Israeli State Comptroller Reveals Critical Failures in Medical Evacuation and Rehabilitation After October 7 War

The Israeli State Comptroller, Matanyahu Englman, released a report on October 31, 2025, exposing severe shortcomings in the medical evacuation and rehabilitation of wounded soldiers and security personnel from the war that began on October 7, 2023. The report highlights a lack of command and control during the initial evacuation, chronic shortages of medical staff, and bureaucratic obstacles that hinder wounded soldiers from receiving proper care and benefits. Approximately 20,000 soldiers and security personnel were injured during the conflict, with around 1,660 treated in rehabilitation departments from the war's outbreak until July 2025. Englman recused himself from the report due to his son’s injury in the war, with Deputy Director General Brigadier General (res.) Yishai Vaknin overseeing the investigation.

The report criticizes the outdated staffing standards in rehabilitation departments, unchanged since 2003, despite the Ministry of Health acknowledging the shortfall. Nearly half of the hospitalized wounded were treated at Sheba Medical Center, where an inverse correlation was found between patient numbers and daily treatment sessions, indicating quality of care suffered as patient loads increased. Additionally, 27% of disability recognition requests submitted to the Ministry of Defense remained unresolved by May 2025, delaying social benefits estimated at 62 million shekels in unpaid compensation.

Regarding the October 7 evacuation failures, the report attributes the root cause to the IDF’s failure to protect southern communities and the absence of organized command, resulting in many wounded waiting hours for treatment. Military medical units did not utilize real-time emergency medical services systems, causing critical information delays. Southern Command’s former commander, Major General (res.) Yaron Finkelman, admitted to being caught off guard and unprepared for the scale of casualties. The Ministry of Health’s national health command center opened two hours after the attack began and failed to maintain an accurate situational picture. The report also criticizes poor coordination between emergency organizations and the lack of a dedicated IDF investigation into the evacuation, except in the Air Force.

The IDF responded by acknowledging its failure to protect western Negev settlements and the challenges of evacuating a high number of wounded under combat conditions. It emphasized ongoing improvements in coordination with emergency services and comprehensive after-action reviews. The Ministry of Defense stated it views rehabilitation as a national priority, having admitted over 25,000 wounded since the war began and expecting up to 100,000 by 2028. It highlighted a public expert committee’s recommendations for a comprehensive rehabilitation plan addressing the Comptroller’s findings.

The Ministry of Defense also defended its "Rehabilitation Before Bureaucracy" policy, which prioritizes immediate medical and psychological care without early disability assessments, and noted unprecedented expansions in mental health and rehabilitation services despite national shortages of medical professionals. It confirmed no debt collection would be pursued from wounded soldiers receiving advance rehabilitation payments. The report calls for urgent government action to improve information accessibility, treatment quality, and systemic readiness for future emergencies.