Hospital ship for Canada

[medicineman]

I wasn't even thinking personnel, but that would be significant. Every time you set something like this up it needs specialized staffing - from somewhere; and the bigger the setup the bigger the demands.

I was more thinking of the facilities. Square footage may be great, but you need things like power, ventilation, oxygen, suction and all the stuff that needs to happen outside of the surgical suite or treatment space to enable them. Maybe that can be all containerized now. I don't know.

Some of that could be containerized, however things like imaging/lab, while able to be containerized, would require space for operations...as well as skilled staff. Hangar decks can be converted to CCP's and the like depending on their size - I was on a SUBSAR ex where we were in the hangar of a Tribal with our 6 person portable recompression chamber set up, as well as our triage/treatment areas. Again, like you said, issues regarding power, storage and square footage come into play when you start needing things for resuscitation/damage control surgery and treatment/recovery, as well as imagery and other things we usually are used to having around.

 

[Dana381]

Some of that could be containerized, however things like imaging/lab, while able to be containerized, would require space for operations...as well as skilled staff. Hangar decks can be converted to CCP's and the like depending on their size - I was on a SUBSAR ex where we were in the hangar of a Tribal with our 6 person portable recompression chamber set up, as well as our triage/treatment areas. Again, like you said, issues regarding power, storage and square footage come into play when you start needing things for resuscitation/damage control surgery and treatment/recovery, as well as imagery and other things we usually are used to having around.

I had understood, rightly or wrongly that she had provisions built in for that. I could be totally wrong and remembering an idea that didn't go anywhere.

 

[dapaterson]

There are medical spaces within the JSS. They will be equipped and outfitted.

There are additional spaces onboard which could, in extremis, be repurposed to expand medical capacity.

As previously noted, and as in the case in most Canadian provinces right now, the limiting factor is not spaces or beds or equipment, but trained medical professionals.

 

[Colin Parkinson]

If you built a hospital ship staff it with nurses from the Philippines and doctors from India. Crew is Canadian deck officers and engineers with Philippine seaman and oilers. pay them more than their home countries, but less than Canadian wages except for Canadians working aboard.

 

[PPCLI Guy]

Real countries have hospital ships because they know that in order to protect their National interest they may have to put troops in harm's way.

Fakey Smarmy Finger Wagging virtue signalling countries make noise about having one to save others and make the world a better place...and hope that the announcement can be made more than once without ever committing to actually making a decision...not even to decide to study the value of the idea

We see you Canada

 

[OldSolduer]

It ain’t ever gonna happen - PPCLI Guy said it better.

 

[lenaitch]

If you built a hospital ship staff it with nurses from the Philippines and doctors from India.

Sounds like healthcare in Ontario.

 

[FormerHorseGuard]

One problem for this ship. Once staffed and operational.

Would host nations accept our medical teams? I remember reading some where Hurricane hit Florida and we sent ships etc and medical teams and some of our staff was not allowed to do medical duties because of red tape. I do not recall all the details been years. Insurance? Union rules? I do not remember.

 

[Colin Parkinson]

One problem for this ship. Once staffed and operational.

Would host nations accept our medical teams? I remember reading some where Hurricane hit Florida and we sent ships etc and medical teams and some of our staff was not allowed to do medical duties because of red tape. I do not recall all the details been years. Insurance? Union rules? I do not remember.

The US is a byzantine place with rules galore, the only Federal Agency that can immediately respond to a disaster is the USCG. Everyone else has to be invited to respond. The rules are going to vary State to State, then throw the Federal rules ontop of that.

You could keep such a hospital ship employed year around, without every going near a developed country. Give it a couple of landing craft and some RO/RO capability or float dock and you could also deploy a Field Hospital. This ship would not have to be run under the DND, but as a civil ship. It would still be a form of power projection and diplomatic tool. It might be a useful tool for a well run country with a firm grasp of how to be a Middle Power and used in conjunction with a skilled and dedicated Foreign Affairs Office and a properly funded and functioning Military. However that is not Canada, so this is just technicolor dreaming.

