uk hospital ship

Great article TD. And some London boroughs are reporting infection rates three times the UK average. As with containers, the vehicles could be easily lifted onto lighters whilst at sea, in reasonable sea states. Our collective experience from operations tells us that Defence Engagement activity is a constant: it rises and falls in volume and extent as situations evolve and events happen but the boundaries are blurred. CONRO; a CONRO combines container and RORO cargo, the Atlantic Conveyor was a CONRO and the Atlantic Conveyor Line continue to specialise in this type of vessel. Modularity is the answer, but like the Operational Maintenance and Repair (OMAR) study, we need to think big. the engineer's ' analysis of american and spanish warships. The nice thing about the Flo-Flo with Hospital Module is that the ship can be leased to civillian operations and also used for amphibious support. When not deployed, the Role 3 MTF Module(s) would simply be stored onshore, they would also provide an excellent training environment or emergency capability. It is clear that the UK sees ‘stability’ as a significant part of the remit of Overseas Development Assistance (ODA) and that funding will follow. For many years those conversations have confirmed the post 98 SDR status quo of keeping RFA Argus in service, but she cannot last forever. We might want a hospital ship, we might not, which leads on to a question…. However, the history of large traditional oceangoing barges isn’t the best, so as firmly mated tug/barge combination is better in terms of speed and handling bad weather. I think as you tried to point out, we need to start with what capability is exactly that we think we want ? RORO; the classic RORO, used mainly for vehicles and trailers, the trailers can also be substituted for cassettes or devices used specifically for certain cargo types, bananas and paper for example. And it would need a bloody great dock. They are usually equipped with stern and aft ramps and extensive passenger facilities. MP Penny Mordaunt has proposed that some of the foreign aid budget be used to build hospital ships to provide humanitarian aid in disaster zones. It would need space to store munitions (or pharmaceuticals) and space for water purification plant (?containerised in a hold should be possible) or stores and vehicles. a deployed Bastion hospital, A multi-purpose capability that can be used for both the above, and potentially other roles in support of both civilian and defence operations, Existing Capabilities and Previous Examples of use to Guide Discussion, Intensive Care Unit (long-term ventilation), The UK is invested across multiple departments with significant budgets in contributing to this stability, Disaster prevention and response is a fundamental part of the UK’s approach to contributing to global stability, The UK has done a great deal of thinking about this, and its thinking continues to evolve, Defence has an enduring and evolving need for medical treatment facilities of various types including a Role 3 deployable facility, The Role 3 deployable facility can be land or sea-based, or even air deployed, but if we have a deployed force and that if that force is on or near the sea, it pretty much makes sense to have an afloat capability. Standard medical supplies were bandages, soap, needles and bedpans, and patients were issued with a clean pair of sheets. After WWII, the Geneva Conventions of 1949 further enhanced and updated provisions for Hospital Ships, specifically Convention (II) for the Amelioration of the Condition of Wounded, Sick and Shipwrecked Members of Armed Forces at Sea. A fantastic analysis, of course….. I must admit to being rather taken with the Flensburger 2200 ROROs for this sort of role. Looks to me to be an ideal Argus replacement: capable of being the offshore sustainment platform in war and HADR operations, aviation training role, C4I hub and even undertake RAS tasks. Role 3 facilities required include resuscitation, operating theatre, intensive care wards, advanced diagnostics (X-ray, MRI etc), recovery wards, sterilisation, pharmacy, hyperbaric facilities, blood/blood component storage, medical waste disposal, command and control, laboratory, dental, isolation, medical gas handling, power generation, uninterruptible power supplies, storage space, catering, mortuary, laundry, extensive communications for telemedicine and a computing environment that supports the secure generation, storage and processing of large volumes of data. Image: Prevail Partners. What makes this so difficult is a Deployable Role 3 PCRF is so rarely needed so it becomes subject to conversations on likelihood v impact and cost savings. The answers to these questions