Severe failures to treat cancer patients at the Ziv Hospital Radiotherapy Institute • Dozens of patients were treated in violation of the guidelines, managers did not report failures - and in an unusual step, the Institute was banned from accepting more patients • Doctors: "The treatment is derogatory and harms the patients"

• Screening device // Photo: Ziv radiotherapy institute

When it opened in June 2017, after a long public battle, the Institute for Radiation Therapy for Cancer Patients at Ziv Government Hospital in Safed - it was defined by the Ministry of Health as a national project and the flagship of the Ministry of Health promoting public health in the north. This is for the benefit of cancer patients, who will no longer have to travel for treatments away from where they live.

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At the opening of the festive institute, the Ministry of Health invested tens of millions of shekels, and it was defined by senior officials of the Ministry of Health as "a historic event through which residents of Safed and the North can receive services that do not fall below the level of residents of the center of the country."

However, internal documents and testimonies first revealed here show that there are very serious deficiencies in radiation therapy in dozens of cancer patients and the Institute's functioning. In addition, serious failures were detected in the Health Ministry and the management of Ziv Hospital, headed by Dr. Salman Zarqa, on hospital screenings.

So much so, that in an unusual move, in April this year, the Ministry of Health banned new cancer patients from entering the Institute. This is because dozens of patients have been treated in contravention of the Health Ministry's signed, unequivocal directives, designed to gradually train all staff and the hospital for radiation screening, and fear of harming the quality of hospital radiotherapy and the chances of cure for cancer if the treatments are insufficiently trained Medical.

As a result of the ban, dozens of patients who were due to be treated at other hospitals in Haifa and central Israel have been referred since April this year. To date, only less than half of the patients are treated by the Radiation Institute by April this year (about 25 patients per day instead of about 50 by April).

Professor Jamal Zidane // Photo: Eyal Margolin - Ginny

Following the announcement by the Ministry of Health, in April, Dr. Zarka wrote to Prof. Jamal Zidane, Director of the Hospital Oncology Institute and Prof. Eliyahu Gas, Director of the Radiotherapy Institute, that he urged them to report "cases that have deviated from the agreement", stating that "the Ministry of Health Notify us of a ban on accepting new patients to the radiology facility in light of our non-compliance with the signed agreement, which defines the cases that we are allowed to treat. "

It is also revealed that at a hospital management meeting in July of this year, Dr. Zarqa warned that the termination of hospitalization had "serious implications for patients and the community, with impact on our staff, hospital image and economic impact." The conduct in recent months has been the result of failure to comply with the guidelines, and the results have been detrimental to patients and the hospital. "

It was also learned that in August of this year, Prof. Zidane warned that following the Ministry of Health's instruction, "it is a pity for the poor patients who are transferred to very simple radiation treatments at the Italian hospital in Haifa." Prof Zidane further warned in January 2018 that the Ministry of Health's conduct towards the Screening Institute was "disparaging and could harm patients".

Misunderstood behavior

Israel Today also learned that in August this year, senior officials at the Sheba hospital complained to the Ministry of Health that they were "very disturbed" by the lack of co-operation between managers and doctors, which led to the control and supervision of hospital funds.

The complaints were forwarded to those responsible, in their capacity, for the control of the new radiation institute: Dr. Osnat Luxembourg, Head of the Medical Technologies, Information and Research Division of the Ministry of Health, and Dr. Ollie Weinstein, Head of the Government Hospital Division.

At the same time, hospital officials say the Ministry of Health's steps have hurt many patients, and one of its wards has told Israel Today that "since April this year, the Ministry of Health has imposed severe restrictions on unprofessional reasons for hospital screenings, and has damaged the medical service for cancer patients. All over the north. "

About a month ago, Professor Gas also wrote to Prof. Zion Hagai, Chairman of the Medical Association, that "at Ziv Radiotherapy Unit there is a skilled team of medical doctors and physicists, and I and Dr. Tova Yonina have more than 30 years of clinical experience, and prior to his arrival at home The patients performed all radiation treatments without restriction. The Ministry of Health's behavior is incomprehensible and harms the cancer patients. "

Dr. Salman Zarqa // Photo: Oren Ben Hakun

However, according to the documents, even a year earlier, in February 2018, the Ministry of Health ordered a "complete halt" of new patients. This is after it was discovered that most of Ziv Hospital's significant commitments were not performed again at the Radiation Institute's controlled and controlled operation, and that Ziv Hospital did not have the close and regular supervision and control required by the management and radiation agreement signed at Sheba Tzvi State Government Hospital, managed by Tel Hashomer. Simon. It should be noted that all of these steps have been taken without the Ministry of Health or Ziv Hospital notifying the public of these restrictions, as required.

