State Comptroller and Ombudsman, Matanyahu Englman, published the first audit reports on civil matters connected to the failures of the government and the IDF during the period preceding 7.10 and thereafter
The State Comptroller and Ombudsman, Matanyahu Englman, published (11.2.25) the first audit reports on civil matters connected to the failures of the government and the IDF during the period preceding 7.10 and thereafter.
A few days after the Simchat Torah massacre, Comptroller Englman visited the Gaza Envelope. During the course of the following months, the Comptroller and employees from his office also visited evacuees in hotels in Eilat, the Dead Sea, Jerusalem, the center and the north. As long ago as 7.1.24, the Comptroller announced the start of the audit on about 60 subjects, on which about 200 audit managers in the Office of the State Comptroller are working.
The Comptroller emphasized three milestones for the audit:
- A comprehensive and fundamental audit vis-à-vis all the echelons – political, military and civilian.
- The audit will name those responsible for the omissions and impose personal liability upon them.
- Insofar as a national investigation committee is formed, the State Comptroller will set sectoral boundaries in conjunction with the committee, as he has done in the past.
The initial intention was to publish the reports concerning the core of the failure that facilitated the 7.10 massacre within a few months. But shortly afterwards the IDF submitted a strong objection to the actual conduct of the audit at this time. To this were added petitions filed in Bagatz (the High Court of Justice), that the Attorney General, the IDF and the ISA were party to, with a demand to block the audit. Bagatz issued an interim order forbidding the exercise of Section 3 of the Basic Law: The State Comptroller vis-à-vis the IDF and the ISA. This section stipulates that "A body subject to the audit of the State Comptroller shall provide the Comptroller without delay, at his demand, with information, documents, explanations, and other material that in the opinion of the Comptroller he requires for the purposes of the audit".
This conduct held up the ability to conduct an audit in the core subjects for about a year. As of the present time, February 2025, there is still an interim order forbidding the State Comptroller from conducting an audit regarding the IDF in the core subjects, where for a year and four months Israeli citizens have been waiting for answers.
Due to the delay caused in the audit on the military and political core subjects, State Comptroller Englman decided that first of all he would publish reports dealing with important and central civilian subjects. This publication is the first among the audit reports on the Swords of Iron War ("Batch 1"). Henceforth, the next audit reports will be published on the war when the work on them is completed.
The public is entitled to answers to the difficult questions concerning the most serious negligence in the state's history. The State Comptroller will not keep quiet until he provides the answers to the omissions of the political echelon and the military echelon, and when the interim order is lifted, he intends to devote most of his attention to these matters.
State Comptroller Matanyahu Englman:
"About three million Israelis are likely to be suffering PTSD symptoms, depression or anxiety since October Seventh. They are not receiving the mental treatment that they are so much in need of. It is inconceivable that they have to wait in line for about six months in order to receive psychiatric treatment at the HMOs.
The mental health array, which was barely functioning even before October Seventh – collapsed during the first days of the war.
Just one month after the massacre I warned about the failures in the field of mental health treatment in a letter to the Prime Minister – but all the defects have not yet been fully rectified.
The Minister of Health Uriel Buso and the Director General of his ministry, Moshe Bar Siman Tov, did not ascertain in advance that the Ministry of Health was prepared to provide mental assistance to hundreds of thousands of evacuees, even though there was a scenario for widespread evacuation of the population according to which the ministry was supposed to act.
The resilience centers, that treat victims of anxiety during times of routine and emergency, are still coping with budgetary uncertainty and a severe manpower shortage.
We take a very serious view of the fact that the government has not yet regulated in law the status of the emergency teams in the localities – Tzachi (emergency and locality resilience team).
Upon the outbreak of the events of October Seventh, the Tzachi teams in the Gaza Envelope localities were the first to give directions to the residents, and in certain cases they were the ones who acted in the locality with the first response teams until the security forces arrived. The Tzachi teams were significantly involved in the evacuations from the localities and following them. They organized, managed and accompanied the evacuation and afterwards coordinated the information about the places where the evacuees were staying, they coordinated their needs and informed the relevant parties of the gaps. The Tzachi teams, operating in many localities throughout the war – in particular in the south and north and along the Seam Line localities – do not receive any recognition in a law that would protect their rights and allow their activity over long periods.
