Medical Care Act

In order to contribute to appropriate implementation of the affairs listed in each item of paragraph (1) of the preceding Article, the national government is to provide necessary information and other forms of cooperation to prefectures.

The prefecture must establish a place of consultation with the administrators of the following entities and other related parties (referred to as the "Council for Regional Medical Care Measures" in the following paragraph), which are to hold consultations with the cooperation of these persons on particulars necessary for the implementation of the particulars listed in each item of the same paragraph concerning ensuring the availability of physicians specified in the medical care plans, and must make a public announcement of the particulars agreed upon through the relevant consultations:

advanced treatment hospitals;

regional medical care support hospitals;

public medical institutions provided for in Article 31 (referred to as "public medical institutions" in item (v)).

hospitals designated by prefectural governors and provided for in Article 16-2, paragraph (1) of the Medical Practitioners' Act;

hospitals other than public medical institutions (excluding those specified by an Order of the Ministry of Health, Labour and Welfare as being equivalent to public medical institutions);

groups of persons with the relevant knowledge and experience in medical practice;

universities prescribed in Article 1 of the School Education Act (Act No. 26 of 1947) (hereinafter simply referred to as "universities") and other organizations related to the training of medical care professionals;

social medical corporations provided for in Article 42-2, paragraph (1) authorized by the relevant prefectural governor; or

other parties as prescribed by an Order of the Ministry of Health, Labour and Welfare.

The particulars to be discussed at the Council for Regional Medical Care Measures pursuant to the provisions of the preceding paragraph are to be the following particulars:

particulars concerning plans specified by an Order of the Ministry of Health, Labour and Welfare as those aimed at contributing to ensuring the availability of physicians in acute physician shortage areas and at developing and improving the abilities of physicians to be dispatched to acute physician shortage areas;

particulars concerning the staffing of physicians;

particulars concerning continuous assistance for the development and improvement of the abilities of the physicians dispatched to acute physician shortage areas in accordance with the plans prescribed in item (i);

particulars concerning measures to alleviate the burden on physicians dispatched to acute physician shortage areas;

particulars concerning measures to be taken in cooperation between universities and prefectures for ensuring the availability of physicians in acute physician shortage areas that are specified by an Order of the Ministry of Education, Culture, Sports, Science and Technology and an Order of the Ministry of Health, Labour and Welfare;

particulars that fall under the authority as set forth in the Medical Practitioners' Act; and

other particulars concerning ensuring the availability of physicians specified in the medical care plan.

The prefectural governor, when holding consultations on the particulars listed in item (ii) of the preceding paragraph, must take into account the information on the number of physicians indicated by the indicator prescribed in Article 30-4, paragraph (2) item (ix), (b) and give consideration to other particulars specified by an Order of the Ministry of Health, Labour and Welfare, so that the dispatch of physicians will contribute to ensuring the availability of physicians in acute physician shortage areas.

Administrators of the entities listed in the items of paragraph (1) and other related parties must endeavor to cooperate, if requested by the prefecture, by participating in consultations carried out by the prefecture as set forth in the provisions of the same paragraph.

When the prefectural governor finds it especially necessary based on the particulars agreed upon through the consultation prescribed in paragraph (1) of the preceding Article (referred to as "particulars agreed upon" in paragraph (1) of the following Article, Article 30-27 and Article 31), the governor may request the establishers and administrators of entities listed in the items of paragraph (1) of the preceding Article and other related parties to provide necessary cooperation for ensuring the availability of physicians in hospitals or clinics in acute physician shortage areas, such as dispatching physicians and developing training systems.

The prefecture, based on the particulars agreed upon, is to endeavor to implement the following affairs in order to secure the medical care required in the region:

to conduct surveys and analyses concerning: trends in ensuring the availability of physicians in hospitals and clinics located in the areas prescribed in Article 30-4, paragraph (5); factors contributing to ensuring the availability of physicians in hospitals and clinics located in the areas prescribed in Article 30-4, paragraph (6); and other particulars concerning the securing of medical care required in the region;

to provide consultation, necessary information, advice and other assistance concerning ensuring the availability of physicians to establishers and administrators of hospitals and clinics and other related parties;

to provide consultation, necessary information, advice and other assistance concerning employment to physicians who wish to work, students majoring in medicine at universities and other related parties;

to provide physicians with consultation, necessary information, advice and other assistance concerning training on the latest knowledge and skills related to medical care and other programs for the development and improvement of their abilities;

to formulate the plans prescribed in Article 30-23, paragraph (2), item (i);

to make the necessary coordination with regard to the implementation of the particulars listed in items (ii) through (iv) of Article 30-23, paragraph (2); and

beyond what is listed in each of the preceding items, to provide necessary support for ensuring the availability of physicians in hospitals and clinics.