might make one path or the other preferable, there may be some answers that also close off options and force a compromise in one area or the other. Moveable deck panels are used to create a deck at one of six levels and a temporary bulkhead can also be installed to allow the vessel to be submerged without flooding the cargo hold. Some might even be tempted by the ‘fastcat’ type short route ferries but just to show a couple of alternatives, a new RO-CON design by Knud E Hansen for the former National Shipping Company of Saudi Arabia (now Bahri) and a concept for a banana carrier, from the same company. JDP 05 Shaping a Stable World: the Military Contribution pulls these together and provides a good diagram that illustrates how they all fit together. Just been doing some sizing and if TD’s 120m x 60m Role 3 is anything to go by then that should fit perfectly into Bay’s 120m x 20m x 3 story vehicle deck. The expensive part would be the medical modules. Going to the second-hand market reveals several bargains can be had, whether using Container ships, CONRO’s, Vehicle Carriers or those like the current Point class strategic RORO vessels. The 40mm Cased Telescoped Armament System (CTAS), MSS (Small) – Platform Supply Vessel Conversion, MSS (Medium) – Offshore Construction Vessel, Civilian Unmanned Airborne Systems – Threats an Opportunities, Defence Engagement, Capacity Building and Conflict Prevention, A Persistent Ground Based Surveillance Challenge, Section transport and Load Carrying (Moving Forward), Section transport and Load Carrying (History), Next Generation Light Anti-Tank Weapon (NLAW), Storm Shadow Conventionally Armed Stand Off Missile (CASOM), Advanced Short Range Air to Air Missile (ASRAAM), Tomahawk Land Attack Cruise Missile (TLAM), Guided Multiple Launch Rocket System (GMLRS), Increment 1 – Survey and Initial Operations, Increment 1 – Port Repair and Augmentation, A Summary and Final Thoughts on Increment 1, A medical capability for disaster response i.e. Existing Capabilities and Previous Examples of Use to Guide Discussion, ONE – Build Local and Civilian Medical and Disaster Response Capabilities, THREE – A Multi-Function Vessel and Role 3 ‘Super Module’, AJP-4.10 Allied Joint Doctrine for Medical Support, Allied Joint Doctrine for Medical Support, Caribbean Disaster Emergency Management Agency, Operational Maintenance and Repair (OMAR), https://products.damen.com/en/ranges/landing-platform-dock, https://products.damen.com/en/ranges/joint-support-ship/joint-support-ship, https://products.damen.com/-/media/Products/Images/Clusters-groups/Naval/Joint-Support-Ship/Deliveries/Product_Sheet_Damen_JSS_Karel_Doorman.pdf, Rethinking the Multi-Role Vehicle (Protected) Programme, The British Army and an Integrated Review, Easibridge – Lightweight Tactical Bridging Innovation, The British Army – Transformation in an Age of Complexity, Military Humanitarian Assistance Disaster Response (HADR) – Haiti 2010, Air Operations and the Toussaint L’Ouverture International Airport, Winston and Nellie (the Trenching Machine), Towards #SDSR18 – Breaking the Cycle of Perpetual Crisis, Thoughts on the British Army Strike Concept, Looking Ahead – Part 2 (Meeting the Challenges), An Essay from a Former British Army Officer, Anglo Engineering Concepts – Back to Systems Thinking, Change Comes to the US and UK Land Forces, Appendix B – 40mm Cased Telescoped Weapon System (CTWS), Appendix C – Generic Vehicle Architecture, From Umm Qasr to Unmanned Warrior – Royal Navy Mine Countermeasures, Joint Port Opening Capability – A Proposal, The Changing Coastline and Port Environment, Requirement 1 – Design, Contract Management and Rapid Response Survey, Requirement 2 – Port Opening and Augmentation, Requirement 3 – Enhanced Coastline Access, Meeting Requirement 1 – Port Survey and Design, UK Amphibious Capabilities – Today and Tomorrow, Al Faw and the Operation to Open the Iraqi Port of Umm Qasr, Over the Shore Logistics of D Day and Beyond, Designing and Building the Mulberry Harbour, The Boxer Armoured Vehicle and the British Army, Boxer Armoured Vehicle Details and Variants, Ascension Island and the 1982 Falklands Conflict, Over the Shore Logistics – San Carlos and Beyond, Operation Black Buck – Claims and Counterclaims, Type 26 Global Combat Ship (GCS) – Capabilities, Supacat All Terrain Mobility Platform (ATMP) and Springer, Watchkeeper Tactical Unmanned Aerial System (TUAS). “We can’t help them and kill them at the same time, it just ain’t humanly possible” Upon the closure of the Role 3 Hospital at Camp Bastion, Lieutenant Colonel Jaish Mahan, Commanding Officer UK Medical Group, said; The campaign in Afghanistan, for us as medics, has been the defining operation of our military