Germany (Joint Support Service), Federal Republic of
Dr med Ulrich Schwederski-Menke
The Medical Service in the Joint Support Service
The Joint Support Service of the Future
The most important factor behind the development of the future Joint Support Service was the orientation towards providing a wide range of capabilities for operations. The previous regional structure with its broad spectrum of capabilities was thus converted into capability coordinationn commands for operations (logistics, C² support, strategic reconnaissance) and the Territorial Tasks Command (with its subordinate Military Police and CBRN Defence Commands). Technical and administrative responsibility as well as training authority are thus brought together. The Armed Forces Office will continue to perform central tasks for the armed forces and will be in charge of, among other things, defence attaché offices and Bundeswehr agencies abroad. The German Joint Support Service Headquarters is in charge of the Federal College for Security Studies, the Multinational Joint Headquarters, Ulm, the Bundeswehr Counterintelligence Office, the Office for Military Studies, the Leadership Development and Civic Education Centre, the Bundeswehr Command and Staff College as well as the German Military Representatives to the NATO Military Committee and the EU.
The following diagram of the Joint Support Service (JSS) can only provide a rough outline of the tasks and responsibilities of the Service. A detailed illustration would exceed the scope of a compendium such as this. This is why the tasks of the medical elements within the JSS are also only outlined. JSS agencies with their own medical elements are shown in the diagram.
The Medical Service in the Joint Support Service
The Medical Service in the JSS provides specialist advice for force commanders, performs military pharmaceutical tasks for the Bundeswehr, and fulfills specific specialist tasks. The JSS further ensures the provision of medical care at Bundeswehr agencies abroad (outside of military operations).
Senior Medical Officers (SMOs) in capability coordination commands serve as medical advisors to force commanders. In addition, they analyse physical and ergonomic requirement profiles for various specialist tasks and contribute medical expertise to the further development of technology and procedures. These tasks are especially important with respect to future personnel development. The Surgeon General of the Joint Support Service, the Bundeswehr Logistics Centre, and medical materiel depots perform military pharmaceutical tasks. Military pharmacy elements in the JSS have in-service and supply responsibility for medical materiel in the Joint Support Service. They furthermore represent the interests and technical issues of medical materiel management in the further development of logistic systems at the interface to the main logistics process. A broad range of specific specialist tasks are performed in national and international HQs, authorities, commands and agencies and are carried out by medical advisors, special instructors at schools, veterinarians for working dogs, and toxicologists in the CBRN corps. The following are examples of medical elements in the Joint Support Service.
Surgeon General of the Joint Support Service /
Senior Medical Officer of the Joint Support Service
The Division of the Surgeon General of the Joint Support Service controls and coordinates health support and medical materiel logistics in the Joint Support Service. The responsibilities of the Surgeon General of the JSS include:
- assessing medical operational readiness in his area of responsibility,
- providing expert advice to the Chief of Staff of the Joint Support Service and the Surgeon General of the Bundeswehr in all medical matters of the Joint Support Service,
- assuming in-service and supply responsibility for medical materiel in his area of responsibility,
- exercising functional control over subordinate medical elements and
- providing intermediary or final reports for decision-making processes.
The Chief of the Division of the Surgeon General of the Joint Support Service is the technical superior of the Medical Service in the JSS and in charge of the division of the same name in the Command and Control Directorate of the JSS HQ. He also acts as Senior Medical Officer of the JSS and represents the interests of the JSS in matters of health support and medical materiel logistics. The Surgeon General of the Bundeswehr is the direct technical superior of the Surgeon General of the JSS.
The Military Medicine and Military Pharmacy branches provide specialist medical expertise for the mission of the JSS. Their tasks include:
- processing, reviewing and co-signing national and international documents, concepts, directives, decrees and service publications containing medical matters,
- ensuring that medical personnel of the JSS receive training and education that is appropriate to their posting,
- monitoring and ensuring medical operational readiness in the JSS,
- analysing and evaluating all guidelines and policy documents with regard to medical relevance,
- implementing requirements of the Surgeon General of the Bundeswehr for the JSS and
- representing the interests of the JSS in medical working groups, committees and study groups (e.g. CIMIC, optimization of assessment systems, organisational health management, evaluation of pre-/post-deployment activities, PTSD, integrated project teams, etc.).
Military Medicine Branch
The chief of the Military Medicine Branch is also the Senior Medical Officer of both the Bundeswehr Command Support Command as well as the Strategic Reconnaissance Command. He provides expert advice and sometimes performs curative tasks with regard to military medical issues. The Military Medicine Branch evaluates findings in the fields of preventive health protection, ergonomics and man machine interaction with regard to their military medical relevance and integrates them into the further development of technologies and procedures used in the JSS and into health support.
