Italy is also working on a plan for hospitals in the event of a military attack

The Ukraine-Russia conflict and the jolts that are spreading - the latest being the drones shot down in Poland - up to a possible extension to the whole of Europe of military hostilities with NATO involvement, have also started to alarm European countries on the front of preparing the hospital network in the event of the worst case scenario, i.e. that of a military attack. France and Germany have already started to develop their strategies in receiving wounded soldiers. But Italy has also begun to take the first steps: a technical table has been set up at the Ministry of Health, which has already met a couple of times, and the first talks have begun on a 'health resilience strategy' in the event of activation of the NATO treaty, which is based on three phases ranging from the arrival of troops to the return of the wounded.

As mentioned in recent weeks, France and Germany have initiated a strategy on the preparedness of the hospital network in receiving wounded soldiers. A circular issued by the French Ministry of Health has informed the regional health agencies on the territory to prepare for the installation, in case of need, of health facilities in cooperation with the Ministry of Defence, so that - as reported by the weekly Le Canard Enchainé - civil hospitals can prepare for a possible major influx of wounded soldiers. In Germany, a plan was presented with the same aim: to prepare hospitals for the possibility of a large-scale conflict in Europe. In Germany, a plan has been presented with the same aim: to prepare hospitals for the eventuality of a large-scale conflict in Europe. And in Italy? On this front there is direction between Palazzo Chigi (in particular the undersecretary Alfredo Mantovano) and the Ministry of Defence. But on the health front, the Ministry of Health is already in the field, which, with a special decree last April, set up at the cabinet office a permanent Table on the resilience of critical subjects composed of ten members, which met for the first time at the beginning of June and then about ten days ago.

The decree (which implements Legislative Decree 134/2024, in turn implementing a European directive) provides that the tasks of the Technical Table also include 'defining a strategy on health resilience that establishes the roles and responsibilities of all the bodies, institutions and entities involved in the preparation of preparedness & response plans and measures for the management of large-scale health emergencies'. The decree also gives two concrete examples, i.e. C.R.B.N. (Chemical, Radiological, Biological and Nuclear) events' or also - this is the case that is most closely linked to current events - 'crisis scenarios such as the activation of Articles 3 and 5 of the Atlantic Pact'. The former in particular commits the NATO countries to develop their capabilities to resist an armed attack through the development of their own resources and mutual assistance, thus maintaining continuous and effective self-defence. While Article 5 is the key to the collective defence system and states that an armed attack against one or more Alliance countries in Europe or North America is considered an attack against all, leading to mutual assistance, including the use of force, to restore security.

One of the aims of this table set up at the Ministry of Health is to 'strengthen civil-military cooperation in the health field', for example 'by promoting common training courses and joint exercises or by defining shared operational plans and guidelines for the management of the chain of command during catastrophic events', the text of the decree of establishment further warns. In this sense, it emerged from the first meetings that NATO requires specific requirements for healthcare in the member countries (called 'Minimum operational requirements'), which Italian hospitals are certainly capable of ensuring. In addition, a hypothetical 'host nation support' scenario was discussed, with military mobility in three phases: from preparation for the arrival of troops, to mobility within the country, to participation in active combat phases abroad, with the possible return of wounded soldiers. The Italian plan to be activated in our hospital network in the event of the borderline scenario of a military conflict could be built on these initial elements.