A Patient Advocate’s Response to the Investigative Report of the Ministry of Health’s Functioning During the Corona Crisis
I usually write my blogs on the ins and outs of being a patient advocate, but I felt the need to respond to the recent article criticizing the Israeli Ministry of Health’s response to the COVID-19 pandemic. As someone who spends most of her day conversing with (or some could say “battling”) the healthcare system bureaucracy, I feel quite equipped to point out flaws in the system, or the gaping lack of specific protocols. However, I was a bit taken aback by the harsh tone of this investigative report, and want to point out some basic misconceptions.
- I take umbrage at the use of the term “lack of coordination and planning” to refer to how the Ministry has dealt with this health threat. Most of the departments I communicate with in the government, the Ministry of Education, Labor and Welfare, as well as Health, are comprised of many different branches, with hundreds of positions working on programs and implementing protocols. In general, there is often a lack of coordination among these branches. The system, overall, is cumbersome, with local and national needs often put in stark conflict to one another, where administrators, and often clerks, must either duke it out among each other or put their heads down and soldier on. This is an endemic part of Israeli bureaucracy and is certainly not unique to the MOH.
Strikingly, I have been quite impressed by the fluid and cooperative manner in which the MOH officials responded quickly to what took other nations weeks and months to “get around to.”
- I was amused by the reference to the State Comptroller’s 2007 report warning of Israel’s unreadiness for a state of emergency and the need for massive change. I wonder if the author has even read any of the Comptroller’s reports. I have and they are always filled with strong, critical language of whatever current government actions they are choosing to criticize, and inevitably the report always finishes with a sweeping recommendation for system-wide change.
I do not know or understand the political machinations in this country so I will not even take a guess as to the purpose of the Comptroller’s report, but, needless to say, I always take it with a grain of salt.
- Bringing in the measles epidemic is a specious argument, in my opinion. Creating strategies to reduce pockets of viral outbreaks among at-risk populations for a disease that has a known vaccine, is completely different than coordinating efforts to combat an airborne, highly contagious illness that currently has no vaccine.
Which brings me to my final point.
No one in the world was prepared for this. I recently heard a professor emeritus from Yale University, who just published a book called Epidemics and Society, being interviewed, who stated that he was completely surprised by the pandemic. Yes, SARS and MERS were warning signs, and yes, maybe everyone who works in the health field should continually walk around with thought, “A pandemic could happen tomorrow. Do we have enough ventilators?” I know those people, by the way; they are NOT fun to hang around with.
I think the take-home lesson is, sometimes, the unexpected does strike. Some things can be predicted and others cannot. Prior to the measles and polio vaccines, thousands of children died or were permanently disabled; the Spanish Influenza ended up killing millions of people worldwide, mostly young, healthy adults from ages 20-40. No one could have predicted that this COVID-19 mutation would affect mostly the elderly and those with comorbidities.
I think instead of blaming the Ministry of Health for not controlling something that, in its essence, most likely was not controllable, we need to ask other questions.
Can the government be flexible? Cooperate with one another in a time of true crisis and not focus on irrelevant details? Ensure that professional experts in the field are the ones making critical decisions, and not figureheads? I think that the Ministry of Health has certainly answered yes to those questions, and I am enormously impressed by the behavior and action that has taken place over the past few months. I think that we need to take a wider picture of what is transpiring before we leap to make blanket statements of mismanagement.