What would you imagine when you hear a medical support ship in the event of a disaster?
Imagine whether it is a small, mobile boat that rushes in a group of three people like an ambulance, or a cruise ship like Diamond Princess, which has become an isolation facility for emerging infectious diseases, or a ship that simply carries people and things that are used to commute to work on remote islands, or what kind of ship is a tough ship like the Hovercraft “LCAC” owned by the Self-Defense Forces?
Cabinet decision in March
At the second meeting of the Ship Utilization Medical Promotion Headquarters held on March 18th, the Cabinet decided on a plan to develop ships that support medical care in the affected areas.
The Cabinet decision is the decision-making in the Cabinet meeting presided over by the Prime Minister and now Prime Minister Ishiba. The Cabinet is a place of decision-making based on legal grounds as stipulated in Article IV of the Cabinet Act.
Article IV
The Cabinet shall exercise its authority by the Cabinet.
2 The Cabinet will be presided over by the Prime Minister. In this case, the Prime Minister may initiate a basic policy and other matters concerning the important policies of the Cabinet.
3 Each Minister may submit a Cabinet meeting to the Prime Minister and request a Cabinet meeting, regardless of the case.
Cabinet law
Under the responsibilities of Article II of the Cabinet Act, Cabinet decisions are made on the principle of unanimous consent of the Prime Minister, ministers, and other members of the Cabinet.
Article I
The Cabinet shall, in accordance with the principles of national sovereignty, exercise the powers prescribed in the Constitution of Japan Article seventy-three and other provisions of the Constitution of Japan.
2 The Cabinet shall be jointly responsible for the exercise of the executive government to the Diet, which consists of members representing the entire people.
Cabinet law
After the Cabinet decision, there will be a Diet deliberation, but if the ruling party holds a majority, the Cabinet decision will pass in the Diet as it is, but under the situation of the minority ruling party, there are many uncertain factors.
However, I think that there are many in favor of disaster countermeasures in terms of overall discussion.
[Reference] Cabinet Secretariat: Marine Utilization Medical Promotion Headquarters
The first was in July last year.
Prime Minister Kishida was the presiding officer for the first meeting of the Japan Society for the Promotion of Medical Care for the Utilization of Ships held on July 9, 2024.
The first attendance is as follows.
- Prime Minister Kishida (Head of the Division)
- Chief Cabinet Secretary Hayashi (Vice Chief Executive Director)
- Minister of State Matsumura (Chairman)
- Parliamentary Vice-Minister of Internal Affairs and Communications Funabashi (Acting Minister of Internal Affairs and Communications, Matsumoto)
- Parliamentary Vice-Minister of Justice Nakano (Acting Minister of Justice Koizumi)
- Deputy Minister of Foreign Affairs Tsuge (Deputy Minister of Foreign Affairs Kamikawa)
- Deputy Finance Minister Yagura (Acting Minister of Finance Suzuki)
- Deputy Minister of Education, Culture, Sports, Science and Technology (Mitsuiyama)
- Shiozaki, Parliamentary Vice-Minister of Health, Labour and Welfare (Acting Minister of Health, Labour and Welfare)
- Parliamentary Vice-Minister of Agriculture, Forestry and Fisheries (MEXT)
- Deputy Minister of Economy, Trade and Industry (Acting Minister of Economy, Trade and Industry)
- Deputy Minister of Land, Infrastructure, Transport and Tourism (Judge Saito)
- Ito, Minister of the Environment
- Parliamentary Vice-Minister of Defense Matsumoto (Representative Minister of Defense Kihara)
- Tsuchida, Parliamentary Vice-Minister for Digital Affairs (Acting Minister for Digital Affairs Kono)
- Parliamentary Secretary of the Minister of Reconstruction Hiranuma and Minister of the Cabinet Office (Minister of Reconstruction Tsuchiya and Acting Minister of State of Takaichi)
- Minister of State Kato
- Parliamentary Secretary of the Cabinet Office (Acting Minister of State Shindo)
- Parliamentary Secretary of the Koga Cabinet Office (Acting Minister of State)
- Deputy Chief Cabinet Secretary Murai
- Deputy Chief Cabinet Secretary Moriya
- Deputy Chief Cabinet Secretary Kuriyu
- Kojima Cabinet Crisis Management Director
- Deputy Chief Cabinet Secretary, Deputy Chief Cabinet Secretary
- Deputy Chief Cabinet Secretary Suzuki
- Nagahashi Cabinet Secretariat Disaster Response and Relief Supervisor
- Cabinet Public Relations Officer Kobayashi
- Kurano, General Secretary-General of the Medical Promotion Headquarters for the Promotion of Medical Care for the
Law of the 79th Law of the Three-Year Reiwa Period
It seems that the law related to hospital ships, etc. is based on the “Act on the Promotion of the Development of a Medical Care Delivery System Using Ships in the Event of Disasters and the like.”
