The case for building a British hospital ship

Feb 24, 2014   //   by NavyLookout   //   Articles, blog  //  9 Comments

RAF Nightingale - British hospital ship

Many in Britain may feel proud that the UK government is giving away £11.2 Bn per year in overseas aid, leading the world in ‘international development’. While growing poverty in the UK leaves increasing numbers dependent on food banks, the armed forces suffer cut after cut and national debt rises by £1Bn per week, for others this generosity is hard to stomach. There is a case for overseas aid both on a pragmatic and moral level – we should do the right thing and besides, lifting people out of poverty should make us all richer. The old adage that “charity begins at home” has lost much of its meaning in the context of the globalised inter-connected 21st century world where what happens in far off nations can have immediate impact at home. The principle that governments of rich nations should be helping the poorest and the most vulnerable in the world is sound and should not just be left to charities or benevolent billionaires.

What is not in doubt is that UK overseas development has been mismanaged in some areas to the point of lunacy. Not only is much of the money wasted by corruption, absorbed by expensive ‘aid professionals’ or put into schemes with no accountability but we have been giving money to growing economic powerhouses such as India and even China. We are sending cash to relieve grinding poverty in India while their government has the resources to run a space programme and build aircraft carriers. We don’t necessarily need to cut our overseas aid budget but we certainly should start spending it far more intelligently. Building and operating a hospital ship is a good example of how we could spend this money better.

With apparent climate change bringing more extreme weather, regular earthquakes and tsunamis, it is sad but safe to say that the services of hospital ships will be needed many times in the coming decades. With 95 of the 100 largest cities in the world port cities and the 90% of the world’s population living within 200 miles of the sea, aid and assistance from ships will often be the most appropriate way to deliver large scale relief.

By diverting a very small part of the Department for International Development’s (DFID) very generous budget into building and running a hospital ship, the MoD would be spared further pressure on its already under-size budget. The taxpayer would be getting a highly visible ambassador for Britain and a force for good in the world. A hospital ship can deliver medical aid direct to those who need it most while avoiding potential corruption and the middle-men that plague so many aid projects.

Ideally we would have 2 vessels. One ‘forward-deployed’ mainly around Africa or Asia making scheduled visits to provide a programme of free medical care but ready to respond to natural disasters. The second vessel would be at home either refitting or in reserve but at a few days notice to respond to emergencies. In their secondary roles, the ships would give the armed forces of the UK and its allies the assurance of a dedicated hospital ship able to cope with large numbers combat casualties. They would also provide a useful back up to the NHS in the event of a major incident or disaster in the UK. It is notable with the closure of Royal Naval Hospital Haslar in 2009, the UK is now the only country in the Western world not to have a dedicated Military hospital.

English: The Royal Fleet Auxiliary vessel RFA ...

RFA Argus (Photo credit: Wikipedia)

RFA Argus is the nearest we currently have to a hospital ship. Designated a “Primary Casualty Receiving Ship” (PCRS), she carries a fully equipped 100-bed hospital. However she is painted grey and does not conform to the requirements of the Geneva Convention on hospital ships because she carries weapons and embarks operational units. She is also the Navy’s helicopter training vessel and in wartime she would be a very useful extra helicopter carrier. Originally converted from a container ship for the Falklands War and then significantly re-built, few vessels have provided the taxpayer with better value for money. Argus is due for retirement in 2020 and like so many “gaps” in MoD equipment, there is no active plan or funding to replace her. We would advocate her replacement as soon as possible this should be treated a seperate issue to the hospital ships which would be white-painted non-combatants with a much larger capacity.

