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Slamming government, medical residents reject compromise offer on shortened shifts

Trainee doctors protest state’s postponement of plan to gradually reduce hospital shift hours from 26 to 18

Dr. Rey Biton (second from right), head of the Mirsham organization of medical residents, holds a press conference at Assuta Medical Center in Ashdod, August 1, 2022. (Flash90)
Dr. Rey Biton (second from right), head of the Mirsham organization of medical residents, holds a press conference at Assuta Medical Center in Ashdod, August 1, 2022. (Flash90)

Medical residents protesting 26-hour shifts and threatening mass resignations over a delay to implement a plan to gradually shorten the shifts to 18 hours, rejected an offer on Tuesday to begin working in 21-hour shifts in some areas in the short term.

The offer was made by the Prime Minister’s Office in an effort to settle growing tensions between medical residents and the government over a delay to a plan that was set to gradually reduce their 26-hour shifts to 18 hours starting in peripheral areas, outside Israel’s central cities.

Residents renewed their struggle this week after the government said Sunday that the plan, which was supposed to begin this year, had been postponed until September 2023.

The Prime Minister’s Office said that representatives of the Mirsham organization of medical residents chose “to insist on moving forward with a plan that cannot be advanced given the existing limitations during an election period,” public broadcaster Kan reported Tuesday.

Israelis are headed to the polls on November 1 for the fifth national election since 2019.

The plan to gradually shorten shifts was supposed to take effect in April, starting with a pilot program in 10 hospitals in the so-called periphery areas. This followed threats of mass resignations last year by thousands of medical residents in protest of the long shifts. The protesters had warned at the time that the proposed government plan was announced, in October 2021, that it was too vague and had no clear rollout.

Dr. Rey Biton (center), head of the Mirsham organization of medical residents, holds a press conference at Assuta Medical Center in Ashdod, August 1, 2022. (Flash90)

Mirsham said on Tuesday that the organization would not agree to a plan that offers to shorten shifts only for residents in peripheral areas and not those in the center of the country.

The organization accused the Finance Ministry of trying to make the issue a way for the government to “give grants” to the periphery and “prevent [the passage of] budgets and national investment that the periphery desperately needs after years of neglect.”

“All the parties involved are taking advantage of the ‘election period’ to evade responsibility and trying to sell us a terrible shortening of shifts plan…so that they can boast about ‘shortening shifts’ and rake in political capital at the expense of residents and patients,” Mirsham said, according to Kan.

On Monday, Dr. Rey Biton, head of Mirsham, revived threats of mass resignation of staff if the government decision to delay was not reversed by August 25.

She promised “extensive protest action inside and outside hospitals” in the coming days and called the delay to shorten shifts a “death sentence.”

The government announcement to delay the plan’s implementation Sunday had come in response to a Labor Court petition by the Clalit health fund that said there was not enough manpower to absorb a cut in resident work hours and as a result, public health would be affected. The petition was filed against the Health Ministry and the Economy Ministry.

In its petition, Clalit claimed another 300 doctor positions would be needed to cover the shortfall if residents’ hours were cut.

In response, Economy Minister Orna Barbivai said on behalf of the government that the matter could only be resolved by the next Knesset following the November 1 elections, according to Hebrew media reports.

Biton said that elections were “a poor excuse for lack of governance.”

Medical residents demonstrate for better working conditions in Tel Aviv, on July 30, 2022. (Tomer Neuberg/Flash90)

“This government failed both professionally and morally, both because it didn’t stand by any commitment and by any agreement with us, and also because it continues the abusive and dangerous employment under conditions of slavery,” she said.

Last October, thousands of residents resigned in protest of the 26-hour shifts they are expected to work. The government then proposed a plan under which the shifts at 10 hospitals in outlying areas would be shortened to 16-18 hours.

It had promised that after the pilot program in the 10 outlying hospitals, the plan would expand to all hospitals if the required budget could be found and if a committee set up to examine the issue could establish that the level of medical care was not compromised.

Up until the year 2000, Israeli medical residents worked 36-hour shifts and sometimes longer. That year, an agreement was signed to reduce the shifts to 26 hours with a two-hour break.

In 2012, following appeals to reduce the hours again, the government adjusted the regulations to limit residents to two shifts a week, and for them to not work more than 71.5 hours in a week.

Most hospitals have not implemented the new regulations.

According to a 2016 poll published in The Marker, 72 percent of medical residents worked more than 26 hours in a row at least once a month, 42% didn’t sleep during their shift, and 27% worked more than 71.5 hours a week.

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