Beyond the affairs listed in the items of the preceding paragraph, the prefecture may carry out free employment placement services for physicians pursuant to the provisions of Article 29, paragraph (1) of the Employment Security Act (Act No. 141 of 1947) or carry out worker dispatching services for medical practitioners by obtaining the license provided for in Article 5, paragraph (1) of the Act for Securing the Proper Operation of Worker Dispatching Businesses and Protecting Dispatched Workers (Act No. 88 of 1985).

The prefecture may entrust all or part of the affairs listed in the items of paragraph (1) and the affairs provided for in the preceding paragraph (hereinafter referred to as "affairs to support regional medical care" in this Article and the following Article) to a person specified by an Order of the Ministry of Health, Labour and Welfare.

The prefecture or a person who has been entrusted under the provisions of the preceding paragraph, when implementing the affairs to support regional medical care or the affairs pertaining to the relevant entrustment, is to endeavor to secure the functions as a center for securing the medical care required in the region.

The prefecture or a person who has been entrusted under the provisions of paragraph (3), when implementing the affairs to support regional medical care or the affairs pertaining to the relevant entrustment, must mutually cooperate with a person who implements the affairs related to improving the work environment or the affairs related to improving the work environment pertaining to the entrustment under Article 30-21, paragraph (2).

A person who has been entrusted under the provisions of paragraph (3) or an officer or employee thereof, or a person who used to be such a person must not divulge any secret that has come to their knowledge with regard to the affairs pertaining to the relevant entrustment without justifiable grounds.

In order to contribute to the appropriate implementation of affairs to support regional medical care, the national government is to provide necessary information and other forms of cooperation to prefectures.

The persons listed in the items of Article 30-23, paragraph (1) (excluding item (iii)) and medical care professionals are to endeavor to cooperate in the implementation of particulars agreed upon and other particulars concerning the securing of medical care required in relevant prefectures. They must also, when cooperation is requested in accordance with the provisions of Article 30-24, respond to the relevant request and endeavor to cooperate in ensuring the availability of physicians.

Public medical institutions (hospitals or clinics established by a prefecture, municipality or other party as prescribed by the Minister of Health, Labour and Welfare; the same applies hereinafter in this Section) are to endeavor to cooperate in the implementation of particulars agreed upon and other particulars concerning the securing of medical care required in relevant prefectures. They must also, when cooperation is requested in accordance with the provisions of Article 30-24, respond to the relevant request and cooperate in ensuring the availability of physicians.

If the Minister of Health, Labour and Welfare finds it specifically necessary for the dissemination of medical care, may order the parties provided for in Article 31 to establish a public medical institution.

In the case referred to in the preceding paragraph, the national treasury is to subsidize part of the costs required for the relevant establishment, within the extent determined by the budget.

The Minister of Health, Labour and Welfare or a prefectural governor may order the establisher or administrator of a public medical institution to undertake the following particulars:

allow the use of all or parts of the buildings, equipment, instruments, and tools for the practice and research of physicians and dentists who do not work at the relevant public medical institution, provided that this is not a hindrance to the medical care services of the relevant hospital or clinic;

provide the necessary conditions for practical training pursuant to Article 11, paragraph (1), item (ii) of the Medical Practitioners' Act or Article 11, paragraph (1), item (ii) of the Dental Practitioners Act, or for clinical training pursuant to Article 16-2, paragraph (1) of the Medical Practitioners' Act or Article 16-2, paragraph (1) of the Dental Practitioners Act; and

undertake necessary measures to ensure medical care in relation to activities to ensure emergency medical care as prescribed by the medical care plan of the prefecture in which the relevant public medical institution is situated.

The Minister of Health, Labour and Welfare or a prefectural governor may instruct the establisher of a public medical institution as necessary on particulars concerning the operation thereof other than those listed in each item of the preceding paragraph.