Chapter One: The General Rules
Act on the Promotion of the Development of Medical Care Provision System Using Ships in Disasters, etc.
(Purpose)
Article I. In Japan, which is surrounded by the sea, when a disaster occurs or an infectious disease occurs, or when there is a risk of an outbreak or an infectious disease (hereinafter referred to as “disasters, etc.”) In light of the effective provision of medical care using ships in order to ensure medical care, the basic principles and other basic principles for the promotion of the provision of medical care using ships in the event of a disaster, etc. are established, and by establishing the Headquarters for Promoting Medical Care for the Utilization of Ships, the aim is to comprehensively and intensively promote the development of a medical provision system using ships in the event of a disaster.
(Basic Philosophy)
Article II The promotion of the improvement of the provision of medical care systems using ships in times of the disaster, etc. is an area where a disaster occurs, an infectious disease occurs, or is likely to be widespread, or likely to be (hereinafter referred to as “areas, etc. where a disaster occurred in Article IV, etc.”) By providing the necessary medical care in the vessel accurately and promptly, it shall be carried out with the aim of complementing the functioning of medical facilities in the region and contributing to the protection of the lives and bodies of the people from disasters or infectious diseases.
(Duty of the State)
Article III In accordance with the basic principles of the preceding Article, the State shall have the responsibility to comprehensively formulate and implement measures for the promotion of the development of a system for the provision of medical care using ships in the event of a disaster.
Chapter II Basic Policy on the Promotion of the Development of Medical Care Provision System Using Ships in Disasters, etc.
(Basic Policy)
Article IV The improvement of the system for providing medical care using ships in the event of a disaster, etc. shall be promoted based on the following basic policies.
Ensure appropriate division of roles and cooperation between medical care provided by ships in times of disaster, etc., and medical care provided in on-shore medical facilities.
(i) Holding a ship to provide the main purpose of providing medical care in the event of a disaster, etc., in order to enable the accurate and prompt provision of medical care required in areas where disasters have occurred (independent administrative agencies) (individual administrative agencies stipulated in the first paragraph of Article 2 of the Act on the General Provisions of the National Administrative Agency (Law No. The same in Article XIII.) (Including holding by persons outside of other countries).
(iii) Ensure that public and private medical personnel, ship personnel, and other personnel necessary for the provision of medical care using ships in the event of a disaster, etc.
(iv) Develop human resources by implementing education and training to provide medical care using ships in the event of a disaster, etc.
V. Ensure that medicines, medical equipment, and other supplies necessary for the provision of medical care using ships in the event of a disaster, etc.
V. Effectively utilize the second vessel for traveling medical care on remote islands, international emergency relief activities, etc., in areas other than disasters, etc.
Utilizing private funds, management and technical capabilities.
8 In addition to the items listed in the preceding items, implement measures that are deemed necessary to promote the development of a medical care delivery system using ships in the event of a disaster.
(Legal measures, etc.)