The State of Israel has a moral obligation to treat the mental health patients in the entire population and in particular among the victims of hostile activity, and assist them in getting back to normal. The government and the person at its head must formulate an inclusive and long-term solution for the victims of October Seventh and the Swords of Iron War – and ensure the necessary budget for this purpose."
The Mental Health Treatment following the Events of October Seventh 2023 and the Swords of Iron War
On Simchat Torah 5784, October Seventh 2023, the Hamas terrorist organization attacked the State of Israel with the launch of thousands of missiles and the invasion of thousands of terrorists to IDF bases, cities and localities in the Western Negev (the Gaza Envelope localities). The terrorists also arrived at parties packed with thousands of participants that were taking place next to the Gaza Strip. The thousands of terrorists that invaded Israel performed atrocious acts that were extreme in their cruelty. They murdered hundreds of soldiers and about 1,000 Israeli civilians and foreigners and committed heinous crimes on women, men, the elderly, children and infants, male and female soldiers. They also wounded thousands of people, committed serious sexual assaults on the victims and kidnapped 251 women, men and children into the area of the Gaza Strip. The terrorists also damaged property – they sabotaged, burnt and destroyed homes in the localities, factories, equipment and other property.
During the fighting in the localities, many residents were compelled to hide for many hours in protected spaces and other hiding places, in great fear of their lives and while becoming aware of the atrocities being perpetrated on family members, relatives, neighbors and friends, and also seeing these things happening with their own eyes (hereinafter: Events of October Seventh); many others saw the terrible events broadcast live on the media and social networks.
The Swords of Iron War, that broke out following these events, is characterized by the launch of thousands of missiles at Israeli localities, the fear of a multi-front confrontation and a long duration in comparison with recent Israeli wars.
These extreme events are liable to affect the mental health of the Israeli population. This gives rise to the need to provide a mental health treatment solution in extensive scopes in order to assist the population return to normal functioning without developing severe chronic mental health symptoms, liable to cause a person and his family prolonged suffering and health and even financial damage due to the difficulty of working.
Studies show that post-trauma, depression and anxiety are common results of exposure to extreme stressful events such as the events of war, life-threatening situations, captivity and torture, and the main recommended treatment for them is conversational therapy (psychotherapy). The window of opportunity for post-trauma treatment, in an attempt to prevent its chronic state, is three to six months, and it is possible that treatment may also be effective nine months to one year after the date of the events that triggered it. Failure to receive treatment during this period is liable to lead to chronic morbidity, accompanied by impaired functioning. This means that in addition to the intense suffering that is liable to be caused following the lack of prompt treatment, there are also likely to be significant financial implications, including requiring National Insurance benefits.
In the State Comptroller's letter to the Prime Minister dated 13.11.23, the State Comptroller set out the state of affairs and the main failures and gaps in the treatment of the home front, as transpired from his tours of the Confrontation Lines localities in the south and north of the country, immediately after the Events of October Seventh. In his letter, the State Comptroller stated that it transpired from the visits to the hotels hosting evacuees from the southern localities that "the public-government array in the field of mental health has failed in the treatment of evacuees, as it is based almost completely on volunteers". The mental health array "has acted without an orderly doctrine, alongside local voluntary initiatives, and without preserving the continuity of treatment and documenting it".
The audit, whose findings are presented in this report, examines the activity of the mental health array shortly after the Events of October Seventh and in the following months, and deals with the system's organization in providing treatment to those needing it among the entire population, including the evacuees, with the emphasis on the wider scope of whoever might have symptoms of mental trauma, anxiety and depression.
The Minister of Health during the audit period was MK Uriel Menachem Buso, and the Director General of the Ministry of Health was Mr. Moshe Bar Siman Tov.
State Comptroller Matanyahu Englman remarks to the supreme authority for hospitalization and health that it did not ascertain that the healthcare system was operating according to the updated reference scenario and prepared for the provision of the mental health treatments that would be required following the emergency events.
The Comptroller further remarks to the Ministry of Health and its Director General, which heads the Ministry and heads the supreme authority for hospitalization and health, that they did not update the departmental reference scenario for the mental health array's preparedness for war and the other traumatic events, and that they did not formulate a special work plan in the field of mental health during emergency in general and in an event requiring widespread population evacuation in particular.
The State Comptroller further remarks to the Ministry of Health and the Budgets Department at the Ministry of Finance on not measuring and tracking the waiting times for treatments in the field of mental health at the HMOs and therefore they are unable to estimate the effectiveness of the budget actually allocated for mental health pursuant to the budgetary agreement and support granted to the HMOs.
