Cuts - precisely in the periphery:
since the beginning of the month there are fewer specialist doctors at the Galilee Hospital in Nahariya in the afternoon and evening, because the hospital has cut the number of specialists present during these hours.
This is the management's decision to cancel the "half-shifts" - the presence of specialist doctors from 4:00 PM to 11:00 PM - due to the need to cut hospital expenses, due to the NIS 100 million reduction in funding the hospital receives from the Ministry of Finance.
The half shifts are one of the achievements of the doctors' agreement of 2011, and they are considered a success story.
Specialist doctors are incentivized to stay in the hospitals during the evening hours, and thus both the patients and the interns benefit. These shifts mainly helped the hospitals in the periphery and those suffering from difficulty in staffing standards.
"The loads are chronic".
Dr. Feldman,
"Israel Hayom" has learned that after consultation with the department managers, the director of Nahariya Hospital, Prof. Masad Barhoum, ordered to cut all shifts by half in the X-ray department, and by 66% in the internal medicine, geriatrics and cardiology departments.
"Whoever is hospitalized in the evening or at night in an internal ward - will only be seen by a specialist on duty, without an expert in the field to help with treatment," explains Dr. Nimrod Rahmimov, chairman of the doctors' committee and director of the hospital's orthopedic department.
"Until now, an expert's eye has also seen tests. The hospital director has stopped all of this, claiming that the Ministry of Health is not budgeting.
An expert who is present at night is not only another head who is present and working, but also a better decision-making ability.
I convened the managers, and we will think about what to do about it."
"to suffocate a breathing patient"
Dr. Rakhimimov explains that according to the agreement, the hospital director has the right to determine the number of half shifts.
"Yes, he is allowed to cut it to a minimum, but for a decade he thought the shifts were necessary - and now he thinks they are not? We have less equipment and beds than Rambam, and now also fewer specialists.
It's poor judgment."
A senior hospital official: "How is it possible to cut NIS 100 million from a hospital in the periphery? It's like coming to a breathing patient and suffocating him. The presence of senior officials in the afternoon and evening is critical. This is better medicine, a safety net for patients, fewer mistakes. I only hear the The word 'no': no equipment, no interns, no shifts. It no longer makes sense, close the hospital and that's it.
slaughtering the periphery."
"Discretion".
Prof. Barhum, photo: Ancho Ghosh / Gini
Dr. Ze'ev Feldman, Chairman of the State Physicians Organization and Deputy Chairman of the Medical Association, appealed to Prof. Barhum and asked him to withdraw his decision: "The shifts are intended to allow the presence of specialists after working hours, out of a desire to improve the medical service.
The health system is dealing with chronic loads, which are more extreme in the periphery and intensify in the evening hours.
Canceling the presence of senior officials will increase the burden and harm the quality of care."
"Lesser of Two Evils"
In response to Dr. Feldman, Prof. Barhum replied that this is a "minimum evil", in order to avoid more severe financial sanctions against the hospital: "The responsibility I hold requires me to act proportionately and judiciously, to protect the center and its patients from harsh decisions."
The Galilee Medical Center stated: "The use of half-shifts is customary in cases of unusual loads, which require the operation of this tool by the management, which has professional and budgetary considerations. This does not harm the service provided in any of the departments."
The Ministry of Finance stated:
"Starting in 2022, the regulations of the national budgeting model for public schools came into effect, by virtue of which funds are transferred to all public schools in the country. Within this framework, the amounts of support for public schools were increased by hundreds of millions of shekels, and great weight was also given to the distribution of funds to public schools in the periphery ".
The Ministry of Health stated:
"The management of the medical center set at the beginning of 2022 a target for an agreed deficit for the center, which embodies the diversity of a peripheral hospital.
A cut of 100 million shekels is unknown to the ministry, and was not done at the direction of the accountant.
"The medical center has taken steps to comply with the provision of services and balanced budget management, as required of every hospital.
All the steps were taken by the decision of the hospital director, according to his priorities and under the obligation to meet the budget. Half duty can be regulated according to the need, and the choice to cut precisely in this area was not made at the guidance of the accountant."
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