gh quality by employing a large number of doctors and by making ximum use of specialists and laboratories. The insurance scheme o covers dependents of the insured member.

Prior to 1948, Jewish communal activities in the fields of education, lth and social services were coordinated by the Vaad Leumi. But it 1 no authority to make health regulations or to prescribe obligatory ndards, nor had it adequate financial resources. The activities of its alth Department were, therefore, largely restricted to coordination the work of Jewish organizations and to the representation of their nands to the Mandatory Government. The Department, however, de skillful use of the limited possibilities at its disposal. When the te of Israel came into being, it formed the nucleus of what later ame the Ministry of Health.

APPENDIX B

ISRAEL ITINERARY FOR THE SENATE HEALTH SUBCOMMITTEE

TUESDAY, SEPTEMBER 14

1845 Arrive by El Al flight 436 from London

1920 Depart airport for Asaf Harofeh Hospital near Lod 1940 Arrive Asaf Harofeh for tour of emergency clinic 2000 Depart Araf Harofeh for Hadassah Hospital, Jerusalem. 2100 Arrive Hadassah Hospital for meeting with the Director of the Hadassah Medical Organization and his staff 2200 Depart Hadassah Hospital for Magen David Adom first aid

station

2210 Arrive Magen David Adom for tour of first aid station 2225 Depart Magen David Adom for Share Tsedek Hospital 2230 Arrive Share Tsedek Hospital for tour of emergency clinic 2250 Depart Share Tsedek for King David Hotel Overnight King David Hotel

WEDNESDAY, SEPTEMBER 15

0715 Breakfast at the Hotel with Doctor Padeh, Director General, Ministry of Health and Doctor Katz, Director, National Insurance institute

0825 Depart Hotel for Ministry of Labor

Arrive Ministry of Labor for meeting with Minister Almogi 0850 Depart Ministry of Labor for residence of Foreign Minister 0900 Arrive Foreign Minister's residence for meeting with Minister

Eban

0940 Depart Foreign Minister's for Knesset Heliport

0950 Arrive Knesset Heliport and depart by helicopter for Sheba Hospital

1030 Arrive Sheba Hospital for tour of the facility and meeting with the Hospital Director, his staff and American doctors 1130 Depart Sheba Hospital for Baka el-Garbiya.

1150 Arrive Baka el-Garbiya for tour of Family Health Care Center 1230 Depart Baka el-Garbiya for Jerusalem

1300 Arrive Knesset Heliport and depart for Hotel

1315 Arrive King David

1350 Depart Hotel to Health Ministry

1355 Working wrap-up with Minister Shemtor and Staff

1435 Depart hotel for Academy of Sciences

1440 Arrive Academy of Sciences for meeting with Medical School

Deans

1545 Depart Academy for Prime Minister's Office

1600 Meeting with Prime Minister Golda Meir

1730 Meet Mayor of Jerusalem, Teddy Kollek at the Municipality Overnight King David Hotel, Jerusalem

THURSDAY, SEPTEMBER 16

0715 Depart King David Hotel for Knesset Heliport 0725 Arrive Knesset Heliport and fly to Beersheva

0800 Arrive Negev Central Hospital, Beersheva for tour of facility and breakfast with Kupat Holim Directors and Hospital

Staff

0925 Depart Negev Central Hospital by way of the Out Patient Clinic for Beersheva Urban Medical Clinic

0930 Arrive Urban Medical Clinic for tour of the facility

1000 Depart Urban Medical Clinic for Shuval Maternity and Child Care Center

1025 Arrive Center for tour of facility

1045 Depart Center for Kibbutz Shuval

1050 Arrive Kibbutz Shuval for tour of Kibbutz Medical Center and meeting with Kupat Holim staff

1145 Depart Kibbutz for Gadera Hospital

1230 Arrive Gadera Hospital for tour of facility and luncheon hosted by Secretary General of the Histadrut Ben-Aharon 1400 Depart Gadera Hospital for Lod Airport by helicopter

1500 Arrive Lod Airport

1530 Depart Lod Airport by El Al flight 459 for Copenhagen

APPENDIX C

THE MINISTRY OF HEALTH

One of the earliest laws enacted by the first Knesset prescribed that the laws of Palestine, with the exception of those restricting immigra tion and land purchase, should remain in force. The executive powers vested in the High Commissioner of Palestine and his Director of Medical Services in all matters of public health were consequently transferred to the Israel Minister of Health. The Department of Health of the Mandatory Administration was succeeded by the Israel Ministry of Health; the district health offices continued their activities along more or less the former lines.