Article V The Government shall take the necessary legal or financial measures and other measures to implement measures based on the basic policies prescribed in the preceding Article. In this case, the necessary legal measures shall be taken within one year after the implementation of this Act.
Chapter III Plan for the Promotion of the Development of Medical Care Provision System Using Ships in the Event of Disasters, etc.
Article I. The government has a necessary plan for the government to take in order to take in order to promote the development of a medical care delivery system using ships in the event of a disaster (hereinafter referred to as the “development promotion plan”) that the government should take in response to the development of a medical care delivery system using ships, etc. You have to formulate.
2 The Prime Minister shall request a Cabinet decision on the proposal of the Development Promotion Plan.
3 When the Government formulates a development promotion plan, the Government shall report to the Diet without delay and make it public by the use of the Internet and other appropriate means.
4 The provisions of the preceding two paragraphs shall apply mutatis mutandis to changes in the improvement promotion plan.
Chapter Four: Marine Medical Promotion Headquarters
(Installation)
Article VII In order to comprehensively and intensively promote the development of a system for providing medical care using ships in the event of a disaster, etc., the Cabinet is responsible for the Promotion of Medical Care for the Utilization of Ships (hereinafter referred to as the “Headquarters”) in the Cabinet. Put it on.
(Hands in charge)
Article VIII The head office shall be in charge of the following affairs.
(i) Comprehensive coordination on the promotion of the development of a medical care delivery system using ships in the event of a disaster, etc.
(ii) Preparation and promotion of implementation of the plan for the development promotion of the plan.
(iii) Matters related to the drafting of legal and government ordinance proposals necessary for comprehensive and intensive implementation of the development of a medical care delivery system using ships in the event of a disaster, etc.
(iv) Liaison and coordination with relevant organizations and organizations related to the promotion of the development of a medical care delivery system using ships in the event of a disaster, etc.
2 Matters relating to the Headquarters shall be the Chief Minister of the Cabinet Act under the Cabinet Act (Law No. 5 of the Cabinet Act of XXII).
(Organization)
The Headquarters shall be organized by the General Manager of the Medical Promotion Division for the Promotion of Medical Care for the Utilization of Ships, the Deputy General Manager of the Medical Promotion Division for the Promotion of Medical Care for the Utilization of Ships, and the Head of the General Manager of the General Manager of the General Manager of the Medical Promotion Division for the Promotion of Medical Utilization of Ship Utilization.
(Director, General Manager of the Medical Promotion Division for the Utilization of Ships)
Article X The head of the headquarters is the general manager of the General Manager of the Medical Promotion Division for the use of ships (hereinafter referred to as the “Director-General”) and fills it with the Prime Minister.
2 The General Manager shall oversee the affairs of the headquarters and shall supervise the staff of the headquarters.
(Deputy General Manager, Ship Utilization Medical Promotion)
Article 11At the headquarters, Deputy General Manager of the Promotion of Medical Care for the Utilization of Ships (hereinafter referred to as the “Vice-General Manager” in the next paragraph and the second paragraph of the next Article) Put it down and fill it with the Minister of State.
2 The Deputy General Manager shall assist the Chief Executive Officer in the duties of the General Manager.
(Ship utilization medical promotion headquarters member)
Article12 At the headquarters, a member of the Medical Promotion Headquarters for the Utilization of Ships (hereinafter referred to as a “Headquartersman” in the next paragraph) Put it on.
2 The head office members shall be appointed by all Ministers of State except for the General Manager and the Deputy General Manager.
(Submission of materials and other cooperation)
Article XIII When it is recognized that it is necessary to carry out the administrative affairs in charge, the headquarters refers to the relevant administrative agencies, local governments, independent administrative agencies, and local administrative agencies (local administrative agencies stipulated in the second paragraph of Article 1 of the Act on the Enforcement of the Law of the Ministry of International Affairs of Japan). (National University Corporations, etc. as stipulated in Article II, Paragraph 5th of the National University Corporation Act, etc.) The head of the head of the head of the law and a special corporation (a corporation established directly by law or a corporation established by a special act of incorporation in accordance with a special law, which is subject to the provisions of Article IV, Paragraph I, Paragraph 8th of the Act on Establishment of the Ministry of Internal Affairs and Communications (Law No. You may ask the representative for the submission of materials, the disclosure of opinions, the explanation and other necessary cooperation.
