Stroke is one of the leading diseases in disability and mortality in old age.
Despite this, more than half of the patients who need neurological treatment are hospitalized in an internal ward and not in a dedicated ward and there is a shortage of 300 neurologists in Israel, according to the report of the committee for the examination of the neurology profession, submitted to Prof. Nachman Ash.
Among the main recommendations in the report is the additional training of 300 neurologists. This is almost a doubling of the number of neurologists in Israel today, which stands at 355. Increasing the number of neurologists in Israel by establishing a fellow scholarship fund for all areas of neurology.
As we published in "Israel Today", there is a shortage of experts in the various fields of neurology.
For example, in Israel there are only 15 Parkinson's specialists, so Parkinson's patients from the south were sent to a treatment center and 4,000 and Parkinson's patients in the north of the country do not have a nearby Parkinson's clinic.
Another recommendation concerns the addition of a total of 380 new neurological beds in the standard, of which 120 beds will be allocated to single-stroke stroke beds in the standard.
In Israel, there are 349 standard neurological beds and only 57 beds for stroke units.
In practice, there are 500 beds in Israel.
Even in the current situation of actual extra beds over half of the patients who come to hospital due to neurological illness are not hospitalized in a neurological ward.
The committee also recommends establishing neurological day hospitalizations in hospitals for the purpose of expanding the therapeutic response, which is now almost non-existent.
Increase the standards for neurologists in neurological departments, stroke units and emergency rooms (emergency rooms). Compare nursing standards in neurological departments to inpatient department. Regulate rates for hospitalization in stroke units, neurological day hospitalization and ambulatory neurological operations.
Some of the recommendations are for immediate application and some for graded application over 5 to 10 years.
Cerebrovascular disease is the fourth leading cause of death in Israel, and the burden of morbidity in various neurological diseases is increasing.
In 2019, there were 19,244 new strokes in Israel (3.2 cases per thousand people).
In addition, there are about 67,000 dementia patients, 82,000 epilepsy patients, about 31,000 Parkinson's patients, about 9,000 multiple sclerosis patients.
The direct and indirect cost of treating stroke cases is estimated at NIS 2.3 billion.
"There is a considerable need to improve the neurological service in its various aspects."
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It is estimated that about 80 percent of stroke events and about a third of dementia cases are preventable or delayable, while developments in the field of neurology have greatly expanded prevention options.
"Over the years, neurological medicine has undergone a revolution - from a diagnostic profession to a therapeutic profession that prevents, rejects and reduces disability," the report said. On its various aspects at the national level, investing in the promotion of neurological medicine in Israel will promote the health of the population and in the long term a national vision will save resources. "
Prof. Nachman Ash, Director General of the Ministry of Health: “The profession of neurology has undergone many changes in recent years, including increasing the therapeutic capabilities in urgent and chronic neurological conditions.
The committee examined the ability of the health system to provide a medical response in the field of neurology in this era.
"We are currently examining the implementation of the committee's recommendations so that neurological medicine in Israel will continue to be one of the leaders in the world."
Prof. Yonatan Halevi, Chairman of the Public Council for Brain Disease: "There is a very large gap between the amazing achievements of neurology, for all its sub-specializations in recent years, and the state of specializations, standards and infrastructure in the country.
Neurological morbidity is the leading group of diseases in the burden of long-term disability and loss of healthy life years, and is expected to continue to rise.
As a result, the demand for neurological services, the need for neurological treatment in the community, the improvement of infrastructure in the periphery and neurological advice in emergency medicine will increase even more.
The committee's report is a groundbreaking event for a real turning point. I am very pleased that the report and its recommendations were received with understanding by the Ministry of Health.
The public council, headed by me, will continue to work on the issue and will make sure to keep brain medicine on the agenda. "
Prof. Natan Bornstein, Chairman of the Committee: "It fell to me a historic right to chair the committee, which mapped the state of neurology in Israel and presented goals and a plan for change.
The committee was appointed against the background of cognitive dissonance: on the one hand, Israeli neurology is one of the world leaders in terms of medical excellence and innovation.
On the other hand, the infrastructure, which benefits the citizens of the country, lags years behind.
We are committed to a horizontal change in the neurological system of public medicine in the country.
In the hospital and in the community, certainly in the face of the aging population and the increase in morbidity. "
Prof. David Tene, chairman of the Israeli Association of Neurology and a member of the committee, comments: "Neurological medicine has undergone a revolution - from a limited diagnostic profession to a broad therapeutic profession that prevents, rejects and reduces disability.
Neuroscience research, and state-of-the-art technologies bring more effective and accurate medical care to patients, and diseases they have not had treatment for in the past and the opportunity is enormous.
However, the Israeli health care system has lagged behind in terms of hospital bed infrastructure, manpower and means in neurology.
I welcome the in-depth work in preparing the report and we will continue to work together with the professionals and the management of the firm for its implementation. "
The state committee headed by Prof. Natan Bornstein, director of the brain system at Shaare Zedek Medical Center and chairman of the Israeli Stroke Society began work last May. The committee was attended by representatives of the Ministry of Health and senior neurologists. Miscellaneous in the Ministry of Health, Nursing, Health Professions, Hospital Associations and more.
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