Military Pharmacy Branch
The Military Pharmacy Branch has in-service and supply responsibility for medical materiel as well as functional control of medical materiel management in the JSS. The main tasks of military pharmacy in the Joint Support Service cover three key areas.
As part of the in-service and supply responsibility with regard to medical materiel, military pharmacy ensures the material readiness of medical facilities in the area of responsibility of the Chief of Staff of the Joint Support Service. By also fulfilling this task for the major organisational element Personnel, the JSS emphasises its role as a service provider for all major organisational elements. The JSS is also the central service provider for all agencies of the Bundeswehr with regard to the provision of medical materiel. Centrally procured medical materiel is managed and kept ready to use in medical materiel depots. The maintenance control of Bundeswehr medical materiel also takes place in the JSS, under the responsibility of the Military Pharmacy Branch. In addition, the Military Pharmacy Branch in the German JSS HQ represents the interests of the JSS to the main process manager for logistics in matters related to the management and maintenance of medical materiel.
This branch also acts as Authorised Representative of the Chief of Staff of the Joint Support Service for military medical projects in the Integrated Planning Process and establishes medical materiel investment and running cost requirements of the JSS for the financial requirements analysis and medium-term financial planning.
The Senior Medical Officer (SMO) of the Armed Forces Office
The Senior Medical Officer of the Armed Forces Office could be considered the unit physician with the largest area of responsibility in terms of geography. He is responsible for the medical care of all German soldiers stationed abroad outside of military operations. This includes all medical advice, especially with regard to travel medicine, the implementation of vaccination programmes, the supply of pharmaceutical products, and medical assessments. Of course he also provides advice and support if family members, for example of a military adviser in Central Africa, experience medical problems.
The Senior Medical Officer is under the administrative control of the Chief of Staff of the Armed Forces Office and under the technical control of the Surgeon General of the Joint Support Service. He organises, commands and leads the medical service of his command area and advises the Commander of the Armed Forces Office, heads of agencies of the command area of the Armed Forces Office in Germany and abroad, German military attachés, heads of Bundeswehr agencies abroad as well as heads of the German Military Advisory Groups in Africa and Asia on all matters related to the medical service.
He has technical control over the following medical areas:
- unit physician at Supreme Headquarters Allied Powers in Europe (SHAPE) in Mons, Belgium;
- unit physician of the German element of the Joint Forces Headquarters in Brunssum, Netherlands;
- Senior German Officer, German Element, Land Command, HQ Izmir, Turkey
- Senior German Officer, German Element, HQ SACT and USJFCom, Norfolk, USA
- German Liason Officer, DCSSA, Paris, France
- German Element, HQ JFC ResDir, Brunssum, Netherlands
- German Element, SHAPE ResDir, SHAPE, Belgium
- German Element, HQ JFC Medical Advisor, Naples, Italy
- Senior German Officer, German Element, NATO School, Oberammergau, Germany
- medical sergeants of German elements of NATO staffs in Fontainebleau, France; Naples, Italy; Lisbon, Portugal; JFC HQ Brunssum, Netherlands and Izmir, Turkey, as well as
- at the German Armed Forces Command, United States and Canada in Reston, USA
- Commander, Bundeswehr School of Dog Handling, Ulmen.
SMO/CJMed Division of the Multinational Joint Headquarters
In 2013, the Response Forces Operations Command in Ulm was transformed into the Multinational Joint Headquarters (MN JHQ) Ulm.
This new command is a multinational joint headquarters at the operational level. Its capability to lead both EU and NATO operations is unique. It leads from the theatre of operations and must therefore be quickly deployable to any place in the world. The headquarters comprises approximately 400 German and multinational soldiers and civilian personnel and is able to lead multinational joint operations of NATO and the EU up to an overall strength of 50,000 soldiers. It is particularly qualified to work closely together with civilian partners, such as the European External Action Service, host countries, international organisations such as the Red Cross and relief organisations (comprehensive approach).
The MN JHQ Ulm staff therefore includes elements such as Intelligence and Knowledge Development, Strategic Communications, and an Operational Competence Centre. In addition, the MN JHQ Ulm provides key personnel for a Germanled EU headquarters at the military-strategic level.
The Combined Joint Medical (CJMed) Division plans and coordinates multinational medical care for each operation. Personnel of this division are closely involved in the operational planning process in all relevant bodies. Medical personnel, for example, are involved in the Knowledge Development element.
Medical support also includes force health protection, medical logistics, and medical intelligence. A key task is implementing the comprehensive approach, in other words in-theatre medical civil-military co-operation with governmental, international and non-governmental organisations.
A patient evacuation coordination centre (PECC) staffed mainly by CJMed personnel coordinates patient evacuation at the operational level.