 

[Stoker]

The US is a byzantine place with rules galore, the only Federal Agency that can immediately respond to a disaster is the USCG. Everyone else has to be invited to respond. The rules are going to vary State to State, then throw the Federal rules ontop of that.

You could keep such a hospital ship employed year around, without every going near a developed country. Give it a couple of landing craft and some RO/RO capability or float dock and you could also deploy a Field Hospital. This ship would not have to be run under the DND, but as a civil ship. It would still be a form of power projection and diplomatic tool. It might be a useful tool for a well run country with a firm grasp of how to be a Middle Power and used in conjunction with a skilled and dedicated Foreign Affairs Office and a properly funded and functioning Military. However that is not Canada, so this is just technicolor dreaming.

Give the task to Federal Fleet to run and have Davie build it. I doubt the RCN wants anything to do with it.

 

[dimsum]

Give the task to Federal Fleet to run and have Davie build it. I doubt the RCN wants anything to do with it.

CAF Reddit pundits: Its gun is too small.

 

[Halifax Tar]

Give the task to Federal Fleet to run and have Davie build it. I doubt the RCN wants anything to do with it.

Well do have a plethora of sailors waiting for a ship lol

 

[lenaitch]

The US is a byzantine place with rules galore, the only Federal Agency that can immediately respond to a disaster is the USCG. Everyone else has to be invited to respond. The rules are going to vary State to State, then throw the Federal rules ontop of that.

You could keep such a hospital ship employed year around, without every going near a developed country. Give it a couple of landing craft and some RO/RO capability or float dock and you could also deploy a Field Hospital. This ship would not have to be run under the DND, but as a civil ship. It would still be a form of power projection and diplomatic tool. It might be a useful tool for a well run country with a firm grasp of how to be a Middle Power and used in conjunction with a skilled and dedicated Foreign Affairs Office and a properly funded and functioning Military. However that is not Canada, so this is just technicolor dreaming.

I don't know but the issue might have been something as simple as the Canadian medical personnel not certified to practice in Florida. We would likely face the same issue with a disaster up here unless provincial regulatory law has some kind of emergent provision (which it might - I don't know). Anchoring within territorial waters might pose similar problems, as might transporting citizens out of the sovereign bounds. An area suffered a crisis but the nation didn't.

Simple humanity would want to waive or ignore the rules but, like you say, it is a Byzantine place, as are probably most developed countries. Less developed/third world/highly desperate countries might look beyond.

 

[daftandbarmy]

It looks like the US Navy is replacing the 'converted tankers' with 'space shuttles'

U.S. Navy expands Expeditionary Medical Capability with two EPFs

At Sea Air Space 2021, Austal showcased a new Expeditionary Fast Transport (EPF) medical ship concept intended to replace the current and aging USNS Mercy (T-AH-19) and USNS Comfort (T-AH-20), two ships converted from oil tankers into hospital ships that are about 35 years old. Naval News asked the U.S. Navy for more information regarding the future replacements for the T-AH hospital ships and what the U.S. Navy intends to do for expanded expeditionary shipborne medical coverage.

U.S. Navy expands Expeditionary Medical Capability with two EPFs - Naval News

At Sea Air Space 2021, Austal showcased a new Expeditionary Fast Transport (EPF) medical ship concept intended to replace the current and aging USNS Mercy (T-AH-19) and USNS Comfort (T-AH-20), two ships converted from oil tankers into hospital ships that are about 35 years old. Naval News asked...

www.navalnews.com

 

[Blackadder1916]

I don't know but the issue might have been something as simple as the Canadian medical personnel not certified to practice in Florida. We would likely face the same issue with a disaster up here unless provincial regulatory law has some kind of emergent provision (which it might - I don't know). Anchoring within territorial waters might pose similar problems, as might transporting citizens out of the sovereign bounds. An area suffered a crisis but the nation didn't.

Simple humanity would want to waive or ignore the rules but, like you say, it is a Byzantine place, as are probably most developed countries. Less developed/third world/highly desperate countries might look beyond.

