
Table of contents
Approximate read time: 10 minutes
On 16 January 2025 the House of Lords will consider the following topical question for short debate:
Baroness Kennedy of The Shaws (Labour) to ask His Majesty’s Government what steps they are taking to support the healthcare system in Gaza.
1. Overview of the current situation for the healthcare system in Gaza
The World Health Organization (WHO) has described the worsening situation for healthcare in Gaza since the October 2023 escalation of conflict in the region:
Airstrikes and a lack of medical supplies, food, water and fuel have virtually depleted an already under-resourced health system. Hospitals have been operating far beyond capacity due to rising numbers of patients as well as displaced civilians seeking shelter. The provision of essential health services—from maternal and newborn care to treatment for chronic conditions—has been severely compromised, due to the lack of access and hostilities near hospitals.[1]
In November 2024, 15 UN and humanitarian organisations wrote a joint statement on the situation. They said:
Hospitals have been almost entirely cut off from supplies and have come under attack, killing patients, destroying vital equipment, and disrupting life-saving services. Health workers and patients have been taken into custody. Fighting has also reportedly taken place inside hospitals.[2]
The statement emphasised that “the entire Palestinian population in North Gaza is at imminent risk of dying from disease, famine and violence”.
The WHO has said Israeli forces have been conducting a “systematic dismantling of the health system” in North Gaza.[3] The UN Commissioner for Human Rights has described a “pattern of attacks” that “begin with Israeli airstrikes and are followed by ground raids and the detention of patients and staff” and leave hospitals non-functional.[4]
Israel has said Hamas and other armed groups were operating from civilian infrastructure, including health facilities. At an emergency meeting of the UN Security Council on 3 January 2025 about healthcare in Gaza, Israel stated this was a “deliberate and systematic strategy, a cornerstone of Hamas’ operational doctrine, their modus operandi”.[5] The UN Commissioner for Human Rights said at the same meeting that Israel “has not provided sufficient information to substantiate many of these claims”. The commissioner called for independent investigations into attacks on hospitals and health infrastructure, as well as whether they were being misused by Hamas and other armed groups. Hamas has asked for UN intervention to protect hospitals and for UN observers to be sent in “in order to determine the truth of what is happening”.[6]
In December 2024, the WHO reported that the last functioning major health facility in North Gaza, Kamal Adwan Hospital, was shut down after Israeli forces ordered a full evacuation, entered the hospital, and detained medical staff.[7] The WHO said that over the previous two months “the area around the hospital has remained highly volatile and attacks on the hospitals and on health workers have occurred almost daily”.
Israel Defence Forces (IDF) said the operation had been carried out because the hospital was a Hamas “terrorist stronghold”.[8]
On 3 January 2025, the WHO reported that 16 of Gaza’s 36 hospitals were partially operational, with 20 closed.[9] The WHO’s representative for the Occupied Palestinian Territory, Dr Rik Peeperkorn, said there were 1,822 hospital beds available for the region. He described this level of capacity as “far below what is needed to address the overwhelming health crisis” in Gaza.[10]
On 31 December 2024, the UN Office for the Coordination of Humanitarian Affairs (OCHA) provided an update on other healthcare infrastructure in Gaza:[11]
- 11 field hospitals were functional (six fully and five partially)
- 38% (52 of 138) primary health centres were fully or partially functional
- Seven of 27 health centres run by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) were functional
- 20 emergency medical teams were in place, though none were situated in North Gaza
Contested figures from Gaza’s Ministry of Health, cited by OCHA, put the number of healthcare workers killed in Gaza at 1,057 as of December 2024.[12]
Humanitarian organisations have also reported difficulties getting supplies and equipment, including medical supplies, into Gaza. In December 2024, of 596 attempted movements of humanitarian assistance which required coordination with Israeli authorities:[13]
- 245 were successful and unimpeded
- 224 were denied by the Israeli Coordination and Liaison Administration (CLA)
- 103 were approved by the CLA, but in practice were blocked or delayed on the ground, leading to either partial success or the mission failing
- 53 requests were withdrawn by the applying organisation for logistical, operational, or security reasons
There have also been challenges getting approval for medical evacuations. OCHA reported that 39% of requests for evacuations for critical patients had been approved. The organisation stated around 14,000 patients still needed medical evacuation abroad as at the end of 2024.
