Israel Medical Association: legislation to ‘devastate’ healthcare system

Science and Health

A two-hour “protest strike” will be carried out on Wednesday by thousands of physicians on behalf of the leadership of the Israel Medical Association (IMA). The labor action will take place between 8.30 and 10.30 am in hospitals and clinics around the country, and information sessions for doctors and others will be during the first hour of the strike. 

The IMA said emergency cases will continue to be treated; others will have to wait for care. “We will do everything we can to prevent harm to the patient population,” the association added. 

Prof. Nadav Rabinovitch, an epidemiologist and public health physician and head of Ben-Gurion University of the Negev’s School of Public Health and previous head of the Israel Association of Public Health Physicians told The Jerusalem Post that the “situation is acute” because the government’s “Reasonableness Clause” is due to pass in the Knesset in a few days. 

The reasonableness clause will pose a ‘great danger’ to healthcare, demanding action

He stressed that this clause and many others due to follow will pose great danger to healthcare. “We carried out strikes in the past, but these were always about working conditions and pay. This strike is about values and the dangers to the health system. Polls we have conducted show that 90% of all Israel doctors are with us along with ‘white coats’ in other medical professions, including mental health. If the legislation passes, we will decide what to do. We can resign, hold hunger strikes and take other action to protest. There is only a small minority of physicians and other ‘white coats’ who favor the extreme weakening of the judicial branch and other legislation pushed by this government.” 

A few days ago, IMA chairman Prof. Zion Hagay said: “We will not hesitate to take organized action.” After a thorough and lengthy deliberation during which various opinions were voiced and different proposals were put forward, the association decided to oppose the proposed law for the abolition of the “Reasonablenss Clause,” arguing that it would “devastate the healthcare system. It is not just a theoretical concern.”

Demonstrators protests against the Israeli government’s judicial reform in Dizengoff Square, Tel Aviv in the 25th week of protests June 24, 2023. (credit: AVSHALOM SASSONI/MAARIV)

Prof. Hagai Levine, chairman of the Israeli Association of Public Health Physicians and co-head of “White Coats – Healthcare Professionals for Democracy,” congratulated the IMA’s secretariat on their decision to authorize the use of all means necessary to stop the legislation. “Abolishing this clause would allow political control over medical professionalism – politicizing medicine – and would harm public health and medical autonomy. This is not reasonable. The responsibility for the emerging chaos lies with the government, which continues its recklessness in dismantling the State of Israel. If the government does not stop, the healthcare system will stop,” stressed Levine. 

After the reform and the cancellation of the clause, said the IMA, the High Court of Justice, the courts and the labor courts will not be able to discuss any issues that are under the authority of the health minister including appointments of a government/district health physician; appointments of the members of ministry disciplinary committees; decisions regarding the punishment for a doctor who commits a disciplinary offense; the preparing of a list of communicable diseases; the establishment or closure of departments and professional units in hospitals; determining instructions regarding the installation and operation of cameras in the common space and in the private space; setting down the powers currently held by the Israel Scientific Council on specialist degrees, exemption from exams and the like; determining the length a suspended doctor’s license; passing a judicial review on the inactivity of the government and the ministers in regards to violence against doctors; supervision of the health services provided to patients; judicial review of the budgeting of the health system and the various treatments for the insured, the provision of vaccines and more; allocation of resources to the psychiatric hospitals; and limiting doctors’ salaries, in which decisions were made by the government and its ministers. They could report to the authorities on the personal status of patients including pregnancies, sexual proclivities, psychiatric illnesses and others. 

Consequences of the reform will limit physicians’ agency 

The IMA said that the legislation could also put pressure on physicians to make medical decisions according to the government’s interests and save money and refuse treatment of some patients. “Political intervention in research studies could harm Israel’s reputation for high-level medical studies and discourage international companies from bringing new technologies to Israel,” the IMA charged. 

The quality of healthcare would also be harmed because the legislation would allow discrimination against women and homosexuals and AIDS patients by doctors who argue treating them would “go against their conscience.” Such physicians could also decide to give priority to male patients, Jews, heterosexuals and policemen (before demonstrators).

The IMA added that regarding the question of a political appointment or an unprofessional appointment, the “Reasonableness Clause” is not appropriate. The same applies to the dismissal of a professional body that one of the ministers demands to dismiss. 

It added that for the most part, “the High Court of Justice has not interfered with a minister’s decision, but the very discussion at the High Court results in a more balanced decision. Thus, for example, the intention to transfer the dispensing of medicines to pharmacists was significantly reduced.”