After a 158-day struggle, the Israel Medical Association and the Ministry of Finance are due to sign a new labor contract tonight, which will end the disruptions and strikes in the health system. The breakthrough came when the Ministry of Finance agreed to greatly improve the cost of the agreement to 47-49% from 39.5%, which the Medical Association rejected last month.
Under the agreement, all doctors will receive a uniform 24% pay hike over nine years. Doctors in the periphery and in fields with shortages will receive an additional 20% over three years. On average, 70% of doctors will receive the full increase within five years.
For its part, the Medical Association promises industrial quiet for the full term of the agreement; there will be no doctors' strike for nine years.
This agreement includes far-reaching and very complex changes for doctors, but the changes should benefit the health system and the public in general. For example, for the first time, the Medical Association agreed that specialists, and not just emergency care and gynecology specialists, will be required to do duty shifts. This means that the public will see more specialists in the afternoon and weekends.
It will work as follows: a doctor with five years' seniority as a specialist will be required to do two full 26-hour duty shifts until 11 pm a month. After a duty shift, a specialist will have the day off, and in both cases, the rate will be substantially higher than the rate of a resident. Over the subsequent five years, the specialist will be required to do two shorter duty shifts, up to the maximum age of 47.
One of the biggest changes for the doctors is that they will be required to punch a clock. The agreement stipulates that doctors can choose between reporting work hours via mobile phone or by signing a time card. The Medical Association fiercely opposed the time clock at the start of the negotiations, but realized that without it, the Ministry of Finance would not agree to any deviation from the general public sector agreement - a 7.5% pay hike over four years.
The agreement's jewel in the crown is the preference it gives to the periphery and for specialists in fields with shortages. For example, under this agreement, a specialist in central Israel who makes six duty shifts a month currently earns NIS 16,600 gross a month will earn NIS 21,600 - a 30% pay increase.
A specialist in a field with shortages in central Israel who currently earns NIS 18,700 a month will earn NIS 35,300 - a 33% pay increase. A specialist in the periphery will see a 52% pay hike to NIS 35,800 from NIS 17,000. A doctor in the periphery who specializes in a field with shortages will see a 54% pay raise to NIS 31,500 from NIS 20,500.
The agreement also stipulates that doctors who move to the periphery will receive up to NIS 500,000 in grants, provided they agree to stay there for 4-6 years.
These benefits for the periphery have not persuaded doctors in central Israel, who will have to accept smaller pay hikes. This morning, scores of doctors went to the hotel where representatives of the Medical Association and the Ministry of Finance were meeting to express their anger at the deal. Most of the doctors came from Tel Aviv's Sourasky Medical Center Ichilov Hospital near the hotel. The hospital administration warned that the protest was in breach of instructions.
"You sold out," said one Ichilov doctor.
The issue now turns to the hundreds of residents who submitted their resignations last week to protest the agreement that was in the works, even though it included their demands for 1,000 more positions and restricting their duty shifts to six a month. The letters will come into affect on September 4, and it is not clear if they were a means to apply pressure or a real attempt by the residents to shake up the health system.
Published by Globes [online], Israel business news - www.globes-online.com - on August 24, 2011
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