Israel’s representative to the UN Security Council has said sufficient aid and supplies are being allowed to enter Gaza, but they are being stolen by Hamas.[14]
Alongside a warrant for Mohammed Diab Ibrahim Al-Masri, also known as Mohammed Deif, commander of Hamas’s military wing, the International Criminal Court (ICC) has issued warrants for the arrests of Benjamin Netanyahu, prime minister of Israel, and Yoav Gallant, former Israeli minister of defence, for crimes against humanity and war crimes.[15] Listing the alleged crimes, the ICC said it had found “reasonable grounds to believe that both individuals intentionally and knowingly deprived the civilian population in Gaza of objects indispensable to their survival, including food, water, and medicine and medical supplies”.
The ICC said those actions, in addition to cutting off electricity and reducing fuel supplies, had “a severe impact on the availability of water in Gaza and the ability of hospitals to provide medical care”. The ICC also said Mr Netanyahu and Mr Gallant had been responsible for “extreme pain and suffering” by intentionally limiting medical supplies, including anaesthetics.
Israel has rejected assertions that it has restricted access to aid, including medical supplies. In December 2024 a spokesperson said: “Israel is facilitating the entry of humanitarian aid into the Gaza Strip and does not impose any restrictions on the quantity of aid entering the Strip”.[16]
2. Risks to health in Gaza
In addition to the risks of conflict injury and death, major health risks for the 1.9 million people displaced in Gaza include:[17]
- Food insecurity and malnutrition: OCHA reported that people in Gaza are facing acute food insecurity, with 91% of people facing crisis levels or worse, and 345,000 people experiencing ‘catastrophic’ levels of food insecurity.[18] Where food is available, the lack of variety has created a high risk of malnutrition, which particularly impacts children and people who are pregnant or breastfeeding.
- Water and sanitation: Damaged water networks and poor sanitation provision have contributed to sanitation-related health risks, including exposure to waste, sewage and pests. OCHA has reported “alarming rates of microbiological contamination”.[19]
- Winter weather and lack of adequate shelter: OCHA reported in December 2024 that heavy rains and cold weather had been affecting displaced families.[20] It said tents had been flooded and damaged, and at least five newborns had reportedly died of hypothermia.
- Maternity and neo-natal care capacity: An estimated 183 women give birth each day in Gaza.[21] The few locations able to provide neonatal care are contending with critical equipment shortages, drug and oxygen shortages, and an increased risk of hospital-acquired infections.[22] There are also no longer any specialist neonatal staff in the region.
Additionally, UNICEF has estimated over 1 million children are in need of mental health support.[23]
There are also serious concerns about the health of hostages being held by Hamas. The House of Commons Foreign Affairs Committee heard in December 2024 that hostages had no access to medical care and medication which had been arranged to reach them had been intercepted and sent elsewhere.[24]
3. UK government view on healthcare in Gaza
Dame Barbara Woodward, UK permanent representative to the UN, spoke in the urgent meeting of the UN Security Council held in early January 2025. She said the UK condemned the damage to and destruction of medical facilities and said it was “completely unacceptable” that “over 1,000 medical personnel have been killed, injured or detained”.[25] She continued:
Following the forcible evacuation of Kamal Adwan Hospital, there are now no functioning hospitals in North Gaza Governorate. Deteriorating access to medical services across Gaza is compounding acute child malnutrition, the risk of imminent famine and the spread of infectious diseases.[26]
Dame Barbara said the UK had three “fundamental demands”:
- civilians and medical staff must be protected in line with international humanitarian law
- UNRWA must be allowed to deliver medical services
- Israel must “do much more to immediately address this crisis and both sides must finally end this war”
Dame Barbara said the UK was aware of reports of Hamas using civilian infrastructure, including hospitals, for their operations. While she condemned any such actions, she reiterated that under international law, obligations to protect hospitals and healthcare workers were “unconditional”.
Dame Barbara said the UK would continue to push for:
- an immediate ceasefire
- the release of all hostages detained by Hamas
- better protection of civilians
- more aid consistently entering Gaza
- a path to long-term peace and security
Answering an urgent question in the House of Commons on 7 January 2025, the government restated its concerns about the situation in Gaza.[27] The government said it had raised its concerns with the Israeli deputy foreign minister and Israel’s ambassador to the UK, including urging Israel to “urgently clarify” the reasons for the detention of Dr Hussam Abu Safiya, director of Kamal Adwan Hospital, paediatrician Mohammed Hamouda and all other health workers detained in Gaza.
