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A United Nations inquiry has accused Israel of carrying out a “concerted policy” of destroying the health care system in Gaza during its year-long conflict with Hamas in attacks it said amount to war crimes.

Israel’s actions in the besieged Palestinian enclave “constitute the war crimes of willful killing and mistreatment and the crime against humanity of extermination,” the commission said in a statement Thursday.

The Israeli attacks resulted in “fuel, food, water, medicines and medical supplies not reaching hospitals, while also drastically reducing permits for patients to leave the territory for medical treatment,” it said.

CNN has reached out to the Israel Defense Forces (IDF), Israeli Prime Minister’s Office and the Israeli foreign ministry about the report, but has not yet heard back. Israel has repeatedly accused Hamas of operating in and around health care facilities in the Palestinian enclave – using them for military operations, including as command centers, weapons stores and to hide hostages.

Israel has released footage they say is evidence of those Hamas operations. The videos do not offer definitive proof, and Hamas has denied the claims.

“Our forces on the ground know where these hospitals are, and nodes are taken into account when they’re operating,” a legal adviser to the IDF told CNN earlier this year about the process of approving strikes against targets near hospitals. “But at the end of the day, as long as Hamas continues to use these hospitals and facilities for the military operations, and our aim is to defeat Hamas militarily, there is absolutely no choice but to go there.”

The report also accused Hamas and other Palestinian militant groups of committing war crimes of “torture, inhuman or cruel treatment, rape and sexual violence” for their treatment of Israeli hostages held captive in Gaza. It also investigated “institutionalized mistreatment” of Palestinian detainees in Israeli prisons.

In a statement accompanying the 24-page report, which does not have the force of law, former UN High Commissioner for Human Rights Navi Pillay said Israel “must immediately stop its unprecedented wanton destruction” in Gaza.

As part of the report, UN experts investigated the killing of 5-year-old Palestinian girl Hind Rajab, who made headlines in late January after a recording emerged of her pleading to emergency workers to rescue her and her family after they became trapped in their car due to Israeli shelling.

Despite an ambulance arriving at the scene while the girl was still alive, the presence of Israeli security forces effectively “prevented access,” meaning the bodies of Rajab’s relatives “could not be retrieved from their bullet-ridden car until 12 days after the incident,” the report said.

The report “determined on reasonable grounds that the Israeli Army’s 162nd Division” which operated in the area at the time is “responsible for killing the family of seven, shelling the ambulance and killing the two paramedics inside.”

The incident was just one of several alleged attacks on health care in Gaza, amid broader wartime conditions.

The report will be presented to the UN General Assembly on October 30.

The commission previously alleged that both Israel and Hamas committed war crimes in the early stages of the Gaza war, and that Israel’s actions also amounted to crimes against humanity.