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Further Reading

T-AH(X) / T-AH Future - Options

T-AH(X) / T-AH Future - HSV Derivative

CNA proposed that en route medical care could be one of the HSV's comparative advantages. The HSV is not large enough to carry a definitive care facility. However, its high speed and shallow draft, joined with a limited medical care capability, could make it a candidate for providing patient ambulance services. Having a dedicated echelon II level medical platform available could take medical mission pressure off the Navy's large-deck amphibious ships. The medical HSVs could augment the L-class ships' mission as casualty receiving and treatment vessels. They could be used for shuttling patients in certain circumstances. For example, the HSV might be useful for shuttling patients from echelon II care on amphibious ships to higher level care at OCONUS facilities if the hospital ship is not yet available.

A myriad of issues must be resolved before the HSV En Route Care Medical Modification could be a practical platform. First and foremost is the matter of moving patients from the battlefield to the HSV It is not large enough to land theV-22 Osprey or CH-53 Sea Stallion helicopters; however, it can land an SH-60 Sea Hawk helicopter, which is used primarily for search and rescue missions, and could probably transport five or six casualty litters in a sortie.

In 2004, the Naval Warfare Development Command conducted a limited objective experiment to evaluate the suitability of the High Speed Vessel as a medical platform. Unfortunately, surgical interventions aboard the ship were precluded by virtue of high ambient vibration, noise levels, and vessel motion (including severe pounding) caused by high speeds and sea state conditions, notwithstanding motion sickness of both patients and staff as well. These findings might clearly affect patient survivability during long range transport aboard these vessels.

T-AH(X) / T-AH Future - LSD-41 Modification

One potential source for new hospital ship(s) is conversion of older L-class ships (i.e., those that have lived their useful lives as warships) into dedicated hospital ships. This concept offers some advantages. First, the amphibious ships are designed to be personnel carriers, and as such already have built-in comfort facilities, such as berthing, mess, and toiletry, for large numbers of people. In addition, they have large cargo spaces that could be used for medical equipment storage. They already have the speed and mobility to keep up with an amphibious ready group (ARG). Perhaps most important, many of the L-class ships have multiple methods for bringing troops and casualties aboard.

Several writers have offered suggestions for which would make the best converted hospital ships. For example, in his widely cited critique of the Mercy-class hospital ships, CDR Pete Marghella recommended that we convert the available Newport LSTs to hospital ships. He correctly points out that, compared to the Mercy class, the LSTs are smaller and quicker, enabling them to more easily deploy with the fleet, to dock at many more beaches, and to produce a far smaller target signature. The LST's stern gate and RO/RO capability could better facilitate patient movement than the current hospital ships.

The LSTs have significant disadvantages as choices for conversion to hospital ships. First, all are over 30 years old and are all inactive. LCDR Richard Guzman and LT Youssef Aboul-Enein, MSC, USN, pointed out that the LST's flat-bottom hull would not facilitate medical and surgical care while under way. Guzman and Aboul-Enein also note that, at just over 500 x 70 feet, the LSTs may be too small to handle high casualty rates.

A practical choice for a dedicated hospital ship would be to convert one or more of the Whidbey Island or Harpers Ferry class LSDs. The advantages would be as follows. First, they are the right ages; the ships will begin turning 30 years old in 2015. Second, with length and beam of about 600 X 84 feet, they could be small enough to avoid FDO status, but large enough to handle most conflict scenarios. In addition, with its relatively shallow draft of 20 feet, the LSDs could pull up to a wide variety of piers. They are powered by four 33,000-hp diesel engines and can go 20+ knots, giving them the speed and maneuverability to travel with an ARG, and engines that could be maintained by MSC and contracted machinists for many years. To facilitate safe and swift patient ingress and egress, they hold two LCACs in their well decks and have two helicopter landing pads that could handle anything from an SH-60 Sea Hawk to aV-22 Osprey.

The disadvantages of using any aged L-class ship are that its useful life as a hospital ship would be limited, and estimation of its conversion costs is uncertain and therefore hard to predict. Also, because the smaller L-class ships are shallow-drafted, they are perhaps not as sea -- friendly as one would prefer a dedicated hospital ship to be.