Owing, however, to the conditions prevailing at the time of the es tablishment of the State and shortly after, it was impossible to plan a proper health administration. Israel was engaged in a war of exist ence that absorbed all her resources and manpower. Simultaneously. mass immigration began. Consequently, all that cou'd then be done was to take over the existing health services as they stood and adapt them to the changing needs; radical changes, based on careful planning, had to be postponed.

The structure of the Palestine Medical Services was not suitable for the new State. The fields of activity covered by the Palestine Public Health Ordinances were very narrowly defined, and this was reflected in the administration. For example, there was no division in the Health Department to deal with the important preventive aspects of tubercu losis, mental health, child health and venereal diseases. Similarly, the only duty of the Chief Sanitary Engineer was to recommend to the Director of Medical Services approval or rejection of sanitation plans submitted to him by local authorities.

Very few experienced medical officers of health were at the disposal of the new Ministry. Hardly any of the large number of Jewish doc tors trained in European universities had had specific experience in public health administration. Moreover, as shown by the following figures for 1946, hardly any Jews had been employed by the Palestine Department of Health:

Source: From the Annual Report of the Department of Health and the Government Staff List, 1947.

In the circumstances, the Ministry had to begin almost from scratch. The personnel recruited were men and women previously employed by Jewish public institutions, such as the Va'ad Leumi, Kupat Holim and the Jewish hospitals, who had the inclination or social conscience to give a hand in the new venture. Preoccupied from the outset with the overwhelming task of coping with the needs of mass immigration, the Ministry had a rather slow start.

The Ministry is the supreme authority in all matters relating to health, and serves as the licensing body for the medical and allied professions. The Minister is a member of the Cabinet and responsible to he Knesset; the Director-General, a physician, is a civil servant. Except for certain unit chiefs directly responsible to him, most divisions and departments are under Assistant Directors-General, both nedical and lay administrators (see Organization Chart).

Corresponding to its two main functions to ensure the provision of nedical care and to be Israel's principal public health agency-the Ministry is organized in two main divisions: curative services adminstration and public health service.

The Division of Curative Services is responsible for operating the Government hospitals (general, mental, tuberculosis, and other longerm illness) and for licensing and supervising non-governmental 1ospitals.

The Public Health Division is essentially a coordinator between inits at headquarters (such as environmental sanitation, vector conrol, communicable diseases, laboratories, maternal and child health, nental health, chronic diseases and rehabilitation) and agencies in the ield (district and sub-district health offices, health centres, mental health and child guidance clinics).

A large measure of authority has been delegated to the units in the ield, but they are far from being autonomous and they report to the Regional Services Administration at headquarters. The proper balince of centralization and decentralization is still a subject of study and discussion.

The Ministry has over 9,000 employees, the professional staff inluding over 900 doctors and 3,500 nurses.

The total bed-strength in Government hospitals is over 7,600. More than 70% of the 1966/67 Ministry budget (IL.151 million) was ¿pent on hospitalization services.

THE REGIONAL HEALTH SERVICES ADMINISTRATION

The body responsible for the planning, execution, supervision and oordination of district and local activities in the Ministry of Health, amely, the Regional Services Administration, functions on three evels: the head office, which forms part of the Ministry's headquarters, he District Health Offices, and the Sub-District Health Offices.

The Director of the Administration coordinates the work of the pubic health units at the Ministry with that of other Government agenies, medical institutions and District Health Offices.