German hospitals bolster defences for wartime casualties

Germany’s hospitals are ramping up preparations for a possible influx of wounded patients during a NATO conflict, with military planners estimating that 300 to 1,000 service personnel could require daily treatment. To handle such a surge, the Bundeswehr, Germany’s military, is preparing by examining ways to secure treatment areas from threats like drones, and exploring the revival of Cold War underground protected spaces.

The trauma units, operating theatres, blood supplies, and specialist staff are under pressure, with roughly a third of the most severely wounded needing intensive care. At one of Germany’s major military medical centres in Ulm, planners are considering hardened windows, barriers against drones, and resilient power and ventilation systems.

Germany is also drafting a Health Emergency Act to clarify responsibilities and coordination among civilian healthcare providers, federal authorities, the Länder, and the armed forces during crises or defence emergencies. The Health Minister emphasized that a resilient healthcare system is a vital security requirement, necessitating dependable infrastructure, stable supply chains, sufficient trained personnel, and improved coordination.

However, the government lacks a comprehensive overview of medical workers' skills to treat wartime injuries, which is significant as battlefield trauma differs greatly from routine civilian injuries. Germany’s military medical service has integrated these lessons into exercises, such as the Bundeswehr’s largest medical exercise since Russia’s invasion of Ukraine, which tested evacuation chains and treatment near the battlefield.

Civilian hospitals are central to the planning, as they would form the backbone of clinical care in a large conflict, requiring systems to distribute patients based on medical need and available beds while continuing to treat the civilian population. Hospital groups have called for dedicated funding for resilience measures, including protected spaces, backup energy, stronger cyber defences, and personnel reserves, warning that ordinary financing does not cover the scale of investment needed for a defence scenario.