The Department of Defense recently announced a new approach for governance and management of the military health system. Deputy Secretary of Defense Gordon England approved the plan, at this time a conceptual framework, on Nov. 27, 2006.

The concept creates joint oversight and leadership of several key functional areas (education and training, medical research, health care delivery in major U.S. markets and critical shared services) across the health system.

Objectives of the new approach are to streamline operations, create greater efficiencies and cost savings, improve coordination of medical services, improve support to war-fighters, leverage better medical research, and create greater jointness and standardization in training of military medical personnel.

This new approach for governance responds to departmental direction that the undersecretary of defense for personnel and readiness, Joint Staff, and military services work together to improve management performance and efficiency of the military health system.

According to England, "This new framework reflects the outstanding work of many in department and the Defense Business Board. The approved concept does not seek a total medical joint command structure, but concentrates on consolidating and unifying key functions and providing authorities needed to make decisions jointly to build a more effective organization."

The under secretary of defense for personnel and readiness, assistant secretary of defense for health affairs, Joint Staff and surgeons general will identify details for the conceptual framework and then appoint a transition team to implement and align the new governance approach.

"With this decision, we will take important steps toward consolidation of administrative and management functions as well as strengthening joint decision-making authorities necessary to operate more effectively and efficiently," said Dr. William Winkenwerder Jr., assistant secretary for health affairs."

He emphasized that "...command authority remains with the military services and combatant commands and the three surgeons general remain aligned with their services. This far reaching governance change represents the most significant realignment in military health system management since the 1991 actions to strengthen medical management, including establishment of the defense health program."

The transition and realignment is scheduled to be completed by 2009.