Prefectural governments will start working out new health-care plans this summer as a preparatory step for reform of the nation’s health-care system that starts in fiscal 2008. Their work will not be easy because they have to pursue two seemingly contradictory goals — improving the quality of medical services while reducing costs. The plans will be renewed every five years.

In the countryside, hospitals are suffering from shortages of doctors and nurses. Local residents’ unease is rising amid closures of emergency medical services and departments of obstetrics and pediatrics. Clearly, prefectural governments alone cannot solve the doctor shortage, especially that of obstetricians and pediatricians. The central government must act quickly by working out short- and long-term measures — securing experienced doctors for the countryside now and nurturing young doctors willing to work there in the future.

In writing the plans, prefectural governments are required to set down numerical goals for securing doctors specializing in obstetric and pediatric services as well as in medical services for times of natural disaster or other emergencies. They are also required to create a network of core hospitals and scattered clinics to improve treatment of cancer, cerebral apoplexy, cardiac infarction and diabetes.

Dissemination of information to local residents will be crucial. Prefectural governments must post detailed information as to what kinds of medical services will be available at what hospitals. Use of the Internet will become important.

In accordance with the central government’s plan to reduce the number of beds for long-term convalescence from the current 380,000 to 150,000 by the end of fiscal 2011, prefectural governments will work out their own plans by considering local situations. In doing so, they will have to improve nursing care facilities and services to accommodate such patients.

Ideas and opinions from local residents should play an important role in making prefectural plans both practical and effective in meeting local needs.

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