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Minister: Reform plan isn't perfect, but starts change

Over 2,500 medical interns resign in labor dispute over 26-hour shifts

In letter to Health Minister Nitzan Horowitz, intern organization says it is everyone’s interest that patients in hospitals not be treated by ‘exhausted’ and ‘unfocused’ doctors

Medical interns demonstrate for better work conditions outside the Tel Aviv District Health Office, October 7, 2021. (Miriam Alster/Flash90)
Medical interns demonstrate for better work conditions outside the Tel Aviv District Health Office, October 7, 2021. (Miriam Alster/Flash90)

More than 2,500 medical interns quit en masse Thursday in protest of 26-hour shifts they are forced to work, telling the government that it is in the national interest that patients in hospitals be treated by doctors who are not too tired to provide proper care.

The 2,590 doctors-in-training signed off on a letter that was delivered to the Tel Aviv District Health office by Dr. Ray Bitton, head of the Mirsham organization of medical interns.

Officials have expressed fears that the move could cripple Israel’s hospitals. According to Channel 12, the resignations would only go into effect in two weeks.

“To my regret, we have gathered here for a very sad day that has befallen Israel in which we are painfully forced to take a drastic step and present the resignation letters of more than 2,500 interns,” Bitton said outside the office.

The resignation came a day after the interns rejected a government proposal to gradually reduce shifts to 18 hours by 2026, but only in 10 hospitals in outlying areas.

The letter, addressed to Health Minister Nitzan Horowitz, said they were not motivated by personal interest and that it should be a national priority that those who arrive at hospitals get treated by doctors “who are not exhausted, tired, unfocused and without empathy due to inhuman conditions.”

The interns wrote that it has become clear to them that have been “abandoned” and accused Horowitz of failing to adhere to his assurances of a reduction in hours for all interns.

Medical interns demonstrate for better work conditions outside the Health Ministry in Tel Aviv, October 7, 2021. (Miriam Alster/Flash90)

Officials closed the doors to the office to prevent interns who gathered at the site from submitting personal letters of resignation, Channel 13 news reported. Instead, the interns stuck their letters to the doors.

Health Ministry Director General Nachman Ash told Channel 12 that for the resignations to go into effect they would have to be delivered to the different hospitals where the interns work.

He said he hoped they would not do so.

The government had promised that after the pilot program in the 10 outlying hospitals, the plan would expand to all hospitals later, but only if the necessary budget could be found and if a committee set up to examine the issue finds there has been no deterioration in the level of medical care.

Horowitz and Economy Minister Orna Barbivai had announced the proposal but admitted that they were acting under constraints of limited medical personnel and it was therefore not ideal.

“The plan is not perfect,” Barbivai said. “But the most important thing in this program is a breakthrough that marks a value-based goal of what we expect from the future generation of medics with regards to labor relations, and working hours are only part of the story.”

However, the interns immediately dismissed the proposal, which Mirsham said would only initially improve the work conditions of 10 percent of medical interns. The organization wants shifts cut for 25% of all interns.

Interns have held a number of protests on the matter in recent weeks; roughly 500 demonstrated outside Horowitz’s Tel Aviv home on Monday evening, and 10 were arrested.

Horowitz on Thursday insisted that the government proposal was “a historic change, a revolution.” He said the issue of intern shifts was “a difficult, complex matter. There are many opinions, interests, many budgetary limitations, and mostly a manpower shortage after decades of neglect.”

The minister asserted that most reactions he’d gotten from interns and doctors had been positive, though he admitted some were disappointed and wanted a more dramatic change. “I too would want to make [a change] in one stroke throughout the country, but it’s not possible, as there simply aren’t enough doctors to fill in the missing shifts,” he said.

“Our plan isn’t perfect, but it is the start of a historic change.”

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