On 11 December 2024, the UK government committed £13mn to UNRWA to support services for Palestinian refugees.[28] This is in addition to £21mn announced in July 2024.[29] The UK’s funding for UNRWA was paused in January 2024 when Israeli intelligence alleged some UNRWA staff were involved in the 7 October 2023 attack against Israel by Hamas. Following an independent review and subsequent action plan, the UK government said in July 2024 it was “confident that UNRWA is taking action to ensure it meets the highest standards of neutrality”.[30] Funding was therefore resumed. The government is also supporting the medical aid charity UK-Med’s field hospitals in Gaza.[31]
The Israeli Parliament, the Knesset, passed new laws in October 2024 which UNRWA has said will mean it is unable to operate in the region.[32] From 28 January 2025, contact between UNRWA employees and Israeli officials will be outlawed. The organisation will therefore be unable to coordinate movements and pass through borders, making it unable to deliver aid and services. The UK government has expressed concerns, stating “there is no alternative to UNRWA at the scale at which it operates”.[33] Speaking for the government on 7 January 2025, Hamish Falconer, parliamentary under secretary of state at the Foreign, Commonwealth and Development Office, said:
I will be saying more about UNRWA in the coming weeks if we are not in a position to see that the Israelis have taken the action necessary to ensure the sustained and continued support that Palestinians require and which only UNRWA can provide.[34]
Across the Occupied Palestinian Territories, the UK committed over £100mn in aid for 2023/24 and £112mn for 2024/25.[35]
The UK government has stated no aid is provided to Hamas, which has governed the Gaza Strip since 2007.[36] Hamas are designated a terrorist organisation by the UK government and are subject to UK sanctions.[37]
4. Read more
- Urgent question on ‘Northern Gaza’, HC Hansard, 7 January 2025, cols 733–58; and Urgent question repeat on ‘Northern Gaza’, HL Hansard, 8 January 2025, cols 729–33
- Médecins Sans Frontières, ‘Strikes, raids and incursions: Over a year of relentless attacks on healthcare in Palestine’, 7 January 2025
- International Committee of the Red Cross, ‘Israel and the Occupied Territories: Obliteration of healthcare system in northern Gaza puts civilians at grave risk’, 30 December 2024
- House of Commons Library, ‘Israel and the Occupied Palestinian Territories: UK response to the conflict since July 2024’, 29 November 2024; and ‘West Bank and Gaza Strip: UK aid and UNRWA—FAQs’, 31 October 2024
Cover image by Kyle Glenn on Unsplash
References
- World Health Organization, ‘Conflict in Israel and the Occupied Palestinian Territory and region’, 20 December 2024. Return to text
- World Health Organization, ‘Statement by principals of the Inter-Agency Standing Committee: Stop the assault on Palestinians in Gaza and on those trying to help them’, 1 November 2024. Return to text
- World Health Organization, ‘Kamal Adwan Hospital out of service following a raid yesterday and repeated attacks since October’, 28 December 2024. Return to text
- United Nations, ‘Security Council debates Israeli attacks on hospitals allegedly misused by Hamas, as UN rights chief urges independent probes’, 3 January 2025. Return to text
- As above. Return to text
- BBC News, ‘Israel forcibly evacuates Gaza hospital and detains medical staff’, 28 December 2024. Return to text
- World Health Organization, ‘Kamal Adwan Hospital out of service following a raid yesterday and repeated attacks since October’, 28 December 2024. Return to text
- BBC News, ‘Israel forcibly evacuates Gaza hospital and detains medical staff’, 28 December 2024. Return to text
- United Nations, ‘Middle East crisis live: Security Council holds emergency meeting on collapse of Gaza health system’, 3 January 2025. Return to text
- World Health Organization, ‘Rik Peeperkorn, representative for WHO Occupied Palestinian Territory remarks at the meeting of the UN Security Council on the situation of the health system in Gaza’, 3 January 2025. Return to text
