Budget for shortening shifts at hospitals to be included in state budget

The plan will be enacted in stages, beginning in the periphery of the country and with a goal of shifts that are no longer than 16 hours.

 Empty beds in the intensive care unit at the Coronavirus ward of Shaare Zedek hospital in Jerusalem on October 14, 2021.  (photo credit: OLIVIER FITOUSSI/FLASH90)
Empty beds in the intensive care unit at the Coronavirus ward of Shaare Zedek hospital in Jerusalem on October 14, 2021.
(photo credit: OLIVIER FITOUSSI/FLASH90)

The State Budget that is expected to be approved in about six weeks will allow the shortening of the shifts worked by hospital interns and residents starting from the beginning of September. According to Mirsham, the organization of interns (in their first year after medical school) and residents (from the second year), about 1,200 doctors sit unemployed at home and not assigned to the rotation, while those on the job in the wards are “collapsing due to lack of personnel to replace them.”

The plan will be enacted in stages, beginning in the periphery of the country and with a goal of shifts that are no longer than 16 hours. According to Dr. Roni Blank, a researcher at the Knesset’s Information and Research Center, no date has been set for the start of the implementation of the plan for doctors studying the specialties of surgery, cardiology, anesthesia and intensive care who are not employed in internal departments. They are, however, supposed to be included in the five-year plan to shorten the shifts.

Also, the amended permit states that the multi-year plan will be implemented during the years 2023-2027 and not in the years 2022-2026 as stipulated in the previous permit. As yet, no target dates have been set for the start of implementation in hospitals in the center of the country.

A patient is comforted by a doctor in hospital.  (credit: NATI SHOHAT/FLASH90)
A patient is comforted by a doctor in hospital. (credit: NATI SHOHAT/FLASH90)

Budget for shortening shifts to be included in designated state budget

Daniel Padon, a health economist in the Finance Ministry’s budgets division, promised on Wednesday at a meeting of the Knesset’s Health Committee that the budget for shortening the shifts of the interns and residents will be included in the designated state budget and transferred in May, allowing for shorter shifts in six months.

Shas MK and committee chairman Ariel Bosso said the path to shorten shifts has been “a long-standing one, and the issue is important and dear to all of us.”

Knesset Committee for Youth Affairs chairman MK Naama Lazimi (Labor) emphasized that “the young doctors currently work in slave conditions, and the patients are operated on when the doctors are not at their best.” Lazimi criticized the absence of representatives of the Israel Medical Association (IMA) and requested that the representatives of Mirsham participate in the committee sessions either as full members or as observers.

AT THE CONCLUSION of the discussion, the two committees sitting jointly demanded that the Health, Finance and Labor and Social Affairs ministries implement the plan, while weighing and thoroughly examining all the variables and the needs of the system so that it would be implemented in hospitals no later than September 1, with an emphasis on those in the geographic periphery areas. In addition, Bosso and Lazimi demanded that Finance Minister Bezalel Smotrich allocate NIS 30 million and transfer it to the Health Ministry as soon as possible.

Health Ministry Deputy Director-General Dr. Sefi Mendlovic said that the duty shifts must be shortened in a responsible manner. “The ministry is promoting legislation that will allow for the regulation of the employment of physician assistants, a profession that exists in the US, and the encouragement of outstanding doctors and research programs to the periphery. These programs are already budgeted.”

According to Mirsham chairman Dr. Rey Boton, “we are not asking for special conditions or an astronomical salary but just to work within hours that are more acceptable for today, to provide the proper care to our patients and to have a family life and to maintain our own health,” she said. “We will also be safer on the roads, when at the end of a 26-hour shift we have been forced to get behind the wheel and drive home independently.”

According to Ra’am MK Iman Khatib Yasin, more than half of interns and residents admitted that they fell asleep at the wheel on the way back from work, and 5% of them were involved in traffic accidents.

Hadash-Ta’al MK Ahmed Tibi, who is by profession an obstetrician/ gynecologist, added that despite the general agreement on shorter shifts, “it is not being carried out” and called on the government to allocate an appropriate budget.

Attorney Yaniv Ya’akov, head of the road safety organization Or Yarok, warned that after shifts, young hospital doctors are “ticking bombs on the road” with a 30% greater risk of being involved in accidents than other drivers. He called on hospitals to provide shuttles to take them home.