Licensing of health care professionals (HCPs) responding to disasters/emergencies in jurisdictions outside that where they are licensed is (or was in my experience) one of the things that's considered when deploying in situations where they may be providing care to civilian patients. In Canada, provincial statute/regulation usually provide for emergency registration (licensing) of out-of-jurisdiction HCPs to practice in an emergency. In Alberta, for example, the Health Professions Act, PHYSICIANS, SURGEONS, OSTEOPATHS AND PHYSICIAN ASSISTANTS PROFESSION REGULATION states

Emergency registers

10(1) An applicant for registration as a regulated member on the physicians, surgeons and osteopaths emergency register must satisfy the Registrar that the applicant is registered in good standing and entitled to practise medicine or osteopathy in another jurisdiction in Canada or in the United States of America.

(2) An applicant for registration as a regulated member on the physician assistants emergency register must satisfy the Registrar that the applicant is registered in good standing or otherwise regulated and entitled to practise as a physician assistant in another jurisdiction in Canada or in the United States of America.

(3) A registration on an emergency register is valid for the period of time that may be required to address an emergency, as determined by the Registrar.

(4) It is a condition of registration on an emergency register that the person must remain registered in good standing in the jurisdiction in which the person was registered at the time of the person’s application for registration on the emergency register, and if the registration in the other jurisdiction is suspended or cancelled, the emergency registration is cancelled.

The CPSA activated an emergency register in 2020 for COVID-19

COVID-19 Info for Physicians - College of Physicians & Surgeons of Alberta | CPSA

cpsa.ca

CPSA launches emergency register​

As per clause 9(2) of the Physicians, Surgeons and Osteopaths Profession Regulation, CPSA Registrar, Dr. Scott McLeod, activated an Emergency Register on March 19, 2020.
The CPSA Emergency Register will allow physicians currently registered in another province or territory to temporarily work in Alberta during emergency circumstances, such as the current COVID-19 pandemic. This registration is free and there is no formal registration process. Here is our criteria to apply:
Interested physicians must:

• be on the general register (and unrestricted) in another Canadian jurisdiction.
• send us a Certificate of Professional Conduct (CPC) from the jurisdiction(s) they are currently registered in (verbal confirmation from their College will be acceptable).
• confirm that they have CMPA membership.
• submit a piece of government issued photo ID.
• agree to the terms outlined in the CPSA Registration Understanding and Acknowledgement for the Emergency Register, which CPSA will send you once you email us.

The CPSA Emergency Register expires after 60 days. Physicians may renew beyond this point.
Lastly, the CMPA will extend assistance to physicians are providing care outside of their usual field of practice or in a different province.

Note that, while the provincial regulation does include the USA in the "other jurisdictions", the 2020 Emergency Register activation applies only to other Canadian jurisdictions.

Medical licensing in the USA is roughly similar to Canada with some differences among states. For disaster situations (specifically Florida as example) permitting out-of-state HCPs to practice during an emergency will often be dealt with by executive order as was the recent case of Hurricane Ian, which seems to be standard boiler plate from previous executive orders.

https://www.flgov.com/wp-content/uploads/2022/09/EO-22-218.pdf

Section 8. Medical professionals and workers, social workers, and counselors with good and valid professional licenses issued by states other than the State of Florida may render such services in Florida during this emergency for persons affected by this emergency with the condition that such services be rendered to such persons free of charge, and with the further condition that such services be rendered under the auspices of the American Red Cross or the Florida Department of Health.

Nothing in there permits out-of-country HCPs from practicing their profession during the state of emergency.

 

[mariomike]

We would likely face the same issue with a disaster up here unless provincial regulatory law has some kind of emergent provision (which it might - I don't know).

Regarding license, or lack of,

That is when the PCP qualified Med Tech appeared in the Reg F. We (at the coal face) knew from the very outset that it was just not sustainable for a variety of reasons. PCP was seen as the one qual that was accepted (mostly) across Canada, allowing our pers to be posted, or employed on DOMOPS without too much difficulty. Reality was very different though, as has been noted above.

