Palestinian President Mahmoud Abbas in delicate position after Gaza hospital strike

Head of the Palestinian Authority in the occupied West Bank faces mounting challenges from rival groups

A demonstration in Ramallah in the occupied West Bank on Wednesday after the Gaza hospital air strike by Israel, which denied responsibility. AFP

Live updates: Follow the latest news on Israel-Gaza

Hours after Palestinian President Mahmoud Abbas boycotted a meeting with US President Joe Biden over Tuesday's Gaza hospital strike, he accepted condolences by phone from American Secretary of State Antony Blinken.

On Tuesday, a massive explosion at the Al Ahli Arab Hospital in central Gaza city killed hundreds of people who had taken refuge there. In the Middle East, the attack has been blamed widely on Israel, which says the deaths were due to an Islamic Jihad rocket misfiring. The group is an ally of Hamas.

Hoping that western powers would support the restoration of full Palestinian rights has been a hallmark of Mr Abbas’s time as President.

He succeeded Yasser Arafat in 2005, but within two years his Fatah party lost a civil war with Hamas, which took control of Gaza. He now presides over a shaky economic situation in the occupied West Bank, where unemployment hovers around 24 per cent, according to the UN.

The secular Mr Abbas, 87, has projected himself as a perceived moderate with whom Israel and the West can do business. Hamas and other Iranian-backed militant groups in Gaza pursued war and stuck by tough rhetoric.

But unlike past wars that Mr Abbas has watched unfold between Hamas and Israel, the current conflict is putting huge pressure on the Palestinian Authority, which Jordanian political commentator Hazem Ayyad says it might not survive.

Demonstrations demanding the removal of Mr Abbas broke out in several Palestinian cities after the Gaza hospital deaths. Some marchers reportedly shouted slogans in support of Hamas.

Palestinian security forces reportedly used lived bullets to disperse the protesters. There were no reports of casualties.

The hospital strike has given Mr Abbas an opportunity to remould himself politically but he turned it down, Mr Ayyad says.

"He should have formed a joint operations command with Hamas," he says. "But it is not [in] his character. He is also incapable of managing a battle."

Frustration at Mr Abbas's lack of action could drive sizeable defections form his security forces to local groups in the West Bank or to Hamas, Mr Ayyad says.

Not even a scenario in which Hamas lost the war decisively would guarantee the political survival of Mr Abbas, Mr Ayyad says.

"This is unlikely to be a short war," he says. "It would take a long time for Hamas to be defeated."

"Street power against him will mount in the meantime,” he says, predicting a possible "disintegration" of the Palestinian Authority and the security forces' loss of will to suppress street protests.

Mr Abbas, however, is a political stalwart who has been navigating Palestinian politics since the 1960s.

So far there has been no sign that the Palestinian intelligence apparatus, which underpins Mr Abbas’s power, is losing cohesiveness.

He is also is well connected within the Palestinian business class.

Before the current Gaza war, a senior Palestinian intelligence officer told The National that regardless of any political reconciliation moves with Hamas, his job will remain preventing the infiltration of the movement into the West Bank.

Reached by phone briefly on Wednesday, he refused to comment on the current events.

“The situation is under control,” he said.