2 When the Headquarters deems it particularly necessary to carry out the affairs in charge, it may ask for the necessary cooperation from persons other than those prescribed in the preceding paragraph.
(Secretariat)
Article XIV The secretariat shall be established at the head office to handle the affairs of the headquarters.
2 In addition to the Director-General, the Secretariat shall have the necessary staff.
3 The Director-General shall take charge of the affairs of the Director-General upon the orders of the Director-General.
(Delegation to Cabinet Orders)
Article XV In addition to the provisions of this Act, the necessary matters concerning the Headquarters shall be determined by Cabinet Order.
Appendix 則
(Enforcement date)
1 This Act shall be enforced from the date prescribed by Cabinet Order to a range of not exceeding three years from the date of promulgation.
(Consideration)
2 With regard to the Headquarters, a comprehensive review shall be made with a view to five years after the implementation of this Act, and the necessary measures shall be taken based on the results.
The summary seems to be as shown in the figure below . This is a document that experts have summarized it so that it is easy for the public to understand, so please take a look there.
In summary, since it is effective to use ships to secure medical care in the event of a disaster, we will promote the development of a medical care delivery system using ships.
[Reference] Ship Utilization Medical Care Promotion Headquarters: Meeting of the Medical Promotion Headquarters for the Utilization of Ships (the 1st)
[Reference] Marine-based medical care promotion headquarters: Survey status so far on ship utilization medical care
Super acute phase is professional in professional
In the super-acute phase, which is within 72 hours of the disaster, professionals who can respond to emergency situations, such as SDF ships and Japan Coast Guard vessels, will move.
Both the hull and the sailor are resistant to emergency situations, and it is planned that professional professionals will respond.
Emergency use is also used by the private sector.
In the superacute phase, civilians are required to respond difficult, such as helping people drifting at sea or transporting them urgently.
Plans are also being made to use private vessels to transport goods, transport patients, and rescue from around the third day of the disaster.
If there is no tsunami, the water will not be much different from peacetime, but the land may take time to open the road, so we are talking about using ships, so if it is a method that can move freely on the water, it will be used regardless of the public and private sectors.
Hospital ship concept
The start of the meeting of the Medical Research Promotion Headquarters for the Utilization of Ships is the initiative to improve hospital ships to compensate for the shortage of medical resources in the affected areas.
According to the documents, there seem to be two roles.
- Escape Ship: Transfer patients to hospitals away from the affected areas while carrying out medical treatment to patients in the affected areas.
- First aid ship: docked at a port near the disaster area and operated on the site for a certain period of time
The first is a doctor car role, and the second one is assumed to be a first aid station.
In practice, we are considering how to go to the disaster-stricken areas by equipping the car ferry with medical equipment and equipment so that both parties can be accommodated.
The advantages and disadvantages of hospital ships are as follows.
| Escape ship | First-aid ship |
|---|---|
| By reciprocating to the receiving area, it is possible to transfer more patients and reduce the burden on medical institutions in the affected areas | It has its own accommodation facilities, storage facilities such as food, and lifeline supply facilities such as power generation, and self-contained. |
| It is expected that it will be difficult for patients and their families to obtain consent to be transported to a place away from the disaster area. | It is expected that it will be difficult to secure patient access to the first aid ship. |
Ships play an active role in the Noto Peninsula earthquake
Ships are also being used to help and support the Noto Peninsula earthquake in Reiwa 6th year.
