will see the outcome if we work according to contracts and regulations.Unfortunately, if we do not take this step today and show decision makers what happens when there are not enough doctors and positions for doctors, we will find ourselves in this reality in the future."

IMA President, Dr Leonid Eidelman announces his hunger

Over the last three weeks the IMA has held intensive negotiations with the Treasury under the auspices of the National Labour Court President. At the request of the Court President, the procedure took place behind closed doors. Under this procedure, and in an attempt to reach an agreement, partial agreements were reached on several issues. However, there were still major points of disagreement between the parties.

Last week the Labour Court threatened to issue restraining orders, as requested by the state, against the physicians unless we reach an agreement. To date, unfortunately, an agreement has not yet been reached. 

On Sunday 24^th July, after 15 hours of deliberations, the Labour Court announced that they accepted the position of the IMA, and rejected the employers' requests for injunctions and the imposition of arbitration on the parties in opposition to the IMA. The court declared that the sanctions which the IMA imposed have been reasonable and proportionate and therefore do not justify an order for interruption.

The IMA is happy with this decision, which means it can continue to fight to save the public health system. 

On Monday 25^th July, a press conference was held at the IMA offices where Dr Eidelman, IMA President, announced that he will start a protest, calling the Israeli Prime Minister, and Health Minister, Benjamin Netanyahu to intervene in the dispute. Dr Eidelman has taken leave from his hospital and began a hunger strike on Sunday morning, which he will not stop until the end of the conflict. He requested that his colleagues do not join him in the hunger strike at this time, so that they can continue to responsibly care for their patients and not damage the health care system.

At 16:30 on Monday, Dr Eidelman began a 4-day walk from the IMA offices in Ramat Gan to the Prime Minister’s office in Jerusalem. Each day Dr Eidelman will be joined by approximately 20 doctors who will march with him. Following police instructions, he will walk with a small group, so as not interfere with traffic. Dr Eidelman is scheduled to arrive in Jerusalem on Thursday 28^th July where he will set up a tent outside the Prime Minister’s office and deliver a petition supporting our struggle signed by more than 25,000 people. 

The IMA hopes that the protest activity will not fall on deaf ears, and that the conflict will soon reach a successful end. 

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134 days after the physicians declared a labor dispute and following 9 months of negotiations, no agreement has been reached.

On the 25th July, Dr Eidelman began a hunger strike and marched from the IMA offices in Ramat Gan to the Prime Minister’s office in Jerusalem, calling on Netanyahu to intervene in the dispute. Throughout the week protest marches were held at local hospitals and among community physicians across the country.

Dr Eidelman arrived in Jerusalem on Friday 29th July and set up a tent in front of the Prime Minister’s office. 

On Sunday 31st July approximately 3,000 doctors and residents protested at the Rose Garden opposite the Knesset, demanding a solution to the crisis in the health care system.  Dr Eidelman is continuing his hunger strike, until an agreement is reached.

Earlier in the day, Dr Eidelman met with President Shimon Peres and other IMA leaders.  President Peres promised that he would speak with the political leadership and the government, in order to try and reach a solution to the deadlock in negotiations. Dr Eidelman restated his call for Netanyahu to personally intervene in the negotiations.

"We were deeply honored to be hosted at the residence of the country's number one citizen. But it is not honor that we are looking for; we are looking for a solution to the problems plaguing the public health system.  We need more doctors to treat our citizens." Dr Eidelman stated.

Following the demonstration the protesters marched to the Prime Minister’s residence, where Dr Eidelman presented a petition with more than 30,000 signatures calling for a solution to save the public health system in Israel. 

Further work stoppages and strike action are planned for the week.

Doctors achieve a breakthrough in discussions with the Ministry

On the 3rd of August, a breakthrough was achieved in the discussions between the IMA and the Ministry of Finance. The state agreed to add 1,000 staff positions for doctors in hospitals, immediately. The 1,000 job slots will be anchored in addition to allocations to expand the number of hospital beds by hundreds within a few years. The state also agreed to grant of up to 300,000 NIS for doctors who move to the periphery or transfer to specialties where there is a manpower shortage. In addition, the number of night and weekend shifts of 26hours in a row will be reduced to six per month. Following this breakthrough, Dr Eidelman, president of the IMA, ended his hunger strike, which began 10 days prior. 

