Fifteen years ago, one of the most profitable tenders in the State of Israel was published: a tender for the provision of long-term care services, in which the National Insurance Institute privatized its responsibility to provide long-term care services for Israeli citizens to the nursing companies. Over the past decade and a half, the companies and associations that won the tender have been providing nursing services, inter alia, through Israeli workers who are sent to nursing patients for several hours a day.
Apart from these, they employ foreign workers. In other words, they receive money from the National Insurance Institute for the employees, spend a slip for some of them, and transfer the money to the employee, without forgetting to derive a share from it for themselves.
This is not a decree from Heaven. A nursing patient who wishes to do so may request to employ the worker himself and without the intervention of a nursing company.
If he chooses to do so, he will have about NIS 500 more left in his pocket each month, a total of about NIS 6,000 a year, according to a study conducted by Deloitte for the Ministry of Social Equality in mid-2021.
But the lobby of the nursing companies is so strong that the National Insurance Institute Law enshrines a default, which is to transfer the money to the nursing companies, not to the patient.
Over the years, a variety of strange phenomena have arisen in this form of employment: the salary slips of foreign workers began to include overtime components, per diem, travel expenses and a fixed bonus. Some nursing companies have begun to carry out placements, holding their own stock of employees, in complete contravention of the provisions of the law.
Finally, there were threats to remove an employee from a patient's home if the patient decided to part ways with the nursing company and switch to direct employment.
But every celebration must have an end, and the National Insurance Institute has issued a new tender. The bidding companies submitted no fewer than 5,000 clarification questions, and there was a delay. Last month, MK Eliyahu Revivo, Chairman of the Knesset Foreign Workers Committee, initiated two meetings and demanded answers from the nursing companies:
Why does the National Insurance Institute transfer an estimated NIS 152 million a year to long-term care companies for travel by foreign workers, while they live in their employers' homes and do not have to travel there?
What happens to the NIS 16 million transferred for sick pay for foreign workers, if they do not take advantage of sick days?
Why do long-term care companies receive national insurance contributions for foreign workers like Israeli workers, and where have the 62 million shekels given to them for expenses they never spent gone?
In particular, MK Revivo sought to understand how it is possible that the State of Israel invests hundreds of millions of shekels in training, yet many of the workers were not even exposed to the possibility of receiving such training.
How is it possible that money that is poured in to improve skill, professionalism and safety in care does not end up coming as an improvement in the care provided to long-term care patients and as training for foreign workers?
A new sheriff comes to town and is determined to get the money back into the public purse. Those who have the best interests of patients, the elderly and the disabled in mind, will not rest until the process is complete.
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