Policy responses for Israel - HSRM


Policy responses for Israel

2.2 Workforce

Israel has a rate of employed physicians that is close to the OECD average in 2017 (3.14/1000 population and 3.44/1000 respectively). In contrast, the rate of nurses is less than half of the OECD average (5.1/1000 and 9.2/1000, respectively). It was well known that there are shortages of nurses in hospitals even before the pandemic. To maintain an adequate supply of health professionals to treat COVID-19 patients, on March 4 the MoH prohibited healthcare workers from leaving the country. Apart from that, no logistical support has been given by the government, and no financial incentives have been provided to maintain the availability of health workers. Some workers not directly involved in treating COVID-19 were put on unpaid leave. Those who remained working needed to find childcare on their own. Some hospitals and universities privately organized childcare for their workers, but only for children aged 3+. 

In the early phases of the epidemic, many hospital professionals became infected or were quarantined. As of March 28, 3,637 healthcare workers were quarantined, of which 892 were physicians and 1,229 nurses. About 141 healthcare workers were sick with COVID-19. This further decreased the workforce available for care provision. In order to expand the health workforce responding to the COVID-19, the MDA recruited medical students to collect samples for diagnostic exams, medical students who were waiting for the start of their residency programs were recruited to treat patients in hospitals, and students in the medical sciences were asked to volunteer in newly built laboratories for COVID-19 diagnosis.
Due to social distancing measures, regular classes for students in the healthcare professions were cancelled. Medical students in their pre-clinical studies continued learning through digital platforms, but studies related to the clinical years of medical schools were cancelled until further notice.
No formal or centrally-led reorganization of hospital staff has been made, and this has been left to the discretion of each hospital. In some instances, interns were relocated from surgical wards and trained to help in medical wards with the COVID-19 treatment. This was necessary both because the volumes of patients increased and because some of the medical ward professionals got ill themselves or were quarantined. In order to speed the training, the MoH uploaded tutorial videos at its website on how to operate ventilators, and how to perform procedures related to the pandemic, such as intubations and treatment of ARDS symptoms.

The MoH has temporarily recruited nurses and physicians to treat COVID-19 patients, mainly in geriatric institutions, most probably due to the lack of staff and high numbers of infected in those institutions (https://govextra.gov.il/ministry-of-health/corona/corona-virus/medical-guidelines-corona/recruitments/)

A mental health support phone-line for healthcare workers and their families has been opened by the MoH with healthcare professionals providing support during weekdays between 10AM-6PM.
Another support line is available for professionals working in geriatric institutions


More health workforce allocated to the healthcare system
Israel has a shortage of hospital nurses (the density of practicing nurses per 1,000 people in Israel is 5, compared with OECD average of 8.7). On July 21, nurse association declared a strike, demanding the creation of more positions in the health system and in hospitals in particular. As a result, the Ministries of Health and Finance signed an agreement with the nurse association.
The agreement provides new positions for 1,600 additional nurses to be added to hospitals and another 400 to health plans. The new workforce intends to handle the challenges of the COVID-19 pandemic and other general healthcare needs
Additionally, in order to cope with the pandemic, another 700 administrative and healthcare workers will be assigned to the COVID-19 wards in hospitals (MoH telegram, 21.7.2020, https://www.ynet.co.il/article/SkdFhvXlv ).