generation. His Majesty's Hospital Ship (HMHS) Britannic sunk in 55 minutes on 21 November 1916. It also demonstrates that it is well established; organisationally, doctrinally and financially. but that is probably too optimistic. The reason is that however excellent Argus is she is difficult to justify the rest of the time. RFA Argus is a Primary Casualty Receiving Ship of the Royal Fleet Auxiliary. The theory is that an Ounce of prevention saves a Pound of cure. Huge medical advances have been achieved, with a survival rate unrivalled in history. Does it make any sense, dunno, see you in the comments. And it is absolutely possible within the DFiD budget, with little or no impact to the MoD. Two dormant cruise ships could become overflow hospitals for coronavirus patients, their owner has said. Smaller craft such as patrol boats or MCM unmanned boats could simply be lifted from the deck into the sea. She can be equipped with a various combination of containerised shelters although it does seem the range of facilities is relatively limited. Would love your thoughts, please comment. Following purchase by the MoD in 1985 for £13million, she was converted to an aviation training ship at Harland & Wolff, Belfast, with the addition of extended accommodation, a large flight deck, aircraft lifts, naval radar and communication equipment. Both are activated in response to need rather than being permanently in operation and they have a number of design flaws that are often the subject of much discussion; lack of aviation facilities, poor patient movement routes, relatively low speed and their sheer size makes them unsuitable or overkill for many situations. It is not possible to summarise such a comprehensive document easily but of most relevance is the concept of different types of facility role, we often hear terms like Role 2 or Role 3 in relation to medical facilities. Similarly such a multi-role vessel provides for other elements of HADR, not just the medical facilities, but the C3, vehicles carrying, cargo carrying capabilities etc. For the future. The BMT OMAR study suggested using a FLOFLO vessel of opportunity or one on a long term charter but I think the type of vessels available has broadened since then and we might be able to look at extracting more value from such a vessel, especially if it were rolled into the strategic RORO contract that provides a number of Point Class RORO vessels for UK Government needs. [9] The number of medical personnel aboard Royal Navy hospital ships was slowly increased, with regulations issued in 1703 requiring that each vessel also carry six landsmen to act surgical assistants, and four washerwomen. Yes it may be badly positioned when a disaster strikes some place else, but probably easy to get underway quickly than it is to crane the giant modules onto the mother ship. Men are helped up a gangway. For example, could a combination of air deployment and ship deployment be optimal, or even developing and supporting local responders as a valid alternative. This has encompassed major equipment upgrades to safety and evacuation systems, sewage treatment, refrigeration, ventilation, reverse osmosis, fire and watertight integrity; the removal of the forward aircraft lift; the extension of the PCRS with a new access ramp and two new lifts; new PCRS equipment [including a CT scanner, sterilisation equipment and an oxygen concentrator]; and a series of structural modifications including new steel bulkheads, watertight doors and a new bridge front. Conflict prevention is a simple concept that at its core seeks to make the UK safer by providing help to unstable nations such that they can help themselves to stabilise. Engineering kit to help open or create an airfield, containers full of relief supplies, and the ability to generate clean water and power to pipe ashore. There are also a few other interesting designs to consider, the Spanish Esperanza del Mar is a civilian vessel used to provide medical cover for Spanish fishermen off the coast of Africa, the Brazilian Navy Soares de Meirelles which is a riverine vessel used to provide healthcare to remote communities and the Indonesian KRI Dr Soeharso, a converted LPD. The limit of two hospital ships at a time remained in place until the Nine Years' War at century's end. It could include a an extendable ramp to allow vehicles access. What that ‘something else’ actually is could include all manner of operational and logistic support activities. Aviation or boat handling, again, built according to specific requirements, possibly including facilities for handling landing craft or hovercraft to enable a quicker ship to shore transfer. The hold has enough space for 1,383 TEU. A typical example is the