Gaza’s health ministry spokesman said an Israeli air strike on Tuesday killed hundreds of people at a hospital in the Palestinian enclave, but Israel said a Palestinian barrage had caused the blast.

The death toll was by far the highest of any single incident in Gaza during the current violence, triggering protests in the occupied West Bank, Istanbul and Amman.

The Palestinian Authority’s health minister, Mai Alkaila, accused Israel of “a massacre” at Al-Ahli al-Arabi Hospital. The strike killed hundreds of people and occurred during Israel’s intense 11-day bombing campaign in Gaza.

Israeli Prime Minister Benjamin Netanyahu said “barbaric terrorists” in Gaza had attacked the hospital, not Israel’s military.

The health ministry spokesman, Ashraf Al-Qudra, said early on Wednesday that hundreds were killed and that rescue workers were still removing bodies from the rubble. In the first hours after the blast, a Gaza civil defence chief said 300 people were killed, while health ministry sources put the figure at 500.

Israeli Military spokesperson Rear Admiral Daniel Hagari told reporters rockets fired by the Palestinian Islamic Jihad militant group passed by the hospital at the time of the strike, which he said hit the facility's parking lot.

Another spokesman, Lieutenant-Colonel Jonathan Conricus, told CNN the military intercepted a conversation in which militants acknowledged a misfire. He said the military would release a recording of the conversation.

Islamic Jihad denied that any of its rockets were involved in the hospital blast, saying it did not have any activity in or around Gaza City at that time. Iran-backed Islamic Jihad took part in the Hamas-led assault on Israel on October 7 and, like Hamas, has fired numerous salvoes of rockets into Israel.

News of the hospital strike and high death toll prompted condemnation from many countries on the eve of US President Joseph Biden’s visit to Israel. Russia and the United Arab Emirates demanded a UN Security Council meeting and clashes erupted in the West Bank.

Earlier on Tuesday the United Nations said an Israeli strike had hit one of its schools where at least 4,000 people were sheltering. The agency said six people were killed and dozens injured by the strike. Israel’s military said it was looking into that report.

While briefing reporters, Hagari cast doubt on the Palestinian death count in the hospital strike and claimed there was no direct hit on the facility. He said military drone footage showed “a kind of hit in the parking lot.”

He said the military did have an Israeli Air Force operation in the area around the time of the hospital blast, “but it was with a different kind of ammunition that does not ... fit the footage that we have (of) the hospital.”

On the death count, Hagari said: “I don’t know how many people (were) hit here, even. Nobody can verify it yet.”

STRIKE DRAWS CONDEMNATION

Biden said he was “outraged and deeply saddened by the explosion” at the hospital and loss of life. In a statement, he said he spoke with the leaders of Jordan and Israel and “directed my national security team to continue gathering information about what exactly happened.”

Health authorities in Gaza said prior to Tuesday’s incident at least 3,000 people had been killed in Israel’s 11 days of bombing since Hamas militants rampaged into Israeli towns on October 7, killing more than 1,300 soldiers and civilians.

Displaced people fleeing the Israeli bombardment have flocked to hospitals, seeking refuge around them in hopes they will be safer.

Last week Israel ordered all people living in the northern half of the Gaza Strip, which is only 45 km (25 miles) long and home to 2.3 million people, to leave their homes and go south.

However, the air strikes have pounded targets throughout the enclave and despite expectations of an Israeli ground offensive, some displaced people have started returning north.

The World Health Organisation said the attack on the hospital was “unprecedented in its scale”. It said earlier on Tuesday there had been 115 attacks on healthcare facilities in Gaza and the majority of its hospitals were not functioning.

Israel has cut off all power, water, food, fuel and medicine supplies into Gaza since the Hamas attack, intensifying an existing blockade of the enclave.

Countries including Canada, Egypt, Turkey, Jordan and Qatar condemned the strike on the hospital.

In the West Bank, where the internationally recognised Palestinian Authority operates, Palestinian protesters clashed with Palestinian security forces, who fired tear gas to disperse them. Palestinian Authority President Mahmoud Abbas cancelled a meeting with Biden.