Whistleblower doctor: ‘Bribes for treatment is daily life for Palestinians’

Palestinian patients cannot get medical care without paying large backhanders


A whistleblower has revealed how he was sacked from his job at the Palestinian Authority Health Ministry after he tried to clean up corruption in the system.

Speaking to the JC at his home in Halhul, near Hebron, Dr Haitham al-Hidri described how he tried to put a stop to the widespread practice of bribery for acccess to Israeli hospitals.

“I began following up every case, seeing what treatments people were getting to ensure there was accountability, auditing how much was being spent,” he said.

“I talked to doctors in the West Bank and in Gaza. And I learnt about the bribes. One official was charging patients up to $3,000 (£2,500) to get on the transfer list.”

His efforts, he said, cost him his job. “They made me a scapegoat,” he said.

His work began in 2018, when the PA health ministry asked Dr al-Hidri, an experienced surgeon, to take charge of its Special Purchase Unit (SPU), the body in charge of referring patients to private Palestinian hospitals and to Israel.

It was there that he discovered that without powerful friends, patients needing advanced treatments only available in Israel were being asked for bribes.

In some cases, Dr al-Hidri said, “the patient would sit weeping in front of the person responsible in a coffee shop, while he calmly smoked a hookah”.

Allegations of endemic corruption in the health system had emerged before.
In 2014, one of Dr al-Hidri’s predecessors, Osama al-Najjar, gave evidence to an inquiry by the Ramallah-based anti-corruption organisation Aman.

He described the “pressures, coercions, and interference from higher-up officials to obtain medical referrals for treatment in Israeli hospitals”.

The PA’s anti-corruption commission said it would investigate. But as Dr al-Hidri discovered, nothing had changed. By the time he took over, the system remained intact.

He told the JC that when he uncovered the corruption, he managed to ensure that some guilty officials were sacked. But after he was forced to step down from his ministry post earlier this year, they were reinstated and the system was restored.

Palestinian cancer patients being treated in East Jerusalem told the JC that Dr al-Hidri’s account matched their experiences. To be put on the PA list for transfer to Israel required either influential friends or a bribe, they confirmed.

Campaigners have long claimed that Israel delays or refuses medical treatment to Palestinians. But the endemic problems disclosed by the whistleblower this week have nothing to do with the Jewish state.

When Dr al-Hidri was appointed to the SPU, he was told that his mission was to reduce soaring costs. In 2018, referrals to Israel and Palestinian private hospitals had cost the PA 1.3 billion shekels, about £325 million.

But, Dr al-Hidri said, he was surprised to discover that in many cases, the treatment was available in public Palestinian hospitals.

“I was trying to clean up the system. I wanted to save the PA money while ensuring standards of treatment were maintained,” Dr al-Hidri said.

“A Palestinian in-patient in an Israeli hospital costs the PA £1,700 a night, as opposed to £450 at a Palestinian public hospital.” In 2022, he forecast, the referral bill would reach two billion shekels, more than half-a-billion pounds. One reason for the high referral rate was officials seeking bribes.

Others took advantage of their political clout. One stroke patient, for example, who was well-connected in Palestinian politics, was transferred to the Hadassah hospital in Tel Aviv for treatment that was available in West Bank public hospitals, he said.

“The total cost was not less than 250,000 shekels (£62,500),” he added. “When we have hospitals and beds, why do we need transfers?”

Moreover, he said, in addition to the money being paid as bribes for transfers to Israel, another 60 million shekels (£15 million) was being siphoned off through other forms of corruption, with officials skimming off money throughout the process.

Dr al-Hidri’s reforms had a powerful impact on the Palestinian health system. By 2020, he had cut the total bill for referrals by almost half. But he was making enemies.

“Fatah [the ruling PA party] members were used to asking for favours and getting them,” he told the JC. “In my first year, I received 5,000 transfer requests from PA ministers on behalf of patients who wanted them. I complied with only 600. This annoyed them.”

Last year, 16-year-old Gazan Saleem Nawati was given permission by Israel to travel to the West Bank for specialist leukaemia treatment unavailable in Gaza.

Arriving there with his uncle, he was refused admission to the al-Najah private hospital in Nablus, where his treatment was supposed to take place — on the grounds that the PA had not paid outstanding bills it owed to the hospital.

On 9 January, he died inside the health ministry office in Ramallah, while still waiting for a bed.

His family blamed PA corruption. “When Saleem went to the hospital, they refused to admit him, saying the PA has not paid its debts, but three other people were admitted — I am sure they had better connections and managed to get themselves in,” his brother Mohannad said.

Dr al-Hidri said he wished he had been able to help Saleem. Earlier, he had managed to persuade a hospital at Beit Jala, near Bethlehem, to treat him, but doctors there lacked the necessary skills and equipment.

The week before Saleem died, Dr al-Hidri was sacked. “I had made too many enemies,” he said.

Soon afterwards, the PA established a committee to look into the boy’s death. It found his case had been “a political and moral failure”. This, Dr al-Hidri said, was too little, too late.

“The international community has to exercise more control over the way it spends its money,” he said. “We have to stop recruiting corrupt people.”

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