In addition, CJMed contributes to further medical development and medical operations analysis at the multinational and national level. The CJMed Division is also extensively involved in the planning, execution and follow-up analysis of multinational pre-deployment and certification exercises. The Chief of CJMed Division is the SMO of the command area during routine operations. At the same time, he is the medical director of each overall operation and acts as a multinational technical superior to all medical forces participating in the operation and as a medical advisor to the force commander.
Medical Services Department at the Bundeswehr Command and Staff College
The Medical Services Department at the Bundeswehr Command and Staff College is responsible for the organisation, execution and further development of medical training for the services and military organisational elements as well as for joint training. The head of department carries out this task along with four teachers and one staff assistant. The Medical Services Department takes an interdisciplinary approach and works closely together with all other departments at the Bundeswehr Command and Staff College. In the medical parts of courses and modules at the Bundeswehr Command and Staff College, staff officers of all military organisational elements develop a comprehensive understanding of the principles of the Medical Service as well as social and economic developments of health services at a national and international level.
Special medical service modules cover a wide range of subjects from civil-military co-operation through medical planning to questions of ethics and operational law. Modules are offered several times a year and are approved as advanced training by the Medical Association of Hamburg.
Leadership Development and Civic Education Centre
The medical officer employed at the Leadership Development and Civic Education Centre serves as an advisor of the commandant in all medical matters. He carries out policy work with a focus on stress and heads the documentation centre for drugs and addiction prevention. In his function as specialist instructor, he is responsible for the preparation, execution and follow-up analysis of the medical elements of teaching at the Leadership Development and Civic Education Centre, especially in pre-deployment courses.
Bundeswehr School of Dog Handling
The Bundeswehr School of Dog Handling in Ulmen is headed by a veterinarian and provides the Joint Support Service with a very special capability from the wide range of Medical Service capabilities. Starting from their recruitment until the end of their service, working dogs of the Bundeswehr receive veterinary care in Ulmen to ensure their fitness for their main tasks of protection and guard duty, searching for missing persons, detecting drugs and explosives, and mine detection. This includes the treatment of illnesses and injuries the animals may suffer on operations.
Following its selection and training, a working dog is handed over to its handler, who will work with this dog until it reaches approximately 8 years of age. With the help of modern technology, the training of dogs and their capabilities are continuously optimised and developed. Time and again dogs have been found to be clearly superior to other sensors. The school's veterinary clinic is equipped with modern medical technology. This means that even major surgical procedures can be performed there. Since 2011, a documentation system for veterinary data has been available at the clinic. The school also ensures that four-legged pensioners and veterans receive lifelong care. If they cannot stay with their handlers' families or be placed with someone else, they remain in Ulmen, spending their sunset years with a pack and housed in modern kennels.
Bundeswehr Logistics Centre
In order to fulfil military pharmacy tasks in the JSS HQ, the senior pharmacy officer in the JSS in the Military Pharmacy Branch relies on medical elements of the Bundeswehr Logistics Centre in Wilhelmshaven. The Bundeswehr Logistics Command in Erfurt and the Bundeswehr Logistics Centre, which has direct authority over fixed logistic installations, follow the capability-oriented approach of the JSS. This means that joint technical and administrative control of medical materiel depots lies directly with the Bundeswehr Logistics Centre. The group for the technical supervision of military pharmacy in the Bundeswehr Logistics Centre and its military and civilian personnel are the central point of contact and control agency for ensuring the provision of medical materiel by the JSS. Medical materiel is provided by the medical materiel depots in Epe and Krugau, which also have the status of Bundeswehr pharmacies.
In addition to materiel requirements and stock management for centrally procured medical materiel, the central maintenance control point for medical materiel is also part of the Bundeswehr Logistics Centre. It is responsible for planning, controlling and coordinating the maintenance of medical equipment throughout the Bundeswehr. It also acts as an interface between different units and military and civilian maintenance facilities across all major organisational elements. The medical materiel depot in Bramstedtlund was closed on 5 June 2014 as part of the reorientation of the Bundeswehr. This reduced storage capacities for medical materiel in the JSS by approximately 34%. The resulting surplus disposal and recycling, but also the consolidation of forces, assets and responsibility have led to a strengthening of core capabilities. These include inspecting modular medical treatment facilities provided by industry, returning such facilities from theatres of operation, and reestablishing their operational readiness. In this context, the medical materiel depot in Krugau was turned into a centre of excellence for the inspection and maintenance of modular medical treatment facility containers. This has reduced the pressure on supply facilities for medical materiel of the Bundeswehr Joint Medical Service.
Medical tasks are only one part of the support activities carried out by the JSS for the Bundeswehr. The Medical Service in the Joint Support Service supports units of the JSS by providing advice on all medical issues and by contributing expertise to further development. The Medical Service also provides the Bundeswehr with special medical, pharmaceutical and veterinary capabilities that only exist within the JSS. The Medical Service in the JSS has been optimised in the new structure in order to fulfil its functions. It will continue to be developed based on lessons learned.