Knesset c’tee holds session on Treasury’s failure to add even one public hospital bed despite cabinet promise of 1,000.
By JUDY SIEGEL-ITZKOVICHASSUTA MEDICAL Center representative with officials 370(photo credit: Judy Siegel-Itzkovich)
Finance Minister Yuval Steinitz signed an agreement on Tuesday with Assuta Medical Centers Ltd. handing over 7 hectares (17.3 acres) of free land in the eastern part of Ashdod, for a private subsidiary of Maccabi Health Fund to build and run the first hospital to be built in Israel in three decades.The construction, which has been held up for years and was mired in lawsuits, is due to end in five years, with two-thirds of the money – some NIS 500 million – to come from the Treasury and the rest to be covered by Assuta. The subsidiary, which promises that the 300- bed medical center will be among the most advanced in the country, will have the right to provide private medical services there to the tune of one quarter of its income.Steinitz took part at the ceremony in his Jerusalem office, which was also attended by Ashdod Mayor Dr. Yehiel Lasri, Deputy Health Minister Ya’acov Litzman and Deputy Finance Minister Yitzhak Cohen, along with Assuta chairman Prof. Yehoshua Shemer and director-general Dr. Eitan Hai-Am (both former Health Ministry directors- general) and other officials. Those present generously praised each other for their involvement in approving the hospital.Steinitz said that when he took over as minister, he immediately committed himself to making the hospital a reality for Ashdod, which now has 250,000 residents and will expand rapidly to 300,000 in the coming years.“There were problems. It is legitimate that there were internal and other disagreements, but we overcame all the difficulties,” he said. “In the country’s first 30 years, many hospitals were set up, but in the last 30, none were. We want to be at the groundbreaking ceremony in a few weeks.”The hospital will have advanced operating theaters, with departments to include obstetrics and gynecology, oncology, pediatrics, orthopedics and internal medicine.The government published the tender in August 2009 and chose Assuta one year ago, although the government passed a law to establish the hospital back in 2002.It will be the first new public hospital in decades, since Netanya’s voluntary hospital, Laniado Medical Center, was established by the Sanz Hassidim. No public hospital beds have been added in the past decade.Asked whether the Assuta model would be used when, or if, future hospitals are built – such as the much-needed facility for the suburbs north of Haifa – Steinitz said he could not predict whether the government would ever build another public hospital.Litzman said that the construction of the Ashdod hospital will reduce crowding in other hospitals. He added that permission has been granted in the period before the hospital opens to provide some medical services. They will be provided in a six-floor building that is currently empty and was built by haredi (ultra-Orthodox) voluntary organization Refuah Viyeshua, which abandoned the tender after spending millions of shekels in an attempt to build a full-fledged hospital.
Shemer asserted that the hospital will be a “unique model,” in which government money will help a private company build a hospital and medical staff will be fully integrated with the community. “The community will have a hospital, not the hospital [will] have a community. I promise the highest level of medicine, and both the poor and the rich [will] receive the same services,” the Assuta chairman said.In regard to private medical services (known as Sharap), however, paying patients will be able to choose their surgeon or physician for medical consultation, and treatments not included in the basket of health services such as aesthetic plastic surgery will be provided for a fee.Bank Leumi was selected to help with construction financing arrangements, and a representative of the bank attended the ceremony.Ashdod’s mayor thanked those present for the gift of the hospital. “[Was it possible] that a quarter-of-a-million people would be left without a hospital of their own?” Lasri asked.Steinitz and Shemer rejected criticism voiced to The Jerusalem Post by Prof. Gabi Bin-Nun, a Ben-Gurion University of the Negev health economist and former longtime deputy director-general for health economics at the Health Ministry. He said that “offering private medical services in a public hospital creates two types of patients and is liable to harm the availability and accessibility for those who cannot afford payments for private medicine.”“The Treasury – which for years opposed approval of Sharap [private medical services] in public hospitals – agreed to the Ashdod hospital, which will receive generous support from the state budget,” argued Bin-Nun. “Approving the running of private medical services in the Ashdod hospital will cause good doctors to leave Barzilai Medical Center in Ashkelon and Kaplan Medical Center in Rehovot [to earn more money from providing private medical services], and will lead to patients in those areas shifting to the Ashdod hospital.”Meanwhile, the Knesset Labor, Welfare and Health Committee held a session on Tuesday about the fact that even though the Treasury and Health Ministry promised last year that over 1,000 new hospitals beds would be added to existing public hospitals, nothing has been accomplished as of yet. The committee was told that Israel has one of the lowest bed-to-resident ratios in the OECD, with only 1.88 beds per 1,000 Israelis. Moreover, the figure is due to decline.The session was initiated by Knesset Health Lobby head Dr. Rachel Adatto. “The prime minister promised last year to add at least 960 [funded] beds in public hospitals,” she said. “A 2011 Health Ministry report on hospital beds showed the truth: that in some places beds have been shut down.”“Where is the money to add beds?” Adatto asked.“We are dealing with problems on the top level [of the ship] while the ship is sinking,” said Dr. Ze’ev Feldman, a deputy chairman of the Israel Medical Association. “We aren’t managing to have enough place to take care of newborns and premature babies, and we are not prepared to deal with the fact that Israel’s population is aging and urgently needs more hospital beds.”Many premature babies are kept in standard neonatal departments instead of in special intensive care beds, Feldman declared, and babies are discharged too quickly.Responding for the Health Ministry, medical administration head Prof. Arnon Afek said: “If, God forbid, we have a hard winter and there is a significant flu epidemic, the situation will be very serious.”Ministry deputy director-general for planning and building Yehuda Ron explained that the Finance Ministry has not yet approved a construction plan that would make it possible to add hospital beds.Adatto countered that it takes seven years to build new hospital departments. “To claim that adding 1,000 beds is a matter of just construction is misleading. Suddenly we are told that we have to build, that it will take time, that it requires more funds.”“What is the message to the Israeli citizen? That we don’t care about your health,” she said.The Knesset committee said it would continue to investigate the issue.
