The lack of precision in published accounts makes calculating exactly how much the UK has given to the PA’s health system difficult. But the total is huge.
From 2008 until 2015, Britain contributed £360 million directly to the PA’s Treasury, under a scheme administered by the World Bank. Health services account for roughly a third of the PA’s expenditure.
Later, from 2017 to March 2021 — when the foreign aid budget was cut — Britain donated another £138 million to pay for salaries in health and education.
This means that over the past 14 years, British taxpayer spending on the PA health system has totalled more than £200 million.
Britain has also funded the Ramallah-based anti-corruption organisation, Aman, which has exposed corruption in the healthcare system. But its investigations have made little impact.
A deserted laboratory at the 104-bed Mahmoud Abbas Governmental Hospital
The Khaled Hasan Cancer Centre was the first of the two ghost hospitals to be launched. In 2015, a Palestinian philanthropist donated 20 hectares of land. This was no small gift: land in the Ramallah area commands high prices.
On 7 January 2016, according to translations from the Arabic press by monitoring group CAMERA Arabic, President Abbas laid the foundation stone.
“The hospital will be built within a year, to treat all cancer cases and reduce treatment expenses,” he said. There was no specialist cancer hospital anywhere in PA territory, forcing most cancer patients to seek treatment in Israel or abroad, at enormous cost.
Muhammad Shtayyeh, now the Prime Minister, was then leading the project. Shtayyeh — who has a doctorate in Development Studies from Sussex University — was standing next to Mr Abbas and interrupted him.
The architects’ design for the Khaled Hasan Cancer Centre
The timescale of one year was too ambitious, he said, but Khaled Hasan Cancer Centre would become a reality “within 18 months”.
The hospital would consist of 15 floors, with more than 200 beds and the full range of cancer diagnostic tools and treatments, including surgical theatres and facilities for radiotherapy, chemotherapy and bone marrow transplants.
That March, Mr Abbas held a public, televised launch for the “Rose of Hope for the People of Hope” fundraising drive, aiming to net the full construction budget of £120 million.
The Saudi-based Islamic Development Bank gave £1.7 million immediately. Other donations and pledges soon topped £15.4 million.
President Abbas said: “[I want to see] bulldozers working tomorrow, not after a month. If there is a dollar, we will start digging with it… The homeland is built brick-by-brick.”
Meanwhile, the PA health ministry sent doctors for additional training in Jordan, Italy and Greece, saying this would “prepare a qualified human cadre to manage Khaled Al-Hassan Hospital upon its opening”.
The design contract was won by a consortium led by the British architect John Cooper, whose firm has built hospitals from Britain to South Africa.
It was paid £2.15 million. His design was unveiled in August 2017, and early the next year the digging began.
Then nothing.
Mr Cooper told the JC: “We were very excited by this project. But something happened and construction just ground to a halt.
“We were dismayed by the dysfunctionality of the Palestinian development organisation we were dealing with, but be honest, we have no idea what happened. All we were told was that they hadn’t been able to get the money. Where there should now be a hospital, there’s just a large hole in the ground.
“It’s very sad when you’ve invested the best part of two years in something and you end up writing it off. It was wasted.”
An empty lab at 104-bed Mahmoud Abbas Governmental Hospital
So what happened? We can join the dots. While the Khaled Hasan Cancer Centre was abandoned, the PA decided to support a new cancer wing at Al-Istishari, a nearby private hospital.
It makes large profits for its shareholders, some of whom are well-connected in the PA. Although treatment at Al-Istishari will be far more expensive, it has now been designated the PA’s “National Cancer Centre” instead of the Khaled Hasan Cancer Centre.
Meanwhile, in January, the PA Health Ministry said that the £6.3 million left from the abandoned Khaled Hasan fundraiser was being mysteriously held at four different banks. There was no indication of what would happen to it.
In contrast with that aborted project, building the West Bank’s second ghost hospital was simple; partly, perhaps, because it was organised and largely financed by the government of Italy.
It too was desperately needed. Jihad abu Asabea, Halhul’s mayor, said that when the project was first proposed, the 250,000 people who lived in the area had no choice but to travel seven miles to the hospital in Hebron.
Sometimes, he said, there were clashes between Palestinians and Israeli settlers. “The roads are closed, and getting to Hebron is impossible,” he told the JC.
“People with emergencies die without treatment. Around here, there isn’t even a private hospital.
“If someone has a heart attack and you could take him to hospital in Halhul, you would be far more likely to save his life than if you tried to take him to Hebron.”
In June, he added, a man was shot in the chest nearby. “He should have survived, but they couldn’t get him to hospital, and he died.”
This, he said, made the existence of the unused ghost hospital just a short walk from his house all the harder to accept.
Like the Ramallah cancer centre, the Mahmoud Abbas Governmental Hospital started with a donation of land. According to Mr Asabea, it was worth £6 million. “It came from local people,” he said. “Twenty acres. We donated it.”
Building of the 104-bed hospital — dubbed a “major project” by the PA health minister, Mai al-Khaila — began in 2018. Italy gave €10 million, while further sums were raised locally. It was finished on time, in early 2020.
Mr Asabea showed the JC round. Outside and in, the building was spotless. Air conditioning kept the place cool. On the ground floor, an airy lobby led to corridors with pristine marble floors, well-equipped laboratories and a pharmacy.
But the outpatient waiting and consulting rooms were silent. No doctors, nurses or patients could be seen.
According to Mr Asabea, the hospital was not totally empty. Five beds were occupied. For months, there had been no sign of any increase in activity.
“It’s so urgent to get this hospital working properly,” he said. “But when we ask the Ministry, all we are told is, ‘It will be soon’. No details are given.”
What is the reason for this? Dr Haitham al-Hidri, a whistleblower who lives in Halhul and has revealed the corruption in the Palestinian health system (see page 10), believes he has the answer.
“This public hospital is beautifully equipped and is barely being used,” he told the JC. “This is because of the number of referrals to private hospitals. They are much more expensive, but can make their owners rich.”
Mr Asabea added: “The Italians, who paid for it, cannot be happy. They donated the money, but without any benefit.”
Health expert Jehad Harb said that there was a common root to the various flaws in the PA health system.
“It’s a lack of transparency and an absence of strategy,” he said. “The Ministry of Health is in bad shape.”
The ghost hospitals, he said, were symptomatic of “the big talk that created dreams in Palestinians’ minds for these great projects”.
He added: “In the health sector, the Government is supposed to serve the people’s needs, with fairness the most important element.
“Yet people get treatment because of their social and political connections. We need to have a system that doesn’t have that.”
Former Labour MP Joan Ryan, executive director of the NGO Elnet UK, which strengthens relations with Israel, said: “The JC has shown that international aid is being diverted from those who need it to those in positions of power — this in a key sector that is almost a litmus test of a government’s ability to meet its citizens’ needs.
“It raises grave questions about the PA’s continuing legitimacy and may explain why opposition to it is building, a problem that may have serious consequences for the prospects of peace.”
