Why does it have to be like this?

I have a patient who is only 52 years old and will die in the next few hours. I spent most of the night doing everything I can to extend his life just enough for the family to get here.

At 11pm I spoke to his brother who said he can arrive by 2pm from Ramallah, but unfortunately, because of the situation at the Kalandia Checkpoint, may not be able to arrive sooner. He did however managed to contact the patient’s teenage son who was nearby and who I spoke to this morning.

I can’t even begin to imagine what this boy is going through, trying to deal with the fact that his father is dying, but he managed to put on a brave face talking to me.

When the boy realised how bad things were he asked if there was anything we could do to try to help his mother get to his fathers bedside before he died. The trouble was that she doesn't have a permit to get through the checkpoint.

After I went this them to Hospital Reception (me as a doctor being there may open some doors), we ended up having to just give the teenager a letter saying that his father is a patient at Hadassah and is dying. He now has to take that to various bureaucrats to get the permit. I hope and pray that someone helpful decides to rush it through, because my greatest fear is that while he is off doing this, his father will die alone.

It doesn't need to be like this.

There should be a number I can call for the officer at the checkpoint. A helpful army soldier should pick up the wife and drive her straight to us. Doors should part.

If not, then I'm not sure the son will ever forgive the occupiers, and I'm not sure how easily I could forgive us either.

Hadassah - most issues resolved, waiting on court decision regarding insurance before we can return to work

Most of the strike issues look like they may have been solved, but we are still not insured sufficiently to work safely. This is being discussed in the courts Wednesday, but after that is resolved, it looks like we may be back at work soon.

The end (of the strike) is in sight.

P.S. after that there is still 3 months of hard negotiations to resolve the problems of Hadassah. But at least we will be working normally.

Stop attacking Hadassah Management!

I have just read a seriously disingenuous article in Ynet about Hadassah. They are accusing the managers of continuing to take large salaries, and to support this claim, they quote figures for how much each manager "costs Hadassah" (allowing them to include pension contributions, Keren Hishtalmut, insurance costs etc.)

I know personally one of the managers well: Yoram Weiss used to be head of Anaesthesia before he was asked to take on the role of Medical Director when this crisis became really bad. He did this without any increase in salary (as noted in the paper but then ignored), and knowing that it is a tough and unpopular job. There is no way I would agree to be standing in his shoes right now - not for twice his salary.
I would also say that in his 3.5 years as head of Anaesthesia in Hadassah, he made the department into one of the best places to train in the country, earning the respect of all his Residents. I have no idea how this mess will end, but Yoram seems to be someone who at least has a chance of moving things in the right direction.

I have only seen Avigdor Kaplan (the Chief Exec) from afar, and have only heard him speak twice. However on both those occasions he impressed me with what appeared to be an honest aim to rescue Hadassah, and an inspirational dream of bringing us back to our position at the top of Israeli healthcare. He also came in during the peak of the crisis, also taking on a job that was certain to be unpopular and tough.

I know that we are on strike, but as the doctors' committee chairs said at the start - we are standing side-by-side with the management and asking for the government for support (not just a bailout. The current system of reimbursement for Israeli hospitals prevents almost any hospital from covering its costs).

So whoever thinks it's a smart idea to make these personal attacks on the people who have taken on the challenge of running Hadassah doesn't seem to have Hadassah's interests at heart. Nor those of the population of Jerusalem.

Hadassah - Chapter 11 Bankruptcy Protection

A quick Hadassah update:
Firstly we were told today that the Anglo-Saxon (ie English) term for the process we are in would be Chapter 11 bankruptcy protection.
The deal is that the court appointed executors can impose deals for 3 months on the workers, management and creditors.
After 3 months there are three possible outcomes:
1) everyone agrees to a deal to save Hadassah
2) the Chapter 11 is extended
3) full breakup or bankruptcy of Hadassah. Effectively all the staff lose our jobs and can be Re-employed if the new management chooses and with any terms they choose.

The Chapter 11 was introduced when the hospital could no longer even buy good or basic medicines for her inpatients. Things were pretty desperate.

We are hoping to receive an advance on next months salary I'm the next few days (it is illegal to give us the second half of our January salaries under Chapter 11 terms). That won't be our full salary.
There are however some conditions we are demanding before we give up the strike. These include:
Adequate medical liability insurance cover.
Payment to the Palestinian doctors (they are paid separately and have done even worse than us)
Continued recruitment of trainees as needed.
Plus done other small points.

When the strike will end is still unclear

Hadassah Updates

After the suggestion of a friend (thanks Arieh), and as a chance to keep some of my non-FaceBook family up to date on what's going on, I thought I'd post some of my recent FB updates to this blog. They are probably shorter and less well thought out than I would normally feel proud to post, but things at Hadassah have been evolving rapidly, and maybe quality can be replaced by timeliness.

I've also tried to back-date them, so please look back over a few posts.

Hadassah - Tax and pensions money going missing

It turns out that my employer has been deducting my pension contributions, Keren Hishtalmut (a government matched saving scheme) and Income Tax (PAYE) from my salary each month...

...and then pocketing it instead of handing it to the Tax Office and Pension Company!!

I can hardly come up with words to describe what I think. This is the behaviour of big fraudsters like Maxwell and Meddof, not a public hospital!

Hadassah - No Medical Liability Insurance

The situation at Hadassah is going from bad to worse. 
As you may know, we have been running a "weekend service", of reduced staff and treating emergencies only, for the last week. 
A decision yesterday by the courts that freezes our debts may also leave us all uninsured against medical malpractice. We are waiting for final confirmation, but in that situation none of the doctors can continue working at all. (In Israel, unlike the UK, you don't have private MDU/MPS insurance - it's all through the work place).

In that case, I have no idea what happens to our several hundred in-patients