From the Natanyahu State commission to management tasks in the Israeli health system

Background: Ben-Gurion University (BGU) in Beer Sheva inaugurated a special training program for junior academic administrative personnel to improve the quality of service in health care organizations through suitable and high-quality administration. The program, the first of its kind in Israel, has been in operation since 1994 and prepares 50 candidates annually for administrative positions within the health system, or a total of 224 graduates to date. The program was founded on the recommendations of a state commission established in 1990 and headed by retired Supreme Court Justice Shoshana Natanyahu (The Natanyahu Commission, 1990). The commission was appointed to examine the performance of the health system in Israel and recommend reforms and changes that would improve the quality and efficiency of health services and the overall performance of the system. Aim: This study examined the integration of graduates of the undergraduate program in Health Systems Management (HSM) within the private and public health system in Israel, including employment trends and a retrospective evaluation of the program. Methods: Within the framework of the study, questionnaires were sent to all graduates of the program. Participants were requested to answer questions regarding their present place of employment, their satisfaction with their academic degree, how they found employment, and so forth. Results: The research results show that 59% of the graduates of the HSM department at BGU who responded to the questionnaire, worked in the health system upon completion of their studies, and in 2002 - at the time of the survey - 42% of all graduates were currently employed within the health system. Most of the graduates who entered the system and remained within the system, were women: out of 46 graduates working in the health system today, 38 (83%) are women. It should be noted that while there is some migration of graduates to work in other systems and sectors of the economy, 78% of the respondents believe that the degree program in HSM is justified. Apparently, according to the study, although the health system needs graduates, it does not always know how, or does not always want to or finds difficulty in absorbing the graduates and effectively utilizing their skills to meet the needs of the system. Conclusions: The data reveals that graduates of the undergraduate program in HSM have integrated well into the health system, but not as well as may have been expected. The graduates encountered difficulties in their absorption into management roles in the public health system and felt that the extent of their abilities has yet to be fully recognized and utilized by the system.