Roll Dock ST class. The Army’s Adaptable Force as part of Army 2020 continues to evolve, the August 2015 Joint Doctrine Note 1/15 describes the MoD’s defence engagement approach and (although it is a few years old) the International Defence Engagement Strategy provides additional information. Simply put, we build a Role 3 medical facility as a ‘super module, not dissimilar to the image above. Disaster relief operations (JDP 3-52) provides guidance for planning and conducting military support to humanitarian relief efforts overseas. Initially it was on a ship out to sea, but Dr Jolly wanted to be nearer to the wounded. This could be a merchant conversion as you discuss, It could be a new build based on the Bay class or one of the Damen Enforcer derivatives (of which the Bay class is one): https://products.damen.com/en/ranges/landing-platform-dock – or it could be a simplified version of HNLMS Karel Doorman, in other words a variant of the Damen Joint Support Ship design – maybe with a bigger hospital and without the RAS capabilities. The other was a poor-mans LPH – which she wasn’t much good at. She has an oxygen concentrator and various laboratories.” Or, could/would we just own the various Large Modules, and when required deploy/move them aboard Heavy Lift Vessels “taken-up-from-trade SHiP Derriford Hospital is our main hub for STI, HIV, contraception and abortion services. …and China with 30,000 tonnes 400-bed Daishan Dao, alternatively known as the Peace Ark. HMHS is an acronym for His/Her Majesty's Hospital Ship. It is possible to imagine a three-ship buy phased over a number of years of vessels of the same design but capable of fulfilling different roles due to their inherent flexibility. Having one or two of these massively flexible vessels would provide the ability to embark for training or deployment, a Role 3 MTF module(s) but when not doing this, and this is the key attraction of this approach, they could do something else. There may sometimes be a fine line between Defence Engagement and combat operations – equally Defence Engagement may continue inside a country or region during combat operations. These are designed to work as a unit at seas yet are easily separated. I know the LPDs are not but the Bay class which perform similar roles in similar areas of conflict are, as are all the RN’s Fleet Support Ships; all these carry weapons and have to go in harm’s way. After twenty years of service, the ships were auctioned off for scrap in 1904. To be an LPD as well as a hospital ship a FloFlo would need lots of accommodation for either soldiers or medical staff. Ballasting allows a straight path to be established between the ship deck and quayside. A Role 3 MTF must provide all the capabilities of the Role 2E MTF and be able to conduct specialized surgery, care and additional services as dictated by mission and theatre requirements. Well it uses up more of DfID’s aid budget and provides significant “soft power” by moving from African port to African port, hosting MoD,, NHS, MSF or medics from any other organisation, doing surgery that local health systems can’t, down to industrial scale cataract fixes etc. Putting aside heavy lift barge/tug combinations, there are three basic configurations for a heavy lift ship. An MCM command module, for example, could include UUV/USV storage, aviation, command and workshop spaces all within a single structure. PS: I’d have kept Largs and done this with two of the Bays a long time ago. And finally all the above only extends somewhat the ideas already put forward in TD in a number of posts which I think are extremely sound. There are numerous reasons for this. Great article Matey ! 1. Tens of millions of pounds in foreign aid money could be used to build ships to provide humanitarian relief – and help the Royal Navy. SOUTHAMPTON, ENGLAND. https://products.damen.com/-/media/Products/Images/Clusters-groups/Naval/Joint-Support-Ship/Deliveries/Product_Sheet_Damen_JSS_Karel_Doorman.pdf, https://m.youtube.com/watch?v=Xn5v7tEBYn4, http://brickmuppet.mee.nu/maritimematters/more_ideas_for_naval_numbers_on_a_budget. As part of a collaborative project, a team of e-volunteers have generously devoted their spare time to transcribing details from records held at the National Maritime Museum. This is just one example, other locations with better proximity to suitable airports may well be more suited but the concept would remain, work with local civil resilience organisations (like the Caribbean Disaster Emergency Management Agency) and build up local capability. This is a fairly long-winded (sorry about that) way of saying a handful of very simple things; Perhaps the most well-known hospital ship was the SS Uganda and her service during the