Hospitals, hostages and an ever-increasing death toll: the issues that will define Israel’s next steps in Gaza

Intense fighting around major hospitals – where Israel says Hamas have command centres – has upped the pressure on Benjamin Netanyahu’s government from allies, writes Kim Sengupta in Tel Aviv

Patients and internally displaced people are pictured at al-Shifa hospital (AFP via Getty)

Israel’s offensive against Hamas is reaching a critical mass with the lethal civilian toll, already the bloodiest by far in the many Gaza wars, becoming a crucial factor in shaping the coming military and diplomatic steps.

Hospitals and hostages are also key issues, both emotive and operational, in what is unfolding. Joe Biden has said that medical facilities must be protected, adding: “My hope and expectation is that there will be less intrusive action relative to hospitals.” His national security adviser, Jake Sullivan, also said: “The position of the United States on this matter is clear. Hospitals should be protected. The United States does not want to see firefights in hospitals where innocent people, patients receiving medical care, are caught in the crossfire.”

But how likely are these strictures to prevail on the ground? The Israeli government has regularly claimed that Hamas uses hospitals in Gaza, including underground tunnels running beneath them, to plan and carry out attacks and have stressed that they needed to neutralise this.