- UN Office for the Coordination of Humanitarian Affairs, ‘Reported impact snapshot: Gaza Strip’, 31 December 2024. Return to text
- The UN coordinates data from the Gazan Ministry of Health regarding casualty figures in Gaza. Israel has been critical of the UN’s reporting, arguing that UN agencies have demonstrated bias against Israel in the past. However, UN agencies remain the only third-party sources coordinating up to date data on the situation on the ground. Return to text
- UN Office for the Coordination of Humanitarian Affairs, ‘Reported impact snapshot: Gaza Strip’, 31 December 2024. Return to text
- BBC News, ‘UN says ‘trickle’ of aid reaches north Gaza, as Israel denies blocking access’, 16 October 2024. Return to text
- International Criminal Court, ‘Situation in the State of Palestine: ICC Pre-Trial Chamber I rejects the State of Israel’s challenges to jurisdiction and issues warrants of arrest for Benjamin Netanyahu and Yoav Gallant’, 21 November 2024. See also: ‘Situation in the State of Palestine: ICC Pre-Trial Chamber I issues warrant of arrest for Mohammed Diab Ibrahim Al-Masri (Deif)’, 21 November 2024. Israel has claimed Mohammed Deif was killed in an air strike in July 2024: BBC News, ‘Arrest warrants issued for Netanyahu, Gallant and Hamas commander over alleged war crimes’, 21 November 2024. Return to text
- Times of Israel, ‘Israel rejects claims it is restricting Gaza aid, says hundreds of trucks waiting’, 3 December 2024. Return to text
- UN Office for the Coordination of Humanitarian Affairs, ‘Occupied Palestinian Territory’, accessed 9 January 2024; and ‘Reported impact snapshot: Gaza Strip’, 31 December 2024. Return to text
- For an explanation of food security phase classification, see: Integrated Food Security Phase Classification, ‘What is famine?’, accessed 9 January 2025. Return to text
- UN Office for the Coordination of Humanitarian Affairs, ‘Humanitarian situation update #251: Gaza Strip’, 31 December 2024. Return to text
- UN Office for the Coordination of Humanitarian Affairs, ‘Reported impact snapshot: Gaza Strip’, 31 December 2024. Return to text
- Shatha Elnakib et al, ‘Pregnant women in Gaza require urgent protection’, Lancet, 20 January 2024, vol 403 issue 10423. Return to text
- UN Relief and Works Agency for Palestine Refugees in the Near East, ‘UNRWA situation report #153 on the humanitarian crisis in the Gaza Strip and the West Bank including East Jerusalem’, 4 January 2025. Return to text
- UN Office for the Coordination of Humanitarian Affairs, ‘Reported impact snapshot: Gaza Strip’, 31 December 2024. Return to text
- House of Commons Foreign Affairs Committee, ‘Oral evidence: The Israeli-Palestine conflict’, 10 December 2024, HC 488 of session 2024–25, pp 33 and 39. Return to text
- Foreign, Commonwealth and Development Office, ‘The deterioration of the healthcare situation in Gaza is completely unacceptable: UK statement at the UN Security Council’, 3 January 2025. Return to text
- As above. Return to text
- HC Hansard, 7 January 2025, cols 733–58. Return to text
- Prime Minister’s Office, ‘PM meeting with UNRWA commissioner: 11 December 2024’, 11 December 2024. Return to text
- Foreign, Commonwealth and Development Office, ‘UK to restart funding to UNRWA’, 19 July 2024. Return to text
- As above. Return to text
- HC Hansard, 7 January 2025, col 733. For more about the work of UK-Med in Gaza, see: UK-Med, ‘Gaza health crisis appeal: How we’re responding’, accessed 9 January 2025. Return to text
- UN Relief and Works Agency for Palestine Refugees in the Near East, ‘‘More people will die’: How Israel’s UNRWA ban affects Palestinians in Gaza and beyond’, 10 November 2024. Return to text
- HC Hansard, 7 January 2025, col 745. Return to text
- HC Hansard, 7 January 2025, col 747. Return to text
- House of Commons Library, ‘‘West Bank and Gaza Strip: UK aid and UNRWA—FAQs’, 31 October 2024. Return to text
- HC Hansard, 8 November 2023, col 139. Return to text
- HM Treasury, ‘Financial sanctions, international counter-terrorism’, 25 January 2024. Return to text