The Palestinian Ministry of Health announced the suspension of all medical transfers of Palestinian patients in the West Bank and the Gaza Strip to Israeli hospitals last month.
The decision came in response to Israel’s deduction of millions of dollars of Palestinian tax clearance revenues that it collects every month on behalf of the Palestinian Authority, which operates limited self-rule in the occupied West Bank.
Last month, Israel cut more than $100 million (Dh 367m) from Palestinian tax revenues, including $11.5 million which, Israel said, is the estimated amount that the PA pays to the families of Palestinians killed, wounded or imprisoned by Israel. The amount Israel will deduct is about $138 million a year.
In protest, the PA rejected the remainder of the money.
Health Ministry spokesman Osama Al Najjar said that Israel routinely overcharges the PA for medical services and constantly manipulates the value of medical transfer bills.
Mr Najjar said that Israel takes those inflated charges from the Palestinian tax revenues without the their permission every month because of the control it exerts on the Palestinian body.
Upon hearing the decision, some Palestinians expressed concern that it would have a serious impact on patients. Others welcomed the decision, saying that it should have been done years ago because the sick should not be treated in Israeli hospitals.
The PA’s Ministry of Health assured Palestinians that the decision will not affect the health services they receive, and that the ministry is committed to providing the necessary treatment to all those who need it.
Most of the Palestinian cases are now, after the decision, going to be treated inside the Palestinian territories because the qualifications and resources of Palestinian medical staff have improved in recent years.
And patients in need of special treatment, which Palestinian hospitals in the occupied West Bank and East Jerusalem cannot provide, will be transferred to hospitals in Jordan, Egypt, and other Arab countries.
Last week, the Ministry of Health reached an agreement with Jordanian hospitals to refer a substantial number of Palestinian patients there with “less costs and a similar quality” to Israeli hospitals.
Every year, tens of thousands of Palestinian patients are referred by the PA to Israeli hospitals for treatment unavailable at Palestinian hospitals, and the Israeli Finance Ministry deducts the charge for their medical bills from the PA’s tax revenues that Israel collects every month on its behalf.
The PA has long accused Israel of manipulating the value of medical transfer bills.
The value of Israeli medical bills paid by the Palestinian government amounted to $100 million a year in recent years, a monthly rate of $9 million.
Mr Najjar, the head of the medical transfers department in the Ministry of Health, told The National that Israeli hospitals often double the real charge of the Palestinian medical bills and the Israeli Finance Ministry then triples it in the same month. He said Israel will not deliver the rest of the tax clearance revenues to the Palestinian government until the Palestinian Finance Minister signs and agrees on these inflated bills.
Mr Najjar said the Palestinian government is not allowed to see or review the bills, and the Israeli side consistently rejects any kind of financial audit. “Every month in past years, Israel continued to deduct any amount of the money they wished,” he said.
“Around a billion shekels (Dh1bn) were stolen in this way by Israel over the past years”, Mr Najjar said.
"Stopping medical transfers to Israel is a difficult decision, but a strategic one that will protect the interests of the Palestinian people, and we will not allow any patient to be affected by this decision," Mr Najjar told The National.
The decision to end all medical transfers to Israel was under consideration by the PA in recent years as its financial condition grew weaker. But the recent steps by Israel are what finally prompted the PA to take the decision, both for political and financial reasons.
For the past two months, the Palestinian government in the West Bank has returned the monthly revenue to Israel in protest at Israel deducting around $11 million from them each.
The clearance revenue covers more than 70 per cent of the salaries of public employees. As a result, the PA paid its 180,000 employees in Gaza and the West Bank only 50 per cent of their salaries in the past two months, according to the Palestinian Ministry of Finance.
The Paris Protocol, which is an part of the Oslo Accords, was an agreement signed in 1994 between Israel and the PLO that defined the economic relations between the PA and Israel.
In accordance with the agreement, Israel collects taxes on Palestinian imports in addition to other taxes on behalf of the PA and transfers the money to the Palestinian government on a monthly basis.
Israel is entitled to take 3 per cent of the total revenue as collection and processing fees. The agreement clearly states that “full, timely, predictable and transparent transfer of tax and custom revenue has to be respected”.
Israel also, in violation of the agreement, often withholds the Palestinian clearance revenue to exert political pressure on the PA. This response comes after actions that vary from the PA’s attempts to reconcile with Hamas, or its applications for international recognition of Palestine.
The decision to cease all medical transfers to Israel is in line with the PLO’s recent Central Council decision to reduce the Palestinian dependency on Israel.
Mr Najjar said that they were hoping to achieve independence from Israel in the health sector after this decision, and that “hopefully soon the PA will reduce its dependency on Israel in every aspect”.
