Occupied Palestinian territory | News | Financial crisis undermines the Palestinian health care system, February 2013

Financial crisis undermines the Palestinian health care system, February 2013

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A new hospital in the town of Tubas, much needed in a marginalized area in the north of the West Bank, has been built and equipped with donor funding but languishes empty, its equipment unused and with warranties now expired, due to lack of funds to staff the hospital.

The financial crisis affecting the Palestinian Authority (PA) has reduced services provided by the Ministry of Health (MoH) in the West Bank due to the MoA’s inability to cover its three largest areas of expenditure --- staff salaries (including staffing of newly built hospitals), procurement of drugs and medical supplies, and patient referrals for  specialized treatment. With a 2012 overall budget of NIS 1.35 billion, salaries accounted for NIS 640 million and running costs for NIS 700 million, dominated by the cost of patients’ referrals (NIS 380 million) and drugs (NIS 278 million).

The Palestinian Authority as a whole has been facing acute financial stress since 2011, due to reduced external support from the donor community and the withholding of tax revenues collected by Israel to cover the PA’s debt to Israeli bodies. Ministry of Health officials say they are not requesting an increased aid package, but only that donors maintain their previous commitments while the MoH works to improve cost efficiency.

Health employees have taken strike action in recent months to protest the irregular payment of salaries and staff shortages. The strikes caused clinics to shorten working hours, hospitals to cancel non-emergency surgeries and ministry offices to empty by mid-morning.


In 2012, the Palestinian Ministry of Health referred a total of 33,469 patients from the West Bank and the Gaza Strip to hospitals outside their region, indicating a high need for medical access, especially to East Jerusalem. Gaza patients, whose process for permit approval is different and includes security interviews, were more likely to receive health access permits than West Bank patients, but less likely to apply.

The approval rate of applications for permits submitted in 2012 by patients, patients’ companions and hospital visitors, stood at 79.7 per cent for West Bank residents and 92.5 per cent for Gaza Strip residents. While the approval rate for Gaza applicants slightly increased compared to 2011 (89.8 per cent), the rate for West Bank residents slightly decreased (81.4 per cent).

The main problems identified by WHO are the lack of transparent criteria, delays in response, and the lack of an appeal procedure once an application is rejected.

You can access this text in OCHA Humanitarian Bulletin, February 2013, Page 6