State Comptroller Says Israel’s Health System Is Failing Older Adults

Israel’s State Comptroller, Matanyahu Englman, published a sweeping report on Sunday saying the Health Ministry has not prepared a multi-year operational plan to address population aging. The audit says the ministry lacks long-term goals, new quality indicators, and a real policy framework for improving healthy life expectancy, reducing loneliness, and adapting services to seniors’ needs. It also found shortages of doctors, especially geriatricians, and weak follow-up on preventive care.

The report says the ministry has not set measurable targets for healthy life expectancy and has not developed a national frailty index, even though frailty data are essential for assessing policy effectiveness. Two health funds, Maccabi and Meuhedet, do use frailty measures, but they apply different scales, different thresholds, and do not preserve historical scores consistently. Across the health funds, nearly all monitored prevention and health-promotion actions were not carried out, with nonperformance ranging from 75% for calcium and vitamin D use to 99% for home adaptation to prevent falls.

The comptroller warned that geriatrics remains a “profession in distress.” From 2020 to 2024, the number of geriatricians per 1,000 people barely changed, and projections for 2030 and 2040 point to further decline as the 75-plus population grows faster than the workforce. He also said 89 geriatric specialists were working as family doctors in 2023, about 16% of the 546 geriatric specialists counted. Training for family doctors in geriatrics has also not materially improved.

Hospital capacity is also under pressure. While the absolute number of geriatric beds rose 8% between 2020 and 2023 and general beds rose 4%, the number of beds per 1,000 people age 75 and older fell sharply, and is expected to fall further by 2030 and 2040. On loneliness, the report says 26% of older Israelis feel lonely, but only a fraction are identified by welfare and social security agencies, and no ministry has been assigned formal responsibility for locating and treating lonely seniors. The report says 95% of surveyed older adults said no professional had spoken with them about loneliness, while professionals cited lack of tools, lack of guidance, and workload as major barriers.