①The prefecture is to establish a place of consultation for consultation with organizations of academic experts on medical treatment, other medical experts, medical insurers, and other related parties (hereinafter referred to as "related parties" in this paragraph and the following paragraph) in each of the areas set forth in Article 30-4, paragraph (2), item (xiv) and other areas that the governor of the relevant prefecture deems appropriate (hereinafter referred to as the "target area" in this Article), and, in cooperation with related parties, is to hold consultations on the following particulars (with regard to the particulars listed in items (iii), (v) and (vi), limited to those related to securing the medical care delivery system for outpatient medical care; the same applies in paragraph (5)), and summarize and publicize the results thereof:

②When related parties are requested by the prefecture to participate in a consultation conducted by the prefecture pursuant to the provisions of the preceding paragraph, they are to endeavor to cooperate by participating in it, and must also endeavor to cooperate in the implementation of particulars which related parties have agreed upon at the place of such consultation.

③When a prefecture consults on the particulars listed in item (iv) of paragraph (1) (limited to particulars specified by Order of the Ministry of Health, Labour and Welfare as concerning long-term care and other services closely related to medical care) pursuant to the provisions of that paragraph, it is to request the participation of the municipalities concerned and take into consideration the contents of the municipal plan prescribed in Article 5, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities, the Municipal Insured Long-Term Care Service Plan prescribed in Article 117, paragraph (1) of the Long-Term Care Insurance Act, and other plans concerning services closely related to medical care, that the municipalities have prepared.

④When a prefecture consults on the particulars listed in item (iv) of paragraph (1) pursuant to the provisions of that paragraph, it is to pay attention to the status of implementation of measures for promoting the maintenance of the health of residents in the target area, the status of implementation of health projects for elderly people (meaning the health projects for elderly people prescribed in Article 125, paragraph (1) of the Act on Assurance of Medical Care for Elderly People) and other projects carried out integrally with them, and the status of efforts toward constructing the community-based integrated care system (meaning the community-based integrated care system prescribed in Article 2, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities; the same applies in Article 70, paragraph (1), item (ii) and Article 70-7).

⑤When the target area coincides with the vision area, etc., the prefecture, in lieu of the consultation set forth in paragraph (1) in the relevant target area, may hold consultations on the particulars listed in the items of the same paragraph at the place of consultation in the relevant vision area, etc.

⑥In the case prescribed in the preceding paragraph, related parties as prescribed in Article 30-14, paragraph (1), when requested by the prefecture to participate in a consultation conducted by the prefecture pursuant to the provisions of the preceding paragraph, are to endeavor to cooperate by participating in it, and must also endeavor to cooperate in the implementation of particulars which related parties have agreed upon at the place of such consultation.

①Where, among the areas prescribed in Article 30-4, paragraph (2), item (xiv), there is an area in which the rate calculated, as provided by Order of the Ministry of Health, Labour and Welfare, as corresponding to the ratio of the number of physicians providing outpatient medical care to the number of out-patients, or other indicators specified by Order of the Ministry of Health, Labour and Welfare, exceed the standards specified by Order of the Ministry of Health, Labour and Welfare, and the prefectural governor finds that, among such areas, there is an area where it is particularly necessary to secure regional outpatient medical care, the prefectural governor is to designate that area.

②When a prefectural governor has made the designation under the preceding paragraph, the governor must give public notice to that effect, as provided by Order of the Ministry of Health, Labour and Welfare.

③A person who intends to establish a clinic (limited to a place where medical practice is conducted and which does not have facilities for admitting patients) in an area designated under paragraph (1) must, except in cases specified by Order of the Ministry of Health, Labour and Welfare as unavoidable, notify the prefectural governor, no later than six months before the date on which the clinic is to be established, as provided by Order of the Ministry of Health, Labour and Welfare, of their intention regarding the provision of regional outpatient medical care in that area and other matters specified by Order of the Ministry of Health, Labour and Welfare.

④When, in an area designated under paragraph (1), a person who has given the notification under the preceding paragraph or another person specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as a "notifying person, etc." in this Article) has indicated an intention not to provide regional outpatient medical care in that area, the prefectural governor may request the notifying person, etc. to participate in the consultation at the place of consultation prescribed in paragraph (1) of the preceding Article and to explain the reasons for not providing it and other matters specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as "reasons, etc." in this Article).

⑤A notifying person, etc. who is requested by the prefectural governor pursuant to the provisions of the preceding paragraph must endeavor to participate in the consultation at that place and explain the reasons, etc.

⑥If, based on the content of the explanation under the preceding paragraph, the reasons, etc. are not found to be unavoidable, the prefectural governor may request the notifying person, etc. to provide regional outpatient medical care in that area by a set deadline.

⑦When the prefectural governor finds that the establisher or administrator of a clinic established by a notifying person, etc. who received a request under the provisions of the preceding paragraph is not providing the regional outpatient medical care to which the request relates, the governor may request the establisher or administrator to attend a meeting of the Prefectural Council on Medical Service Facilities and explain the reasons, etc.

⑧The establisher or administrator of the clinic, when requested by the prefectural governor pursuant to the provisions of the preceding paragraph, must endeavor to attend a meeting of the Prefectural Council on Medical Service Facilities and explain the reasons, etc.

⑨Based on the content of the explanation under the preceding paragraph, if the reasons, etc. are not found to be unavoidable, the prefectural governor may, after hearing the opinions of the Prefectural Council on Medical Service Facilities, recommend that the establisher or administrator of the clinic provide regional outpatient medical care in that area.

⑩When a prefectural governor has made a recommendation under the preceding paragraph and the establisher or administrator of the clinic that received the recommendation has not complied with it, the governor may make public that fact.

⑪When a notifying person, etc. who received a request under the provisions of paragraph (6) has not complied with it, when the prefectural governor has made a recommendation under the provisions of paragraph (9), or when the establisher or administrator of the clinic that received the recommendation has not complied with it, the prefectural governor is to notify the Minister of Health, Labour and Welfare to that effect.

The administrator of a hospital or clinic must endeavor to take measures to improve the working environment of medical care professionals working in the relevant hospital or clinic and other measures that contribute to ensuring the availability of medical care professionals.

The Minister of Health, Labour and Welfare is to establish and publicize particulars that should serve as guidelines for the appropriate and effective implementation of measures to be taken by administrators of hospitals and clinics in accordance with the provisions of the preceding Article.

①The prefecture is to endeavor to implement the following particulars in order to promote the improvement of the working environment of medical care professionals:

②The prefecture may entrust all or part of the affairs listed in the items of the preceding paragraph to a person specified by an Order of the Ministry of Health, Labour and Welfare.

③A person entrusted pursuant to the provisions of the preceding paragraph, when implementing the affairs listed in each item of paragraph (1) or the particulars pertaining to the relevant entrustment, is to pay special attention to the following particulars:

④The prefecture or a person entrusted pursuant to the provisions of paragraph (2), when implementing the affairs listed in each item of paragraph (1) or the affairs pertaining to the relevant entrustment, must mutually cooperate with a person who implements the affairs to support regional medical care prescribed in Article 30-25, paragraph (3) or the affairs pertaining to the entrustment set forth in the same paragraph.

⑤A person entrusted pursuant to the provisions of paragraph (2), 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 concerning the affairs pertaining to the relevant entrustment without justifiable grounds.