Israeli State Comptroller Reveals Failures in October 7 War Casualty Evacuation and Rehabilitation System

The Israeli State Comptroller, Matanyahu Englman, released a report on Tuesday addressing the medical rehabilitation of casualties from the war that began on October 7, 2023. According to the report, by September 2025, approximately 20,000 soldiers and security personnel were wounded, with around 1,660 treated in hospital rehabilitation departments from the war's outbreak until July 2025. Due to the injury of Englman's son during the war, the report was overseen by the Ministry Director-General, Brigadier General (res.) Yishai Vaknin. Vaknin emphasized the state's duty to support wounded soldiers and highlighted systemic shortcomings, including many injured not fully understanding their rights and relying on informal information channels.

The report found a longstanding shortage of rehabilitation staff, noting that workforce standards set in 2003 have not been updated despite increased needs. Nearly half of the hospitalized war casualties requiring rehabilitation were treated at Sheba Medical Center, where an inverse correlation was found between patient numbers and daily treatment sessions, indicating quality of care was impacted by patient volume. Additionally, as of May 2025, 27% of disability recognition requests submitted to the Ministry of Defense remained unresolved, with an estimated 62 million shekels in unpaid social benefits to disabled veterans and their families.

Regarding the evacuation of casualties on October 7, the Comptroller identified deep systemic failures rooted in the IDF's failure to protect southern communities. The absence of organized command and control led to many wounded waiting hours for treatment. Military medical units did not utilize the Magen David Adom system installed in the Gaza Division, resulting in critical information gaps. Former Southern Command Chief Yaron Finkelman admitted the IDF was caught by "basic surprise" and unprepared for the scale of casualties. The Ministry of Health's national emergency center opened two hours after the attack began and failed to maintain an accurate situational picture. Nearly half of casualties were evacuated independently by civilians or local forces due to insufficient military medical response. The report criticized bureaucratic overlap between emergency organizations and the lack of coordination.

The IDF responded by acknowledging the challenges faced during the intense fighting and evacuation efforts, emphasizing ongoing investigations and improvements in command, control, and coordination with emergency services. The Ministry of Defense stressed the unprecedented scale of casualties requiring rehabilitation, with over 25,000 wounded admitted since October 7 and projections of up to 100,000 by 2028. They highlighted a comprehensive expert committee's recommendations to address the issues raised by the Comptroller.

The Ministry also defended its "Rehabilitation Before Bureaucracy" policy, which prioritizes immediate medical and psychological care without early disability assessments, and noted that 70% of wartime disability claims were recognized within 48 hours. Despite national shortages of medical professionals, rehabilitation services have expanded significantly, including new facilities and innovative programs. The Ministry confirmed no debt collection will be pursued against war casualties receiving advance payments under this policy.

The report calls for urgent government action to improve information accessibility, treatment quality, and systemic readiness to better serve Israel’s wounded veterans and civilians affected by the war.