Israeli forces have reached the gates of Gaza’s largest hospital as hundreds of patients, including dozens of babies, remained trapped inside. Thousands of people have fled al-Shifa hospital in Gaza City, but health officials said the remaining patients were dying due to energy shortages amid intense fighting between Israeli troops and Hamas militants. At least 32 patients, including three premature babies, had died over the past three days, Gaza’s health ministry said. Life-saving equipment such as incubators cannot run without fuel to run generators. “Yesterday I had 39 babies and today they have become 36,” Dr Mohamed Tabasha, head of the paediatric department at Shifa, said in a telephone interview on Monday with Reuters. “I cannot say how long they can last. I can lose another two babies today, or in an hour.” Israel has imposed what it calls a “complete siege” on Gaza for more than a month, allowing in only a trickle of supplies. The Israeli military said it was providing safe corridors for people to escape intense fighting in the north and move south, but Palestinian officials inside Shifa said the compound was surrounded by constant heavy gunfire. Fighting has been concentrating in a tightening circle around Shifa’s gates since Israeli ground forces entered Gaza, after Hamas militants killed at least 1,200 people and abducted 240 hostages in Israel in a surprise attack on 7 October. The Israel Defence Forces (IDF) has repeatedly said Hamas operates from bunkers underneath Shifa. This has been denied by Hamas and hospital staff. UN officials and rights experts have stressed that hospitals should never be used by Palestinian armed groups to hide, nor should those claims be used by Israel as a pretext to attack them. There are between 600 and 650 inpatients at Shifa, as well as 200 to 500 health workers, and about 1,500 displaced people seeking shelter there, according to information shared with the World Health Organization. The WHO chief, Tedros Adhanom Ghebreyesus, said in a post on X that Shifa was “not functioning as a hospital any more”. The WHO has previously said that forcing some critically ill patients to flee hospitals in Gaza would be a “death sentence”. Another hospital in Gaza City, al-Quds, was forced to shut down on Sunday because it had run out of fuel. The Palestinian Red Crescent, which operates the facility, said Israeli forces were stationed nearby and that preparations were being made to evacuate 6,000 patients, medics and displaced people. However, fighting could block their escape. The IDF published footage online on Monday that it said showed a militant with a rocket-propelled grenade launcher inside the hospital grounds. As the war entered its sixth week, fresh clashes on Israel’s northern border with Lebanon and more US airstrikes on Iran-linked militia targets in neighbouring Syria renewed fears of a wider regional conflagration. Pressure is growing on Israel to agree to a ceasefire as allies including France and the US expressed growing concern at the death toll in Gaza. More than 11,000 people have been killed, about 40% of them children, and more than half of the population have been made homeless, Palestinian authorities have said. Joe Biden, the US president, offered muted criticism of Israeli tactics around al-Shifa on Monday, saying: “It’s my hope and expectation that there will be less intrusive action relative to the hospital. The hospital must be protected.” The EU’s 27 countries issued a statement on Sunday demanding “immediate humanitarian pauses” in Gaza and condemning Hamas for using medical facilities and civilians as “human shields”. Ashraf al-Qidra, the Gaza health ministry spokesperson who was inside Shifa on Monday, said an Israeli tank was stationed at the hospital gate. “The tank is outside the gate of the outpatient clinic department, this is how the situation looks this morning.” Israel has told civilians to leave and medics to send patients elsewhere. It says it has attempted to evacuate babies from the neonatal ward and left 300 litres of fuel to power emergency generators at the hospital entrance, but that the offers were blocked by Hamas. Qidra denied rejecting the offers of fuel but said the 300 litres would power the hospital for only half an hour. Shifa needed 8,000-10,000 litres of fuel a day, which must be delivered by the Red Cross or an international aid agency, he said. On Monday, the UN agency for Palestinian refugees said Israel’s navy had struck one of its facilities in southern Gaza. Philippe Lazzarini, the UNRWA commissioner general, said: “This recent attack is yet another indication that nowhere in Gaza is safe. Not the north, not the middle areas and not the south. The disregard for the protection of civilian infrastructure including UN facilities, hospitals, schools, shelters and places of worship is testament to the level of horror that civilians in Gaza are living every day.” UN aid agencies observed a minute’s silence on Monday for 101 staff members killed in Gaza so far, the largest toll of humanitarian workers in any war since the global body was founded after the second world war. The UN has run a huge operation for generations in Gaza, where most residents are refugee families from the wars surrounding the creation of Israel in 1948.