Internal documents show that in the past year, dozens of patients have been treated with cancer screenings, contrary to the Ministry of Health's directives, which limited radiation therapy only to certain cancers, and have prohibited the Institute from providing radiation therapy beyond these restrictions. According to the internal documents, there are dozens of patients that the Ministry of Health has not been allowed to treat, with diseases of the liver, pancreas, lungs, stomach, stomach, brain, spine and neck.

According to senior doctors, this means that there is a concern about the quality of radiation therapy received by these patients and that this is also a serious and ongoing failure of the hospital's internal control and the Ministry of Health's own control. According to the internal documents, the Radiation Institute also identified some of the most serious cases of "significant errors" in the design of radiation therapy in cancer patients. These errors were not reported to the Ministry of Health, as required by the Ministry of Health's instructions.

The employment stoppage storm

"Israel Today" examination also reveals that Ziv hospital director Dr. Salman Zarqa recently decided to terminate the employment contract of Prof. Eliyahu Gas, a senior physician in this field in Israel, who has been running the hospital's radiotherapy institute for the past two years. Senior doctors at the hospital have expressed concern and criticism when Dr. Yevgeny Solomonov, director of the surgical department, wrote to Dr. Zarqa that "Professor Gas should be retired and the functional fitness of the radiation center's entire oncology team" should be avoided. .

Dr. Ren Katz, director of the urology department, warned that "his termination of work would cause real harm to oncology surgery at the hospital. This is a first-rate professional with a great deal of knowledge and unparalleled experience. "

Professor Elijah Gas

Comments: "The Institute is professional and high quality"

The Ministry of Health said: "As part of the Ministry's policy to reduce peripheral health gaps and to improve the peripheral care provided to oncology patients, the Ministry of Health has approved the opening of a satellite radiotherapy center at Ziv Medical Center. Since radiotherapy is a highly complex therapeutic area, requiring professional experience and advanced equipment The radiotherapy center in Safed will operate as the Sheba Medical Center's radiotherapy institute - this means that the Sheba Medical Center supervises a professional radiotherapy center under which an agreement has been signed between the two centers, training courses have been carried out at the training center and the Sheba radiotherapy institute, doctors in Yirim Shiba (including the Director of the Radiotherapy Institute) comes to work with the staff in Safed, perform radiation testing, etc. As this is a new institute, the Ministry of Health monitors the management of the hospitals and the professional teams to review the implementation of the agreements and the changes required to make the guidelines from time to time. Radiation by experienced Zionist staff who have undergone extensive professional training in Sheba, beyond his personal professional experience. The guidance and accompaniment of Sheba Medical Center continues to take place and the areas of the Institute's activities in Safed are updated from time to time. "

Ziv Hospital said: "Ziv Medical Center in Safed works to provide advanced and full health services to the northern residents while developing missing and promoting existing services, with the assistance and support of the Ministry of Health. Our goal is to give the northern residents essential and excellent medical services close to their place of residence and save them the burden of travel "From this evidence, the Ministry of Health established the Radiation Institutes and Pat City in Ziv and is working to make Ziv the northern center for the treatment of cancer patients."

"The Ziv Medical Center Radiation Institute is equipped with the most advanced technology possible, while maintaining a high standard of construction and staffed by professional teams with experience from other hospitals. As part of establishing such a significant and special service, it has been determined that the Radiation Institute at Sheba Medical Center will accompany the institute and promote it. The Bezio Institute is undergoing development in terms of the treatments it is licensed to provide, most of which are cancer, breast, prostate and urinary tract, advanced and simplified cancers that require sticky (palliative) treatment are provided by highly skilled and competent staff and accompanied by experienced staff. In the months Ended in September the number of treatments and patients can be addressed shone, grew as part of the Ministry of Health to promote the operation of Ziv to state that most treatments will be given to him. "

"The Sheba Institute reports, which are based on frequent work, visits and controls, on the Ziv Institute, indicate professional, quality and worthwhile work, as do many of the Northern patients who have received professional help from us. We thank the Sheba Screening Institute staff for the near future. "We can expand the number of treatments and patients at the Ziv Institute for the people of the north. We work in full cooperation with the Shiva Institute and the Division of Government Medical Centers for the development and promotion of the Ziv Institute in the coming year and for the sake of one or the other, it is inappropriate to manage the issue over the newspaper pages."

Sheba Hospital said: "Sheba Medical Center will continue to assist, guide and support every new department, unit and service that will be set up in the periphery, as part of our national duty to access healthcare and strengthen the public health system."