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Misconception 8:
A Strong Israel with Weak Social Services

Over the years, right-wing governments thinned out the public sector and brought it to the verge of collapse. On October 7, when the government did not function, we paid a heavy price for this starvation of social services.

2003

 In his speech about the “fat man and the thin man,” Finance Minister Benjamin Netanyahu alleges that the public sector is the main problem facing Israel’s economy and a burden on citizens. He unveils a plan for deep cuts in social services and public sector wages.

2004

Netanyahu pushes legislation that would require Israeli governments to gradually reduce their budgetary allocation for public services.

2014

Governor of the Bank of Israel, Karnit Flug, says that the Government is failing to respond to the public’s needs and that public expenditures must be increased.

2016

Israel falls to the next-to-last place in the West in public expenditures on social services.

2022

Israel’s social services face an unprecedented crisis, including a shortage of 1,500 social workers and more than 10,000 psychologists.

June 2023

 According to an OECD report, the number of physicians per capita in Israel is 10% below the average in the West and a severe shortage is imminent.

September 2023

  The Government of Israel cuts the funding of mental health organizations by 70%. Mental hospitals and clinics begin to dramatically reduce their hours because of a severe shortage of personnel. The chair of the State-Employed Physicians Organization says that the mental health system has already collapsed.

October 7, 2023

 In the wake of the Hamas attack, hundreds of thousands of citizens are left homeless, wounded, and traumatized. The state cannot provide services to all in need of welfare and mental health services, so it calls on psychologists and social workers to work pro bono.

Exactly 20 years have passed since Benjamin Netanyahu, as finance minister, delivered his famous speech about “the fat man and the thin man.” The metaphor was meant to illustrate that the thin and efficient private sector carries the fat and convoluted public sector on its back, and Netanyahu invoked it to justify the economic policies he initiated then: cutting taxes while slashing support for the public sector, and especially social security and public service employees’ wages.

This policy, which significantly trimmed public spending, is the best reflection of the right-wing economic doctrine that took hold of the Israeli economy in the mid-1980s and reached its zenith in the first two decades of the current century. The idea is that cutting back on social services and privatizing much of it will not weaken the system but make it “more efficient.” Ostensibly, one can hold both ends of the stick—reduce expenditures on services in order to maintain a lower public debt–to–GDP ratio and reduce taxes, while also maintaining an appropriate level of services. This policy was promoted by a series of governments and finance ministers, with the support of right-wing economic think tanks like the Kohelet Policy Forum, whose influence on the government has grown in recent years.

In fact, as many economists all over the world have acknowledged, the idea of starving the public sector collapsed during the COVID-19 pandemic. It became obvious then that such policies prevented governments from functioning effectively during an emergency. To make it through the months of lockdowns and isolation, governments all over the world had to provide their citizens with a much more comprehensive response, dramatically increasing spending on public health. In Israel, by contrast, the message was never internalized and the starvation budget remained official policy.

On the eve of the October 7 massacre and its dramatic effect on Israeli society, Israel faced a shortage of 1,500 social workers and more than 10,000 public-sector psychologists. An OECD report published this year stated that the number of physicians per capita in Israel is 10% lower than the average in Western countries and warned of a severe shortage of medical personnel. Just six days prior to October 7, we learned that since the pandemic the government had cut funding for mental health organizations by 70%. Mental health facilities were forced to make a drastic reduction in their hours because of a severe shortage of personnel. According to the chair of the State-Employed Physicians Organization, Dr. Zeev Feldman, the mental health system has already collapsed. “If sometimes you have to wait a year for treatment of acute problems, it means the system doesn’t exist,” he explained.

On the eve of the October 7 massacre, Israel faced a shortage of 1,500 social workers and more than 10,000 public-sector psychologists.

This was Israel’s condition on October 7. The country faced a national disaster with unprecedented impact on the domains of medical care, welfare, mental health, and all the other social services—precisely the sectors that right-wing governments cut back consistently over the years. It’s no wonder that in the moment of truth, the system proved unable to do its job. To a large extent this remains the situation today.

Since the catastrophe, professionals in the medical, mental health, welfare, and education systems have been working around the clock, throughout the country, to provide preliminary assistance and care for victims and their families—but they cannot do it all. Instead of the state providing the public with the psychological and therapeutic treatment so desperately needed, thousands of social workers, psychologists, and other professionals in private practice have mobilized to work without pay. The vacuum left by the state has been filled by civic initiatives and volunteers.

Instead of the state providing the public with the psychological and therapeutic treatment so desperately needed, thousands of social workers, psychologists, and other professionals in private practice have mobilized to work without pay. The vacuum left by the state has been filled by civic initiatives and volunteers.

The chair of the Social Workers Union, Inbal Hermoni, fears that “when the emergency is over we can expect a general catastrophe in welfare and mental health.” The director of a mental hospital predicted that “when the war is over there will be a tsunami we won’t be able to deal with.”

Most absurd of all, the state, instead of immediately hiring more professionals to fill the void, actually published advertisements seeking therapists willing to work pro bono.

Unlike the security debacle that took the entire system by surprise, in the case of social services there was no surprise at all: what is on the verge of collapse in normal times will certainly crumple when there is a crisis. Israel’s social services have been in crisis for years. Administrators of all categories of social services report understaffing, low retention of professionals, and challenges in recruiting qualified staff because of inadequate salaries and poor working conditions.

Israel’s public health system, for years thought to be one of the best in the world, is progressively losing its ability to provide appropriate care, due to long queues for treatment and a shortage of equipment and personnel. It is hard-pressed to provide a full solution for the public’s emotional, developmental, and functional needs. As noted, the situation is particularly severe in the state mental health system, which has been starved to the point that it can provide only a fraction of the services required by the population in normal times, and even less in an emergency.

Similarly, the Israeli welfare system, which in normal times is beset by overwork, low status, extensive privatization accompanied by inadequate supervision, and poor-quality residential facilities, must now work overtime. According to data from the Social Workers Union, even before the calamity there was an acute shortage of social workers, with each social worker forced to handle the files of 250 families single-handedly.

According to data from the Social Workers Union, even before the calamity there was an acute shortage of social workers, with each social worker forced to handle the files of 250 families single-handedly.

Public social services’ inability to provide an appropriate response to victims of the attack is the result of the doctrine of “small government” and the clearest indication of its bankruptcy.

Civil society’s enlistment to provide assistance in the wake of the disaster is a ray of light. As has become obvious since the start of October, against the backdrop of the public system’s deficiencies, this mass mobilization is essential for the country’s survival. But it cannot be a substitute for functional public systems. Private initiatives cannot reach everyone in need and maintain standards of equality, professionalism, and long-term care. What is more, they are temporary. When the spotlight of public attention dims, the victims will still need help and a long period of rehabilitation. When the fighting dies down and the soldiers return home from the front, social workers will remain alone on the front lines of rehabilitating individual victims and society as a whole. Without a fundamental change in how the state treats these valiant workers, they will have no hope of winning that battle and civil society will have no hope of recovery.

Civil society’s enlistment to provide assistance in the wake of the disaster is a ray of light. Given the public system’s deficiencies, this mass mobilization is essential for the country’s survival. But it cannot be a substitute for functional public systems.