Knesset committee debates issue of money vs geriatric services

A special joint committee in the Knesset asked on Tuesday that a clause on geriatric-nursing assistance be removed from the Treasury’s Arrangements Law because it could result in the families of sick elderly people taking money instead of geriatric-nursing services being provided to the patients.

A group of 49 MKs from the coalition and opposition petitioned the joint committee of the Labor, Social Affairs and Health Committee and the Economics Committee to take the action regarding the Arrangements Law, which is formulated by the Finance Ministry and has to be approved en bloc along with the budget bill.

Until now, geriatric patients had received services approved by the government, but the Treasury’s reform would allow families to take money as the default option, and decide later whether or not they want to use it to get actual services. Families of very old, weak or demented patients could take the money and leave the relatives without care, the MKs suggested.

The request to the joint committee headed by MK Tali Ploskov (Kulanu) was initiated by Zionist Union MK Leah Fadida, who said: “This is a complex and sensitive issue, with implications for a million senior citizens. Such a decision should have been formulated after a thorough and in-depth discussion. It should not be passed overnight, as the program is worth NIS 1.8 billion over the next four years. As public servants, we are committed to avoiding action that could harm the welfare and quality of life of elderly citizens.”

During the discussion, MKs, representatives of nursing agencies and various non-profit organizations expressed resentment at the Treasury’s intention to change the default option for a large proportion of the elderly, so that they would receive financial benefit instead of actual nursing services. Alternatively, they may announce that they choose to receive direct services.

Ploskov said that she, too, did not think the state should give money by default and called for allowing a financial benefit only after the authorities reported that the elderly person was being treated well.

MK Nachman Shai (the Zionist Union) worried that families may not resist the temptation and take the money.

But Orna Zamir, head of the National Insurance Institute’s nursing department, maintained that one of her representatives contacts every person eligible for care and “talks to him or with his family. But only 6% of the elderly have so far chosen to receive money, so why are they objecting to the default option?”

But others pointed out that many patients, including Holocaust survivors, may be too old and even demented to voice their opinion freely.

Pleskov said more discussions will be held on the matter soon. MEANWHILE, A SUBCOMMITTEE on narrowing the health gaps in the North, headed by MK Moti Yogev (Bayit Yehudi) heard that gaps in healthcare available in the center of the country compared to what is available in the North are substantial. The discussion was held to mark Galilee and North Day at the initiative of the Knesset’s Galilee Lobby.

“Every citizen deserves equal healthcare,” said Yogev. There are higher morbidity and mortality rates, a shortage of doctors and hospital beds, and inadequate rehabilitation facilities for children in the North. It also affects adults, including wounded soldiers from the North who are hospitalized in the center. The construction of a rehabilitation hospital for the North, the shortening of queues, the unification of services and the bringing of specialists to the North are needed.”

Health Ministry associate director-general Prof. Itamar Grotto conceded that there is a higher rate of death and illness and even infant mortality in the North. The rate of beds per 1,000 people is lower, as is the ratio of physicians – 2.3 doctors per 1,000 people in the North compared with 5.1 in Tel Aviv.

In the paramedical professions there is also a significant gap between the North and South. “We are working hard to try and narrow the gaps,” Grotto said. He added that the Poriya Medical Center, located on the Poriya ridge above Tiberias, will be allowed to build a rehabilitation facility starting next year.

Dr. Salman Zarka, director-general of Safed’s Ziv Medical Center, said: “We are [moving] in a positive direction, but it is too slow; northern residents pay with their health. We open institutes, but we have no medical manpower to run them. There is a shortage of doctors. You can’t open facilities if there isn’t enough manpower in advance.”

The training of personnel for the rehabilitation center takes four years, Poriya’s Dr. Erez On said, adding: “Unless staff is trained now, the center will become a white elephant.”