In a hope to end the dispute, the Treasury and the IMA will enter into accelerated and intensive negotiations, as decided by the Supreme Court, in order to deal with the remaining issues. The IMA also agreed to cancel the work sanctions scheduled for the beginning of next week.  Dr Eidelman reiterated that the struggle is not over yet and that there are many more such issues on our agenda.

Doctors agree to week-long Mediation

At a High Court hearing on the 15^th August, after another week of intensive unsuccessful negotiations, the parties have agreed to adopt the recommendation of the court and begin a mediation process. The IMA accepted this on the condition that the mediation will only be for one week, over the course of which public health care institutions will continue to strike. The non-binding mediation will be held between the 16/08/11 - 08/23/11.

The Parties agreed that the mediation will include only a few issues, which they have not yet reached agreement as follows:

1.   Cost of the agreement

2.   Distribution of the agreement

3.   Duration of the agreement

4.   The requirement that doctors clock in and out for shifts.

The selection of a mediator lasted several hours, where different candidates, were discussed.  Eventually it was decided to Prof. Yitzhak Peterburg, who previously served as CEO of Clalit Health Services and is currently the CEO of Cellcom will act as mediator.

On Tuesday 23/08/11 the High Court will be updated on the results of the mediation.

An Agreement is Reached

After a long and complex struggle, a ground-breaking agreement was reached for public medicine.

After more than five months of a difficult and complex fight, and the management of intensive negotiations, on Thursday the 25^th August 2011 a breakthrough agreement was signed for Israeli public medicine.

The Israeli Medical Association and representatives of the Treasury signed a new collective agreement, which will change the face of the public health system.

Under the agreement, there will be significant additions to the health care system:

• The addition of more than 2.5 billion NIS in funding  
• 1,000 new doctor positions in public hospitals   
• Limit the number of resident on-call shifts to 6 a month 
• Salary increases between 32%-80%  
• 49% increase in average hourly wage  
• Very significant salary increases for doctors working in the periphery, and a one-time grant of 300,000 NIS for doctors who move to the periphery  
• Salary supplements and special grants for doctors who choose to work in specialties with a severe shortage of up to 300,000 NIS 
• 20% of the increases will go into effect immediately, and 70% will be phased in the next 3 years. 

Dr. Leonid Eidelman, President of the IMA stated: "We set out to bring about change in public medicine in Israel and I'm proud to say that we achieved the goal."

"The road was not easy. But throughout the journey we believed in ourselves and the importance of the goal we set."

"In fact, the change we made to the concept: those who work more will get more. Those who invest more in public medicine will earn significantly more.  This will assure that the people of Israel will receive better quality of medicine in a more equal health system."

"It is important for me to thank the multitudes of doctors who persevered with the demonstration and took an active part in the long fight. I also send my thanks and deep appreciation to the Israeli public and patients, who stood behind the doctors and showed us their support and tolerance. You have given us the power to bring about a real change".

Paramedic Licensing Exams Can Now be taken in English

On the 1^st November the Knesset Labor, Social Affairs and Health Committee approved a bill allowing that state licensing exams for the paramedical profession to be taken also in English. 

Previously, these exams have only been available in Hebrew and Arabic.

The change is applicable to exams for physiotherapists, clinical communications specialists (hearing and speech), occupational therapists and clinical dieticians.

Deputy Health Minister Ya’acov Litzman asked the committee to approve the regulations for paramedical professionals in order to ease the process of licensing for new immigrants. For this reason, licensing exams for doctors have long been available in a variety of languages, and those for nurses have been produced in English and Spanish for a number of years.

Representatives of Nefesh B’ Nefesh have asked the chair of the committee MK Haim Katz to add further optional languages for state licensing exams. MK Katz said he was willing to do so.