The Office of the State Comptroller also remarks to the Minister of Health, who is responsible for what is being done in his ministry for not ensuring that his ministry is ready and prepared in accordance with the departmental reference scenario, including in all matters pertaining to the mental health array. It is recommended that the Ministry of Health, in collaboration with the HMOs, ascertain the suitability of the national plan for the mental health array, which it began to formulate even before the Events of October Seventh, to the increase in the need of the array's services following them. Such a plan must ensure the provision of treatments in an extensive scope within appropriate time periods, the determination of short-term and long-term measurable goals, as well as priorities for the provision of the treatments with the emphasis on populations at increased risk, and periodical audit of the allocation of budgets for achieving the goals in the field of mental health. For formulating the plan, it is recommended that the Ministry of Health consult with other government ministries, such as the Ministry of Welfare and Social Affairs, the Ministry of Education and the Ministry of Finance, who will appoint one integrating party to spearhead the plan and that it would be budgeted in accordance with its goals. It is also recommended that the plan be brought for government approval as a national plan, and that the Ministers of Health, Education, Welfare and Social Affairs and Finance act, each one in its own field, to ensure its success. It is further recommended that in order to execute the plan to be formulated, the establishment of a mental rehabilitation administration should be considered, in collaboration with the Ministry of Health, the Ministry of Welfare and Social Affairs, the Ministry of Education and the National Insurance Institute, which will provide a full and complete envelope for mental health patients from the Events of October Seventh that will help them get back to normal life.
The Minister of Health must ascertain that his ministry is ready and prepared for the provision of mental health services in times of emergency as prescribed in the departmental reference scenario.
The Operation of Resilience Centers in the Confrontation Lines Localities since the Outbreak of the Swords of Iron War
Since the outbreak of the war and until the beginning of January 2024, about 210,000 people were evacuated from or left their homes. Likewise, according to a survey conducted by the Office of the State Comptroller in April of that year, 38% of the participants of the survey reported symptoms of post-trauma, depression, anxiety or a combination of them, at a medium or severe level. Five days after the outbreak of the war, on 12.10.23, the Ministry of Health was approved a tender-exempt engagement with the Israel Trauma Coalition to reinforce the activity of the resilience centers and the establishment of a non-regional (national) resilience center. The center was designed to provide emotional treatments online or in clinics with therapists employed for this purpose. The two resilience centers in the north are operated by the Resources Center, and the other resilience centers – by the Israel Trauma Coalition. The resilience centers had and still have a central role in the preservation and rehabilitation of the personal and communal resilience of the state's population both as individuals and as a society.
State Comptroller Matanyahu Englman determines that the Ministry of Health must ensure the certainty of the budgeting of the resilience centers and the transfer of essential budgets for the operation of the centers in emergency times, while establishing a professional and budgetary control mechanism over the centers' activity.
The supreme steering committee and the Ministry of Finance, in collaboration with the Prime Minister's Office, should determine an annual budgetary framework for all resilience centers, which will be anchored in the Ministry of Health's budget basis. Likewise, the Comptroller determines that the Ministry of Health must complete the procedure for operating the resilience centers so that it shall apply to all the resilience centers, as well as regulate matters that have not been regulated as arising from the audit. In order to ensure the provision of resilience services safely and in a protected atmosphere, reinforce the effectiveness of the treatments and reduce the mental damages that are liable to occur on account of the lack of protection, the Ministry of Health must ensure that all the resilience centers comply with the Home Front Command's protection demands. The Minister of Health, in collaboration with the Minister of Finance and the Prime Minister's Office, and with the other partners that are members of the supreme steering committee, must promote a framework that will ensure the existence, reinforcement, expansion and professionalism of the resilience centers over the years for the benefit of all citizens of the State of Israel and establish a budget mechanism for the resilience centers that will adapt itself to the activities required from the resilience centers during states of emergency.