Design & build

To have sufficient capacity to cope with large numbers of casualties or medical cases the ship would need to be fully equipped to a standard similar to a large general NHS hospital with at least 500 medical beds. Procurement of these ship need not be particularly expensive. A new build vessel would provide welcome work for the Portsmouth, Cammel Laird or Appledore shipyards. However a merchant ship conversion would probably be more affordable and could be done faster. Ideally the ship would be able to manage a sustained 25 knots as speed of response could be important, although most merchant ships can manage a maximum of 18 Knots. A flight deck and large hangar would be required to support several helicopters. There would be ramps and a vehicle deck to allow casualties and stores to be driven on and off when in port. A couple of light landing craft (LCVPs) in davits would also be useful for embarking casualties when port facilities are damaged or unavailable and the ship has to lie at anchor.If the ship had an RFA crew and was based in Portsmouth or Devonport it would utilise existing training and support infrastructure keeping costs down. The medical staff would come from across the armed forces and it would provide valuable experience for them, especially as the superb work of the battlefield medical teams in Afghanistan winds down.

Existing examples

This video showcases the amazing work of the Mercy Ships charity - a great example of what can be done with a hospital ship. With an annual budget that is probably less than what DFID spends on paperclips, their ship MV Africa Mercy spends several months in ports of the world’s poorest nations providing free medical care ranging from simple medical checks to major operations.

USNS Comfort

The US operates the 2 largest hospital ships in the world, USNS Mercy and Comfort. Pictured above is USNS Comfort arriving to assist in the wake of the earthquake in Haiti in 2010. Both are merchant ship conversions operated by the Military Sealift Command – a civilian organisation similar to the Royal Fleet Auxiliary. (US Navy Photo)

Chinese Hospital ship - Peace Ark

Launched in 2007, the Chinese Navy have a dedicated purpose-built hospital ship called the “Peace Ark”. This shows how China understands the value of  investing in ‘soft power’ while rapidly expanding its naval and military capabilities. (Image via Wikipedia)


The humanitarian aid mission is often forgotten in political discussions around the size and shape of the navy. We should perhaps consider allocating further DFID funds to support  branches of the forces which can and do contribute significantly to humanitarian aid operations. If we purchased additional naval auxiliaries, helicopters and heavy lift transport aircraft we would be better equipped to respond to crises and have more badly needed assets without increasing the defence budget. Indeed there are already signs the government is thinking this way. With public opinion increasingly hardening against involvement in armed interventions, it is likely that humanitarian missions will occupy a growing proportion of our forces work. A British hospital ship is an ‘everyone wins scenario’ and would be a popular first step to reshaping the aid budget and would avoid the howls of criticism that aid money is being diverted to weapons spending.



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  • I for one also think the foreign aid budget should be switched to the mod/defence funds to get our forces upto scratch.
    we need 4 x45s 4 more astutes,4 opvs ,keep the army at its current force,get to grips with this f35 program.48 units isn’t any good for 2 65000 ton super carriers for gods sake.
    And increase the number of special forces this is a must.!!

  • Such a simple and obviously good idea. The ships suggested could provide valuable continuing aid to poorer parts of the world and be available for service in hotspots whenever they emerged.
    Massive fillip to the north east/Scotland while they are being built, tremendous training platform for our medics, helo crews etc and absolutely invaluable sea time for our sailors.
    This must surely be an effective – and proper – way for overseas aid to be spent? Better even than building hospitals overseas which fall into disrepair due to poor management and supporting infrastructure.
    Who could argue against this? Why isn’t it already happening? How can people like me help to get it into the politicos’ heads?

  • Sounds good to me maybe we could develop the concept a tad further say have one deployed permanently in the south east Asia region and one deployed during the hurricane season in the West Indies.

  • Well I think it would be a very good idea if the government, rather than scrap the illustrious carrier, she could spend to have it converted to a hospital ship,.

  • HMY Britannia was supposed to have been convertible into a Hospital ship except she may have been too small, had no facility for a helipad and never used as such. However she did have the large spaces for wards.

    Its a good idea to have a hospital ship as opposed to shore based medical facilities, because its sovereign territory. Go for it.

  • Would the UK have the nerve to put a cross on a ship?

    • in which way a cross being a nerve
      we have had hospital ships in the past..

  • This is all good and well, and a great idea,
    but sadly talking to the British government, you might as well talk to aliens, they would talk for years , then if anything just kick it to the long grass whilst still giving to china and India and others,

    a great idea for our ship yards , workers , and world recognition ,
    but our government at this moment just wants to close everything and save money, with the exception of the overseas aid.

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