Hospital ship doctrine in the United States Navy: the Halsey effect on scoop- and-sail tactics.

Although hospital ships have a long history, naval strategists have paid little attention to their tactical employment in naval and amphibious warfare. Often employed as floating ambulances, operational doctrine for hospital ships did not permit their use as floating combat surgical hospitals until the final amphibious campaigns of World War II. Based on operational archives-ships' logs, war diaries, battle plans, and other official records-this essay traces the evolution of tactical doctrine on hospital ships from Guadalcanal to Inchon. Early in World War II, there were insufficient hospital ships to permit much flexibility in their employment. By the Philippine campaign in 1944, the increased availability of afloat medical assets prompted Third Fleet Commander Vice Admiral William F. Halsey to propose that the ships be used as acute surgical hospitals at the amphibious landing sites rather than as sea-going ambulances. Facing the prospect of a growing number of casualties for the major assaults being planned, Halsey needed to maximize medical and surgical efficacy and return-to-duty rates to conserve the fighting strength of his invasion forces. Admiral Chester A. Nimitz approved Halsey's proposal, and the battle plan at Iwo Jima combined the careful triage of casualties at the waterfront with early, forward employment of hospital ships. Despite more than 21,000 casualties at Iwo Jima, they were handled better than at any previous operation in the Pacific theater. The tactical doctrine for hospital ships suggested by Halsey has since been employed in every major amphibious operation, including Okinawa and Inchon, and has also been used in modern-era contingency and humanitarian missions.