While attaching supreme importance to the matter of saving lives, the Ministry of Health, the supreme steering committee and the Prime Minister's Office must integrate the resilience centers into all the local government and healthcare systems' organizational arrays, in order to allow the provision of professional and effective treatment for all citizens of the State of Israel affected by wars, hostile activity and extreme natural disasters. Following the development of the campaign in the north, while the preparation of the report was in the final stages, the importance of the resilience centers' activity was highlighted, in particular in the provision of services to all the localities under fire. Only a full integration between all the parties dealing in the field and awarding the resilience centers a central place for treating the mental health patients and reinforcement of the communal resilience and preparation for emergency, while placing their budgeting at the top of the Israeli government's national list of priorities, will ensure national resilience that is steadfast in situations like the one with which the State of Israel has been dealing since the outbreak of the Swords of Iron War and the future states of emergency in the coming years.
Regulation of the Localities' Emergency Teams (Tzachi)
About 20 years ago, several regional councils initiated the establishment of emergency teams in the localities (Tzachi) in their jurisdictions, designed to provide a communal response in states of crisis and emergency for the locality's population in general and the injured residents in particular. Tzachi is supposed to be the first locality's party that responds to states of crisis and emergency and lead the communal response for the locality's population. In 2002, the Ministry of Welfare and Social Affairs developed the concept of the operation and activity of the Tzachi teams, in collaboration with other government ministries, the Emergency Economy Array (MALACH) and the Home Front Command in the IDF. During an event of organized evacuation or hurried evacuation, the IDF's Operations Directorate (AMATZ) bear inclusive responsibility for evacuation; the Southern Command or the Northern Command, in accordance with the geographical region being evacuated, are responsible for the command over the evacuation event.
The evacuating regional councils assist the IDF in the evacuation effort and they will also assist in the absorption of the evacuees in the absorption site. Upon the outbreak of the Events of October Seventh, the Tzachi teams in the Gaza Envelope localities were the first ones to give directions to the residents, and in certain cases they were the ones who acted in the locality with the first response teams until the arrival of the security forces. The Tzachi teams were significantly involved in the evacuation of the localities and thereafter – they organized, managed and accompanied the evacuation and thereafter coordinated the information regarding where the evacuees were staying, they coordinated their needs and notified the relevant parties of any gaps.
State Comptroller Matanyahu Englman determines that the Ministry of Defense, via the National Emergency Management Authority (NEMA), the IDF (the Home Front Command), the Ministry of Welfare and Social Affairs, the Ministry of Interior and the regional councils, must implement the recommendations in this report in order to maximize the potential of the Tzachi teams during times of emergency.
Regulation of the Assistance to Victims of Hostile Activity from the Events of October Seventh
The Events of October Seventh are extreme by any standard, and in particular in relation to the hostile activities that have occurred in Israel in the past – from the aspect of the number of victims and the number of localities invaded by the terrorists simultaneously, from the aspect of the level of cruelty in the hostile activity perpetrated, and from the aspect of the duration of the events. A significant outcome of these events is the effect on mental resilience to the point of mental trauma, an effect that requires budgetary systemic preparation – to reduce the risk that the victims will develop post-trauma or other mental disorders in the future, and so that they can return to their normal lives as soon as possible.
This report makes a distinction between the victims of "the first circle" – whoever was physically present at the hostile event and had a tangible and direct causal connection between the alleged injury and the hostile activity, allowing them to be recognized as victims of hostile activity;
And the victims of "the second circle" – whoever was exposed to the hostile event and mentally affected as a result thereof, but who do not comply with the rules determining the status of a victim of hostile activity, and who are therefore not eligible for the benefits and payments by virtue of the Compensation Law.
Pursuant to the Compensation Law, the competent body for determining whether an injury that occurred is a hostile injury is "the Approving Authority" at the Ministry of Defense, and therefore the National Insurance Institute sends the claims for its decision. The Approving Authority's determination that a hostile injury is concerned is a condition for the continuation of the National Insurance Institute's treatment of the victim, including handling claims for compensation and benefits by virtue of the Compensation Law.
The State of Israel owes a moral obligation to take care of the needs of the victims of hostile activity and ascertain that they receive the necessary treatment and rehabilitation envelope to assist them in returning to normal life.
State Comptroller Matanyahu Englman determines that the Ministry of Finance, the Ministry of Health, the National Insurance Institute and the Ministry of Justice should formulate a holistic and long-term response for the victims of October Seventh, including formulating the necessary rehabilitation envelope for such victims over time. This should be done, among other things, via the customization of the Compensation Law to the reality that has been created, also with regard to future hostile events, or, alternatively, via the promotion of another unique arrangement allowing accompaniment and support for those requiring it, to assist them in returning to normal functioning.
