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A total of 54 Palestinians died awaiting permits in 2017, research by Al Mezan Center for Human Rights found, in what rights activists called an overly bureaucratic system which deprives Palestinians of their right to healthcare.

The World Health Organisation said Israeli authorities approved permits for medical appointments for only 54 percent of those who applied in 2017, the lowest rate since the WHO began collecting figures in 2008.

As a result, 54 Palestinians, 46 of whom had cancer, died in 2017 following denial or delay of their permits.

In a joint statement, Al Mezan, Amnesty International, Human Rights Watch (HRW), Medical Aid for Palestinians and Physicians for Human Rights-Israel called on Israel to ease restrictions.

"We're seeing Israel increasingly deny or delay access to potentially life-saving cancer and other treatment outside Gaza, with shockingly high numbers of Palestinian patients subsequently dying, while Gaza's healthcare system – subjected to half a century of occupation and a decade of blockade – is decreasingly able to meet the needs of its population," MAP's CEO Aimee Shalan.

Gazans require Israeli permits to leave the enclave and travel to Jerusalem or the West Bank for treatment which the Palestinian Authority, the internationally recognised Palestinian government, pays for.

High-quality medical care for conditions such as cancer is not possible in Gaza, largely due to a shortage of facilities and Israel's restrictions on imports of key medical technology it argues could be seized by Hamas for military purposes.

Israel argues rigorous checks are necessary for security reasons for those coming from the Gaza strip.

Of more than 25,000 applications to travel for treatment in 2017, only 54 percent were granted in time for their appointments.

This was down from 62 percent the year before and 92 percent as recently as 2012, the WHO said.

Omar Shakir, Israel-Palestine head for HRW, said they had seen "wider and wider" use of security justification to reject or delay permits for Palestinians.

"It is not based on security but based on a political strategy to isolate Hamas that uses the people of Gaza as collateral in that calculus," he told AFP.

Gaza's two million people endure what the UN labels "a protracted humanitarian crisis".

Amid widespread poverty and unemployment, at least 10 percent of young children are stunted by chronic malnutrition, up to half of all medicines and medical items in Gaza are completely depleted or below one month's supply, and chronic electricity shortages have caused officials to cut health and other essential services.

Last year a cancer patient was caught smuggling explosives for Hamas through the Erez crossing, allegedly after being duped into taking a container.

"Hamas operates every day to take advantage of the civilian measures that the state of Israel promotes," said a statement from COGAT, the Israeli defence ministry body responsible for coordination of such permits.