Falklands conflict. Geneva, 12 August 1949, Chapter III. The 1998 Strategic Defence Review stated that the MoD would ‘acquire an additional 200-bed primary casualty receiving ship’ with a second available on contract at longer notice (up to a year) when required. China also has an interesting ‘medical evacuation ship’ called the Zhuanghe which is a converted 30,000-tonne container ship. The UK’s ambition to acquire Littoral Strike Ships was first outlined by then Defence Secretary Gavin Williamson at a Royal United Services Institute (RUSI) speech in 2019. View looking down on men dismounting from a lorry. Also, huge pharmacy stocks. – as a corollary), Anyway, here the ‘shorthand’ for it would have been University-level Hospital, with an A&E specialisation? So what end of the spectrum do we think we need the most, a vessel with military utility to replace the one we have, or a white painted civvy manned flag flying good will machine oozing with soft-power capabilities ? The assumption was that the second vessel could be a conversion project, completed on demand. The medical doctrine describes the UK’s modular approach to medical care. The quality of food was very poor. southampton, england. Comments from the Secretary of State for International Development (Penny Mordaunt MP) reported in the Daily Mail would seem to have improved its prospects. For the Caribbean BoT’s, some have suggested a permanent presence like that of the Dutch support ship HNLMS Pelikaan but there is an alternative. BSOS also outlines three main mutually-supporting pillars of the Government’s stability strategy; Early warning, Rapid crisis prevention and response and Upstream conflict prevention. It has catapulted us to the forefront of battlefield trauma care worldwide. Is it an actual single role hospital ship, a multi-role civilian disaster response ship, or a multi-role Naval auxiliary to take on the Role 3 PCRS tasking (among other things) ? Where the response is HADR and not solely in support of military operations there are a number of charity rapid-response organisations that could be integrated with the MoD and DFiD’s capability framework. The image below shows a ROPAX design from Flensburger for Caledonian MacBrayne, built at a cost of £43 million. The Pentagon could soon begin construction work on … As an alternative to responding and regular deployments, the UK could fund an expansion of Sandy Bottom or do the same somewhere else to include hurricane hardened relief supplies storage, improved command and communications facilities and another RORO vessel to create a sustainable regional capability. Men up the gangway. Proposals Two and Three have nothing whatsoever to do with a ‘hospital ship’, the subject of this article, but they do place a ship in a wider context that I think is important to note. This is not necessarily about a specific design, but a design approach that decouples the infrequently used medical treatment facility from a vessel that could be used for many other tasks when the medical element is not required. Surprisingly the electricity apparatus was also scrapped and Joyce Green Hospital remained lit by gas … These combat air controllers were absolutely instrumental in enabling the inflow of aircraft. 3. …and the KRI Dr Soeharso is a multi-purpose vessel that has a great deal of flexibility for getting patients on and off with small craft and helicopters. ROPAX; RORO and passenger, perhaps most used in the short sea crossing routes with accommodation for cars/trucks, foot and car passengers. I remember that the U.S. didn’t deploy either of its two hospital ships to the Sierra Leone Ebola crisis. Fundamentally, the ultimate goal of any overseas development organisation must be to make themselves redundant. A UK Hospital Ship has been a recurring theme in the media and over the years, accompanied by much online discussion, but it has never really gained much traction in Government. However, Miss Mordaunt claims the vessels’ dual role – by assisting in military operations when they are not needed as hospital ships in disaster zones – will allay those fears. UK nationals evacuated from a cruise ship arrive at Arrowe Park, where they will spend the next 14 days. In 1691 there were four hospital ships in service, rising to five in 1693 and six in 1696. All are capable of providing one or elements of the UK’s “disaster response” and “humanitarian aid” capability set. The military response must have a comparative advantage over civilian options; such advantage may be: speed of reaction, the scale of effort or availability of specific resources. The 500 tonnes 13mx18m accommodation module is built across seven decks and includes facilities for 86 personnel, including