 

[lenaitch]

Licensing of health care professionals (HCPs) responding to disasters/emergencies in jurisdictions outside that where they are licensed is (or was in my experience) one of the things that's considered when deploying in situations where they may be providing care to civilian patients. In Canada, provincial statute/regulation usually provide for emergency registration (licensing) of out-of-jurisdiction HCPs to practice in an emergency. In Alberta, for example, the Health Professions Act, PHYSICIANS, SURGEONS, OSTEOPATHS AND PHYSICIAN ASSISTANTS PROFESSION REGULATION states



The CPSA activated an emergency register in 2020 for COVID-19

COVID-19 Info for Physicians - College of Physicians & Surgeons of Alberta | CPSA

cpsa.ca

Note that, while the provincial regulation does include the USA in the "other jurisdictions", the 2020 Emergency Register activation applies only to other Canadian jurisdictions.

Medical licensing in the USA is roughly similar to Canada with some differences among states. For disaster situations (specifically Florida as example) permitting out-of-state HCPs to practice during an emergency will often be dealt with by executive order as was the recent case of Hurricane Ian, which seems to be standard boiler plate from previous executive orders.

https://www.flgov.com/wp-content/uploads/2022/09/EO-22-218.pdf

Nothing in there permits out-of-country HCPs from practicing their profession during the state of emergency.

Thanks for all of that. Great information.

Even in terms of your Alberta domestic emergency, how would that apply to military medical personnel? I'm wondering if they are considered 'regulated' in the same sense; i.e. by a 'college of x'? Probably not for Reserve personnel since I assume they are practicing professionals in their day job. It might be answered by Marionmike's quote of Staff Weinie but I don't understand the context of the quote.

In terms of deployment in the example scenario to Alberta, if military personnel fit the mould, would the CAF have to send a list and CV for each individual?

There has to be a way around this. When I worked on FNTs in n/w Ontario, the personnel at the nursing stations and federal (Department of Indian and Northern Affairs back in the day) were obviously federal employees working within federal jurisdiction but there was a steady stream of doctors in all sorts of specialties from southern Ontario - mostly U of T and McMaster - to perform tours who would obviously be provincially regulated.

In an emergency, one would hope that reasonable people would invoke the 'forgiveness vs. permission' principle; doing the right thing vs doings things right, but governments generally don't operate like that. Somebody in Ottawa, at some time, must have sprung up in bed, sweating, saying 'this is a problem'.

 

[mariomike]

Probably not for Reserve personnel since I assume they are practicing professionals in their day job. It might be answered by Marionmike's quote of Staff Weinie but I don't understand the context of the quote.

This is the policy for off-duty paramedics in Ontario,

https://tbrhsc.net/wp-content/base-hospital/policies/MC-400.pdf

The paramedic must be on duty as an employee of a licensed ambulance service when providing any advanced life support care to any patient within Ontario to be covered by their respective Base Hospital Program Medical Director’s License.

Off-duty, I could dial 9-1-1 with the best of them.
But, other than basic first-aid, CPR, and AED ( if one was available ), that was all we were / are licenced to do.

Including when I, or others, was / are in the PRes.

In Ontario,

Paramedic Labour Mobility Equivalency

is open to paramedics who have completed a Primary Care Paramedic (PCP) or Advanced Care Paramedic (ACP) program outside of Ontario, and are registered/licensed in good standing in another Canadian jurisdiction. Upon successful completion of the Paramedic Labour Mobility Equivalency process, you will be issued an AEMCA certificate and/or an ACP certificate as applicable. Once you have obtained your Ministry of Health certificate(s) you can begin to seek employment opportunities in Ontario.

If licenced in another province,

Application and Verification forms for the Ministry of Health (MOH) Paramedic Labour Mobility Equivalency for Paramedics who hold a valid license or certification in good standing from other Canadian provinces or territories and wish to obtain equivalency in Ontario for their paramedic qualification.

Paramedic Labour Mobility Application - Central Forms Repository (CFR)

Application and Verification forms for the Ministry of Health (MOH) Paramedic Labour Mobility Equivalency for Paramedics who hold a valid license or certification in good standing from other...

forms.mgcs.gov.on.ca

See also,

Medics requiring to maintain a license​

Medics requiring to maintain a license

Doctors created a system where doctors hold higher rank and are in charge. DGHS during Rx 2000 was Lise Mathieu...who was not a doc, but HSO via RN IIRC. The "Surgeon General" was Scott Cameron, a mere Colonel then...whose 4 rings stacked up were as tall as he was. Much like in civilian...

www.milnet.ca

3 pages.

