State Comptroller Matanyahu Englman has published a series of special reports detailing a harsh picture of how Israel handled the wounded from the October 7 massacre, spanning the earliest hours of the Hamas attack through the ongoing medical rehabilitation process, and exposing what he describes as a national failure in caring for roughly 20,000 people wounded in the assault.
The reports find that while Israel's medical and rescue personnel confronted an unprecedented event, a series of systemic failures alongside their efforts now demand urgent attention. In examining the evacuation of the wounded, Englman describes a reality in which many casualties reached hospitals on their own or with the help of civilians, after large areas could not be reached quickly by official emergency services due to ongoing fighting and the security situation on the ground. The report presents extensive testimony describing improvised evacuations and the extraordinary burden placed on both the evacuation system and the hospitals receiving the wounded.
The comptroller's report also examined the medical rehabilitation phase, finding that Israel's healthcare system was forced to contend with an unprecedented number of casualties. According to the data, as of September 2025, roughly 20,000 soldiers and security personnel had been wounded, alongside approximately 1,600 wounded civilians. About 10 percent of the wounded were classified with severe or moderate injuries, and roughly 1,660 of the wounded were hospitalized in rehabilitation wards.
Alongside the expansion of the rehabilitation system during the war, the comptroller pointed to gaps that still require attention. The report found that before the war, Israel had only about 850 rehabilitation beds nationwide, and that only in response to the extraordinary caseload were roughly 320 additional beds approved for opening. The report also describes significant strain on the rehabilitation system and the continued need to strengthen personnel, infrastructure and computer systems in order to provide adequate care to the thousands of wounded who require long term treatment.
The comptroller concluded that alongside the efforts made during the fighting, Israel must quickly draw lessons and strengthen its national readiness for future mass casualty events. Among his recommendations, Englman called for improving evacuation processes, strengthening cooperation between all relevant bodies, expanding rehabilitation capacity, and accelerating the upgrade of computer systems within the Defense Ministry's Rehabilitation Division, in order to improve service to disabled IDF veterans and wounded from the war.
A separate comptroller's report found that Israel similarly entered the war without adequate preparation when it came to managing civilian aid efforts following the October 7 attack. According to the comptroller, the government only attempted to establish a coordinating body to centralize the activity of donor and volunteer organizations after the war had already broken out, and that attempt ultimately failed. The report further found that roughly half of the government ministries that worked with aid organizations had no designated official responsible for maintaining contact with those organizations, either in routine times or during emergencies.
The comptroller noted that organized coordination mechanisms were never established even before the war, and that the necessary personnel readiness in this area was never completed. Even nearly a year and eight months after the outbreak of the Iron Swords war, the government unit responsible for multi sector cooperation has still not consolidated the knowledge gained from the war in order to draw lessons and better prepare for future emergencies.
Responding to the findings, the Defense Ministry said it views the rehabilitation of wounded security personnel as a foremost national challenge. The ministry said that since October 7, its Rehabilitation Division has taken in more than 25,000 wounded from the war, and estimates it will be treating roughly 100,000 wounded by 2028. The ministry noted that, in line with the comptroller's recommendations, an expert committee headed by Professor Shlomo Mor-Yosef was established and has formulated a comprehensive action plan addressing issues raised in the report.
The Defense Ministry further emphasized that its policy of rehabilitation before bureaucracy is designed to allow wounded individuals to receive full medical and psychological care without first having to go through medical committees, and that 70 percent of recognition requests submitted during the war were approved within 48 hours. The ministry added that all wounded individuals received medical and rehabilitative treatment even before their disability rating was determined, and that no debt collection would be pursued against those who received advance payments under the relevant framework. The ministry also noted that despite a nationwide shortage of therapists and physicians, rehabilitation and mental health services were significantly expanded.
The IDF, in its response, said it views the treatment and evacuation of the wounded as an issue of the highest moral importance, and acknowledged that the IDF failed in its mission to defend the communities of the western Negev on October 7. At the same time, the military noted that the scale of casualties was extraordinary relative to evacuation capacity on that day, and that forces operated under intense combat conditions while prioritizing saving lives and repelling the terrorists.
The IDF added that responsibility for distributing the wounded among hospitals does not fall under the Home Front Command, but rather under the Health Ministry and the National Hospitalization Authority, and that following lessons drawn from the war, Magen David Adom's command and control systems were integrated into IDF medical command centers to improve coordination. The military further stated that it supports the comptroller's recommendation to establish a shared information system with the Rehabilitation Division, aimed at improving continuity of care for the wounded.