| Civilian Vessels | Ship Outline | Details of Support |
|---|---|---|
| HAKUO | ○Car ferry (17,345t) ○ Ships secured by the Ministry of Defense by the PFI method | ○Used as a temporary rest facility for victims |
| Natchan World | ○Car ferry (10,721t) ○ Ships secured by the Ministry of Defense by the PFI method | ○Used as a disaster base where national and municipal officials collect and share information |
| Higashishunmaru | ○Special tank ship (499t) ○ Owned by Coown Marine Co., Ltd. and Tosoh Logistics | ○Transportation of relief supplies such as water and simple toilets to Nanao Port ○ Dispatched as voluntary support by shipping companies |
| Ferry Awland | ○ RORO ship (451t) ○ Holding of Wako Ship Co., Ltd. | ○Transportation of showers and other relief supplies to Wajima City and Suzu City ○ Dispatched as part of the support activities of The Nippon Foundation |
| Teshimamaru | ○ Former Kosen training ship (240t) ○Holds by Peace Winds Japan | ○Transportation of food and other relief supplies from Omishima to Iida Port ○ Continued transportation of goods from Nanao Port to Iida Port |
| Kizuna | ○ Submarine cable laying ship (8,598t) ○ Operated by NTT World Engineering Marine | ○ Operated as a base station on board ○Restored lines in mobile phone areas along some of Wajima City (limited to docomo and KDDI) |
| Neo-Cycluster, etc. | ○ Multipurpose workboat “Ezei Maru” (697t) ○ In addition, “The 18th Matsumae Maru” is also active | ○Transportation of materials used for restoration work to Wajima Port ○ (one company) Activities with the cooperation of the Japan Landfill Dredding Association |
| Wakashiomaru | ○Training ship (231t) ○Used by Toyama National College of Technology | ○Transportation of disaster relief supplies to Nanao Port |
Cabinet decision
The contents of the Cabinet meeting at the meeting of the Medical Research Promotion Headquarters for the Promotion of Maritime Utilization held at the Prime Minister’s Office from 8am on March 18th, 2025, were released on March 21st.
It is necessary to develop a system for providing medical care using ships, and in order to do so, ships are necessary, so it is written that we should first secure ships.
In order to provide medical care, it is necessary to secure medical personnel, so the method is also described.
Human beings must secure not only medical personnel but also ship personnel, so it is written that it will be adjusted.
It is written that it is necessary to establish a system for the procurement and loading methods of pharmaceuticals and medical equipment.
Hospital Ships
In New York, where the medical collapse caused by COVID-19 was occurring, we did everything we could to save lives, including field hospitals and hospital ships.
When I saw the report in 2020 that there is a hospital ship with a capacity of 1,000 people, I thought it was really the United States.
I think that there was a medical support ship in Japan that went to a home visit, but when it comes to hospitalization and surgery, it will be a ship of the Self-Defense Forces, etc., so if you use it too much in domestic activities, your defense power may be weakened, so I think that it is not easy to call at the port.
Mitsubishi Heavy Industries Nagasaki Shipyard & Machinery Works was located at the Nagasaki Shipyard & Machinery Works Hospital of Mitsubishi Heavy Industries, Ltd. It is now an independent medical corporation as the Heavy Industries Memorial Nagasaki Hospital.
Mitsubishi Heavy Industries Kobe Shipyard & Machinery Works is home to Mitsubishi Kobe Hospital.
In this way, if a hospital adjacent to the shipyard can have a hospital bed on the ship, it is likely to be built a hospital ship that can be used in peacetime, but it should have been hospitalized in Kobe, but if you notice it, you may be in a distant place, so it seems that it is not easy to use in peacetime.
If it is a human-ducor facility, basically all healthy people are, so I think that you can ask me to leave immediately. Endoscopes, CTs, etc., can operate a certain level in peacetime, and if you use them a few days a week, you can confirm normal operation, so it seems to be good in terms of maintenance.
[Reference] U.S. Department of Defense: USNS Mercy, USNS Comfort Receiving Patients in LA, New York City
[Reference] Heavy-Engineering Memorial Nagasaki Hospital
[Reference] Mitsubishi Kobe Hospital
