The Health Ministry published a series of recommended changes to Israel's in vitro fertilization (IVF) system on Wednesday.
After a recent sharp increase in the number of IVF treatments carried out by private clinics, the Health Ministry has decided that further regulations and guidelines are needed.
The ministry stressed the need to ensure proper quality and safety of treatment for patients. This comes two months after a child conceived at Assuta Medical Center was found to have no genetic connection to the father.
These events prompted the director-general of the Health Ministry Moshe Bar Siman Tov to appoint a team to examine the IVF system in Israel and formulate appropriate policy measures. The team examined an array of features including structural and financial failures which led to medical malpractice.
The first issue discovered by the team was a market access issue, they found that market conditions had led to people increasingly choosing private clinics over public ones, leading to an increase in workloads for private clinics, with some found to not be working properly.
Another issue relating to the market was availability because there was no central planning with regard to clinics, services became centralized around two major institutions located in the center of the country, leading to a dearth of clinics in the periphery, creating an inequality in service.
What did the Health Ministry recommend?
The first recommendation is to increase competition between private and public institutions. This would include strengthening public units and making them more attractive to patients, one example was allowing patients to pick which physician would attend them at no extra cost.
Improving the standard and quality of care and safety as well as improving the operation of clinics and laboratories, was another recommendation. This means a particular focus on the monitoring of samples and upgrading computer systems to prevent misidentification errors.
The promotion of a program that would incentivize clinics to improve their compliance with different elements of staff training, equipment, technological arrays, and infrastructure development.
Further regulations on the care provided, for example defining the maximum scope of activity allowed at each clinic according to their space, equipment, and personnel. They would also implement a limit of 8,000 treatment cycles per clinic per year, while at the same time monitoring the gradual increase in capacity at other clinics so that long-term operation problems or long queues don't develop.
The introduction of new mechanisms to allow for a unified work routine would allow for a multi-professional team while still being under clinic managers. The committee hopes this would allow patients to receive comprehensive care and improve the quality and safety of treatment as well as improve patient satisfaction. One direct recommendation is to require that all the clinic's doctors be employed by the clinic directly, at least part-time.
The final recommendation is to curb payment mechanisms in which the doctor is directly paid when the treatment is not part of their health insurance basket. As well as examining the pricing in the public sector and the incentives they create.