It turns out when the Credentials Cell did an audit that only 17% of Med Techs had kept their license current after the initial licensing event in BC or QC during QL3.

 

[Spencer100]

This is the policy for off-duty paramedics in Ontario,

https://tbrhsc.net/wp-content/base-hospital/policies/MC-400.pdf

Off-duty, I could dial 9-1-1 with the best of them.
But, other than basic first-aid, CPR, and AED ( if one was available ), that was all we were / are licenced to do.

Including when I, or others, was / are in the PRes.

In Ontario,

Paramedic Labour Mobility Equivalency


If licenced in another province,

Paramedic Labour Mobility Application - Central Forms Repository (CFR)

Application and Verification forms for the Ministry of Health (MOH) Paramedic Labour Mobility Equivalency for Paramedics who hold a valid license or certification in good standing from other...

forms.mgcs.gov.on.ca

See also,

Medics requiring to maintain a license​

Medics requiring to maintain a license

Doctors created a system where doctors hold higher rank and are in charge. DGHS during Rx 2000 was Lise Mathieu...who was not a doc, but HSO via RN IIRC. The "Surgeon General" was Scott Cameron, a mere Colonel then...whose 4 rings stacked up were as tall as he was. Much like in civilian...

www.milnet.ca

3 pagesAs a society we are Licensing and Credentialing ourselves to death.

It came to me when you now need a license to cut hair and must pay yearly. Really? What true danger are we risking not having a licensed barber? Its just feather bedding and modern guilds

Even things like painting, the general construction worker license. I understand electrical, construction licenses and maintaning standards and safety. But we have gone way to far.

And then things like high school teachers. And retired Accountant can't even teach Gr12 university accounting in Ontario because of the closed shop union.

Lets take everyone favourite sport even. There is a shortage of licensed referees to ref games in Ontario after COVID. Do you think they would open up the school and courses to more people? Nope. Still just 1 or 2 opening to take the course work per HC centre. There are 16, 17, 18 year olds that can do the course, love hockey and can use the money. They won't be ref'ng U16 AAA but for U8 house league they are perfect. But the hoops a teenager has to go through are crazy. My son used a connection though the girl's hockey association to get an un used spot. And its not like the first course are in person its just two online powerpoint type classes. but the whole thing is operated as a 17 century guild.

It even goes as far as job listings. This job requires a BSc or a Masters. But in the end does it really? I have in most cases removed the BSc or BA from our listing. And in this day and age it not like we get a million resumes to any job postings as it is. So why limit it. But I see it all the time.

 

[mariomike]

It came to me when you now need a license to cut hair and must pay yearly. Really? What true danger are we risking not having a licensed barber? Its just feather bedding and modern guilds

Even things like painting, the general construction worker license. I understand electrical, construction licenses and maintaning standards and safety. But we have gone way to far.

And then things like high school teachers. And retired Accountant can't even teach Gr12 university accounting in Ontario because of the closed shop union.

Lets take everyone favourite sport even. There is a shortage of licensed referees to ref games in Ontario after COVID. Do you think they would open up the school and courses to more people? Nope. Still just 1 or 2 opening to take the course work per HC centre. There are 16, 17, 18 year olds that can do the course, love hockey and can use the money. They won't be ref'ng U16 AAA but for U8 house league they are perfect. But the hoops a teenager has to go through are crazy. My son used a connection though the girl's hockey association to get an un used spot. And its not like the first course are in person its just two online powerpoint type classes. but the whole thing is operated as a 17 century guild.

It even goes as far as job listings. This job requires a BSc or a Masters. But in the end does it really? I have in most cases removed the BSc or BA from our listing. And in this day and age it not like we get a million resumes to any job postings as it is. So why limit it. But I see it all the time.

In hindsight, getting a licence to cut hair would likely have been easier.

For candidates in Ontario, those are the rules. I didn't make them.

https://www.toronto.ca/wp-content/uploads/2022/11/905c-Recruitment-Guide-2023.pdf

Just played the game.