Sivilt-militært samarbeide - Status og fremtidige muligheter

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2 Sivilt-militært samarbeide - Status og fremtidige muligheter Jan Sommerfelt-Pettersen Kontreadmiral, lege, specialist i samfunnsmedisin Sjef Forsvarets Sanitet Samfunnssikkerhetskonferansen, Stavanger

3 Agenda

4 Agenda Military Capacities Military Medical Capacities Military Civilian Health Cooperation Structure and status Ongoing work Conclusion and Summary

5 Introduction

6 Forsvarets oppgaver

7 Military Capabilities

8 STRUCTURE Strategic level C H O D Operational level / Command and control N J H Q I N T Force providers A R M Y N AV Y A I R HG S O F Support functions N AT I O N A L D E F E N C E L O G I S T I C S C Y F O R M E D I C A L

9 F35

10 Military Medical Service Military medical service is a force multiplyer for combat capability and endurance. Only a military force with good health can provide and maintain maximum effort Motto Health for fighting strenght FORSVARETS SANITET

11 The Surgeon General Commander Armed Forces Joint Medical Services Medical authority in all Armed Forces Medical adviser for the leadership of the Armed Forces Coordination authority for civilianmilitary cooperation of healthcare

12 Concept

13 Concept NATO Principles and Policies of Medical Support - MC 326/3 Norwegian Armed Forces Doctrine for Military Medical and Veterinary Services

14 Chain of treatment installations - doctrinally Role1 POI Role2 Role4 Role3

15 Chain of treatment installations in reality POI Role 1 MIL & CIV Role 2 CIV Role 4 CIV Role 3

16 Is Norway a small or large country?

17 Norway : Svalbard/Jan Mayen : Maritime Zones : Total Area: km² km² km² 2,42 mill km² Honningsvåg Svalbard Kirkenes Murmansk Lindesnes - Honningsvåg

18 The answer is Both

19 Structure

20 One military medical system

21 One health care system

22 Nasjonalt - sivilt Lov om pasient- og brukerrettigheter Lov om kommunale helse- og omsorgstjenester Lov om spesialisthelsetjenesten Lov om helsepersonell m.v Lov om helsemessig og sosial beredskap

23 Kampkraft og bærekraft Forsvaret av landet er en av statens viktigste oppgaver. Forsvaret står i et gjensidig avhengighetsforhold til andre beredskapsmyndigheter i hele krisespekteret Det er behov for å videreutvikle totalforsvaret for at samfunnets samlede ressurser om nødvendig skal kunne mobiliseres for forsvaret av landet. Sivil støtte er helt nødvendig for å opprettholde og videreutvikle relevant forsvarsevne. Sivil støtte til Forsvaret har hatt liten oppmerksomhet de senere årene.... det [er] kritisk med tilgang på sivilt helsepersonell og sivile helsetjenester.

24 One door Defence Joint Medical Service Healthcare Directorate of Health

25 Medical personnel Ca 1000 medical personnel out of total force Employed Contracted Conscripted Requisitioned Only civilian hospitals Military doctors and nurses work in civilian hospitals usually 50/50 Only civilian university and college education Military and medical education for medics Military education for civilian educated medical personnel both officers and other ranks Military medical education for all in the military medical niches

26 Personnell dimensions Moderate to minimal change in war

27 Military-Civilian Health Cooperation

28 Council for Health Preparedness - a cross sectional tool of coordination National Council for hospital and Military Health Preparedness Preparedness Council for National Health Council for Health Preparedness Central Forum for Total Defence

29 Council for Health Preparedness - a cross sectional tool of coordination Director of Health, chair Surgeon General, vice chair Commander National Joint Headquarter Commander Defence Logistics Director National Public Health Institute Director Norwegian Radiation Protection Authority Director The Norwegian Directorate for Civil Protection Director Regional Health South East Director Regional Health Mid Norway Chair Council of County Governors Director Preparedness Directorate of Police

30 Balance and size

31 How much medical military service? How much civilian health care? Which balance will produce sufficient operative military forces? Which balance will give maximum survivability?

32 Principles Minimalize Defence Medical Service Integrated medical care Military medical niches Mutual Support in Peace, Crisis and War Maximize Civilian Health Support Principle of Resonsibility Principle of Equality Principle og Proximity Principle of Interaction

33 Ongoing work

34 Health Preparedness Council initiatives Changed composition of the council Nordic Cooperation? Working Panel Personell Working Panel Command and Controle Working Panel Medical Supplies Working Panel Blood Working Panel Comprehensiv Evacuation and MCI Working Panel Legal? Working Panel Competence?

35 Summary and conclusion

36 and the message was

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