The crisis of the Authority threatens the localization of medical services in Palestine

Awad Rajoub-Hebron

While the private health sector in Palestine expressed optimism about the leadership's tendency to resettle medical services and reduce medical transfers abroad, especially the Israeli hospitals, the financial crisis of the Palestinian Authority threatened this trend due to the accumulation of debts of the Authority in favor of the private sector.

Representatives of the private sector, whether hospitals or suppliers of medicines and medical supplies, hold on to the vision of leadership, but they talk about the negative repercussions of not receiving their dues to the extent that some hospitals are unable to pay the salaries of their employees for several months, and stop development projects needed by hospitals.

According to the data of the Union of Hospitals and private and private medical centers, the ratio of remittances to its employees is now 95%, and the rest is going abroad and Israeli hospitals, which means the ability of this sector to serve the Ministry of Health away from the pressure and extortion practiced by the occupation when transferring patients and mediation on clearing funds.

Digital data
According to a periodic report by the Ministry of Health published in July, the number of cases of purchasing the service from outside the ministry facilities reached about 110 thousand transfers in 2018 at a total cost of approximately 725 million shekels (about 207 million dollars).

According to the report, in the same year, 89 thousand 133 cases were transferred to private and non-governmental hospitals in the Gaza Strip, the West Bank and East Jerusalem, making up 81.2% of the total referrals in 2018, compared to 20 688 referrals to hospitals in Egypt, Israel, Jordan and Turkey.

According to the report, the number of transfers into the Green Line (Israeli hospitals) amounted to 18,348 referrals, or 16.7% of the total number of service purchases in 2018, and going to the Palestinian private sector means to stop these transfers.

So far, the president of the Union of Hospitals and private and private medical centers Nizam Najib talks about the close cooperation between the union and the Department of Medical Transfers in the Ministry of Health, and stresses the adherence to the implementation of the vision of political leadership in the localization of medical services, but warns of the worsening crisis.

In figures, Najib pointed out that the number of referrals to national hospitals has increased this year to 95% this year, estimating the annual cost of referrals to NIS 600 million.

Najib explained that the number of patients referred to Israeli hospitals today is 800 patients, most of whom are following previous treatment and only about 60 cases.

He said 70,000 referrals were made this year to national hospitals as part of a wide basket of services for the Ministry of Health covering most cases.

Impotence and inertia
Despite his satisfaction with the localization of the service, Najib pointed out that the debt problem affects the private sector, estimating the debts owed to the government by about one billion shekels (about $ 286 million), in addition to previous debts that have not been settled.

The President of the Hospitals Union looks forward to paying the debts owed by the Authority "so that the national hospitals can carry out the burden on them and to buy medicines and medical equipment and equipment and pay the staff."

Al Jazeera Net has reached out to the Ministry of Health to obtain answers to several questions regarding private sector dues, but has received no response despite promises to respond for nearly two months.

But Najib spoke of a payment of 100 million shekels (about $ 29 million) to be distributed in cash and bonds to private hospitals this week, and he looked forward to paying more.

The President of the Federation talked about a government plan to cover all patients and illnesses that go to Arab and Israeli hospitals by 100% until September 2020, but stressed "in return for resettlement must be the development of hospitals and the payment of accumulated debt in the form of periodic payments."

Success is conditional
For its part, revealed the Union of suppliers of medicines and medical supplies of the accumulation of frightening dues of the private sector to three government agencies: the Ministry of Health and the Ministry of Finance and Military Medical Services.

Muhannad Habash, director of the federation, said that the total debts owed by the union to the Ministry of Health alone amounted to 404 million shekels (about 115 million dollars) as of early September.

Habash spoke to Al Jazeera Net about the negative repercussions on the agent companies and importing medicines, as they resort to borrowing from banks to pay their obligations towards the companies supplying them, and to run out of the ceiling of the facilities granted to them, some resorted to personal guarantees and mortgage mortgages to ensure that they continue to work.

Habash warned that the accumulation of risks and debt could make drug suppliers unable to proceed with the supply to the ministry and to hospitals that provide services to the ministry because it does not pay its debts to drug suppliers unless it receives its dues from the government.

He pointed to previous agreements with the government to continue to provide services, but the latter did not comply with them, pointing out that these days to pay a payment constitutes 23% of the debt owed to companies, although the previous agreement talked about a payment of at least 50%.

The Palestinian trade unionist concluded that "the vision of the localization of medical services will not succeed unless the government is committed to the regular payment of the private sector."