The State Comptroller's report published this afternoon (Tuesday) shows large disparities in hospitalization of children in central and peripheral hospitals.
The report authored by auditor Mattanihu Engelman and his team examined the Dana Children's Hospital of the Ichilov Hospital in Tel Aviv and the Barzilai Hospital in Ashkelon.
According to the interim report, on the day of the inspector's office team's visit to Barzilai Hospital, 23 children were hospitalized in the children's ward and 6 in the intensive care unit - a figure that represents approximately 83-100 percent of the bed capacity.
However, during a visit to Dana Hospital, on the day of the team's visit, 42 children were admitted in the pediatric ward and 21 in the hemato-oncology ward - 11 beds above the standard.
"It is unthinkable that a child in Ashkelon would be discriminated against," the auditor Engelman wrote harshly in the report.
"The lack of specialist doctors for children in the periphery in the hospitals and in the community prevents proper and equal treatment of these children."
The director of Dana stated that about 20% of the children sick with malignant diseases and hospitalized in the pediatric hemato-oncology department require treatment to prevent suffering and pain, but the shortage of nursing personnel and the lack of dedicated standards do not allow such treatment to be provided.
In addition, the lack of standardization in paramedical personnel may result in the hospitals not being able to hire this professional personnel, which may harm the care of children and their families. Dana
Hospital reported that the standards of doctors are lacking and no longer meet the needs, and that the hospital is overcoming This is through the agreements he has with the municipality of Tel Aviv-Jaffa and with the funds that improve the ability to recruit and employ doctors specializing in pediatrics.
The auditor found that the situation at Barzilai Hospital in Ashkelon is even worse.
According to the report, all the interns in Barzilai are not graduates of medical faculties in Israel, but graduates of faculties abroad. The visit revealed that there is difficulty in recruiting specialized doctors and specialists to the periphery and that there is only one specialist in each field, so that sometimes there are periods when the hospital works with a lack of doctors In a certain field, for example, only in 2019 was a pediatric neurologist recruited.
Due to the lack of specialist pediatricians, many of the doctors who treat children in the south of the country are not specialist pediatricians, but family doctors or general practitioners who have not completed a residency.
The report also shows that the children's intensive care unit in Barzilai has one specialist doctor as well as another standard worker, but they were not able to help Aisha.
It was reported that when the unit's specialist doctor was absent for 15 days last year, for about half of the time it was a pediatric pulmonologist on call who replaced him and the rest of the time the unit was closed.
Barzilai Hospital in Ashkelon (Photo: Reuven Castro)
The Ministry of Health responded: "There is a shortage of hospital beds in Israel. The Ministry is working to build a multi-year plan and in the Ministry's budget for 2023 there is a reference to a multi-year staff plan for the general hospitalization system and a development budget of hundreds of millions of shekels."
On the issue of children's hospitalization, the ministry stated that "We continue to examine the issue and check which other hospitals there are that meet the defined criteria. In addition to building a national survey for children's hospitalization departments, the ministry will establish a work team to formulate standards, a toolbox for the treating teams and formulating regular monitoring and request mechanisms for hospitals".
Regarding the shortage of doctors, the Ministry of Health said in response: "The Ministry operates on one axis whose goal is an increase in the number of doctors in general and an increase in the number of students studying medicine. The other axis is to address the unique challenges of the periphery. This year the Ministry of Health will establish an advisory committee in the field of manpower in order to carry out long-term national planning of medical personnel, including in the field of pediatric intensive care. The Ministry assigned standards to the HMOs with the aim of encouraging the training of specialists, including in pediatrics. The existing difficulty is that most of the training takes place in the hospitals in children's wards and therefore the pace of training is limited."
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The effectiveness was proven to be low - and experiments on humans confirmed
another chapter in the auditor's report dealt with the development of the vaccine against Corona at the Biological Institute in Nes Ziona and from it a bleak picture emerges.
Auditor Engelman stated that the Ministry of Health approved the institute to proceed to the stage of experiments on humans even though no storage mechanism had been proven.
It was also found that only about 60 percent of the experimenters who took a high dose of the vaccine had neutralizing antibodies.
The amount invested in the vaccine and antibody development project is approximately NIS 230 million.
In July 2022, the project was closed without the development and production of the vaccines being completed - when by August 2022, 41 vaccines against the corona virus had been approved in the world.
"The project failed," the reviewer wrote.
"The biological institute presented a false representation of progress and costs when the reality was completely different. Even if this can be accepted in the initial period of the state of emergency, it is forbidden to agree to conduct that is inconsistent with the rules of proper administration in the period after."
The institute's initial requirement in February 2020 for the implementation of the vaccine development project was 63 million shekels and 50 employees, finally an amount of 230 million shekels was invested, when the estimated budget required to complete the development of the vaccine was approximately 1.4 billion.
The auditor claimed that the budget additions were presented in parts and did not give a complete picture of the situation.
The expected schedule for the execution of the project was extended from about 11 months to about 36 months - an increase of 227%.
The former Director of the Biological Institute Shmuel Shapira with then Defense Minister Benny Gantz (Photo: official website, Ariel Harmoni / Ministry of Defense)
This prevented a full reflection of the expected schedule and the investment required for the project, which ultimately led to its failure.
At the end of the audit, July 2022, the vaccine and antibody project at the institute, which was defined as a national mission, was closed without the development and production of the vaccines and antibodies being completed, and without them being approved for human use.
The state auditor found that the proposal of the director of the institute, Professor Shmuel Shapira, to Prime Minister Netanyahu, following which the directive was given to promote the project, was not in line with the limited capabilities of the institute in the field of production before the outbreak of the corona epidemic, and that the MLA allowed the issue of the vaccine to be brought up for discussion and present the proposal to the Prime Minister, even though he was aware that the Assistant Defense Minister's Headquarters did not know about Professor Shapira's proposal and there was no control process on the matter. In addition, the project was not managed in accordance with the procedures when one update meeting was held and the rest of the time there was a lack of cooperation on the part of the Institute. Headquarters The Assistant Minister of Defense allowed the project to proceed without the required control processes having been carried out.
According to the auditor's report, the development of the vaccine and antibodies took place without the required basic documents being written, including a document that focuses on the need for the medical product and its characterization, and without analyzing the possibilities of the means available in the world and the estimates regarding the costs of development, procurement and equipping.
Also, the project was conducted without a development committee accompanying it.
An escort and support team for the project that the assistant minister of defense instructed to establish met only once on 22.6.20, did not receive cooperation from the institute and did not meet again.
The Ministry of Defense welcomes the audit and considers it an important tool for examining and adjusting work procedures.
As a lesson from the treatment of the corona epidemic, it was decided, among other things, in the Ministry of Defense to transfer the responsibility regarding the response to the pandemic to the National Emergency Authority (NAE). The transfer was carried out in an orderly manner in 2022, including the 'Healthy Surge' program."
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