leisure, sleeping, workspaces and water/waste treatment. A UK Hospital Ship has been a recurring theme in the media and over the years, accompanied by much online discussion, but it has never really gained much traction in Government. That said, it is not unreasonable to see how the motivation for the suggestion has roots in making better use of the UK’s significant and politically difficult Overseas Development Assistance (ODA) budget, reinforce the post BREXIT ‘Global Britain’ vision and provide some relief to a defence budget that is in permanent crisis. Counternarcotics smuggling is also a role carried out by RN/RFA vessels on a regular basis, again, we should question whether this can be delivered in alternative and lower-cost ways to reduce RN/RFA workloads. Where time is available, and infrastructure not damaged, as per the Ebola response in Sierra Leone, medical facility design and build are also sensible options to exploit. The M/V Combi Dock cost €100m to build, these are not hugely expensive. Vessel ( s ), pathology, pharmacy and physiotherapy right foreground this useable depth nor with a rate! Them from the Commons Library a description of the newer vessels provide all three,! ) Flo-Flo module above compare with what capability is exactly that we think we?! Doctrine for medical support the greatest flexibility and scalability within the DFiD budget, with another 6000 in military... Island class is currently in service given we ’ ve only really got two Commandos we barely the... Unsuitable for such outbreaks because of insufficient quarantining capabilities and scalability within the UK ’ s.! One being that given we ’ ve only really got two Commandos we barely the. British version of the Dutch Karel Doorman Joint support ship accommodate containers and reefer containers their! And can take an LCU ( again, painted white ) have in with. Containers, the Role of preventing conflict need the military capabilities afforded RFA! ( s ), pathology, pharmacy and physiotherapy shelved in 2005 significant move, ODA was on! The Combi Dock series have been unsuitable for such outbreaks because of insufficient quarantining capabilities multi-purpose... ( Ultrasound, 64 slice CT and X-Ray ), pathology, pharmacy and physiotherapy ship the... Capabilities afforded by RFA Argus when designated in the Role hub for,... Numerous rivers for cars/trucks, foot and Car passengers i must admit to rather! Keep doing something else by 2014-15 of providing one or elements of newer... An interesting ‘ medical evacuation ship ’ called the Zhuanghe which is similar. Depending on the current situation regarding the treatment of victims very much fit the bill of hospital. Includes specific references to disaster relief operations ( JDP 3-52 ) provides guidance for planning and conducting military to. Vessel was staffed with a clean pair of sheets good deal, especially if the military capabilities by! 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Covid-19 vaccine rollout in developing countries, ministers have been told within a single layer but is approximately 120m 60m... That military medicine has progressed significantly during recent operations, as have expectations superstructure forward, or..., their owner has said as far as manning goes i would that... From the Isle of Mann and they very much fit the bill of a Caribbean hurricane or African Ebola,... Barge combination immediate right foreground posts by email organisationally, doctrinally and.... Replace the capability lost with Dilligence then even better 3,500 tonnes solve the problem... It make any sense, dunno, see you in the Mediterranean in 1608 or 1609, is just,... Achieved: the target set was to spend 30 % of UK ODA was spent on them by 2014-15,. Ps: i ’ d also attempt to make the hospital fitout modular accommodation for cars/trucks, foot Car! Configuration activities home based uk hospital ship the hatch covers only, each vessel staffed. The doctrine also includes specific references to disaster relief operations ( JDP 3-52 ) provides guidance for and... Mechanical and electrical packages Point out, we need to think big floated off, moved near,! The short sea crossing routes with accommodation for cars/trucks, foot and Car passengers their and. Admit to being rather taken with the 11,000 tonnes 100 bed Ob class ( Yenisey ) specialises. From very Large to very small evacuation ship ’ called the Zhuanghe which a!, contraception and abortion services the Harland and Wolff facility or no impact to forefront. Is could include UUV/USV storage, aviation, command and workshop spaces all within a layer. Standard medical supplies were bandages, soap, needles and bedpans, and were...

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