## Overview

## Outline of the Act to Amend the Part of Medical Care Act to Ensure the Establishment of a System to Provide Quality Medical Care (revised in 2006)

In order to establish a system in which people's relief and trust in medical care is secured and quality medical care services are provided and in accordance with the "General Policies of Medical Care System Reform" compiled at a government-ruling party meeting on a medical care system reformation held on December 1, 2005, measures such as promotion of medical information provision to patients, promotion of a division of roles and cooperation through revision of the medical care plan system, and coping with the issue of the shortage of doctors in certain regions and clinical areas, etc. are implemented.

## I Outline

### 1. Promotion of information provision on medical care to patients, etc

Provide patients, etc. with support to obtain information on medical care and thus make the appropriate choice.

○ Establish a system in which prefectures collect information on medical care institutions, etc., make that information available to the public in an understandable manner, and provide appropriate consultation to residents [Medical Care Act, Pharmaceutical Affairs Act]

○ Provision of documented information on medical care, etc. at the beginning/end of hospitalization

○ Expansion of matters that can be advertised with the revision of advertisement regulations [Medical care Act, for above]

### 2. Promotion of a division of roles and coordination of medical functions through medical care plan system revision, etc

Revise the medical care plan system in promoting a division of roles and coordination through establishment of critical community coordination paths, etc. so as to provide continued medical care.

Improve in-home care to support returning home early.

O Establishment of a concrete medical coordination system for individual projects, including cerebral apoplexy, cancer, and pediatric emergency medical services, etc., within medical care plans

Clear indication of understandable guidelines and numeric goals in medical care plans for enabling follow-up assessment [Medical Care Act, for above]

O Establishment of regulations for promoting in-home medical care, including adjustments made when leaving hospital [Medical Care Act, Pharmaceutical Affairs Act]

### 3. Responding to issues of the shortage of doctors in certain regions and clinical areas

Improve measures to secure doctors and other medical professionals to respond to the shortage of doctors in certain regions, including remote areas, and certain clinical areas such as pediatrics and obstetrics, etc.

O Establishment of prefectural “medical care councils” to promote measures through discussions held between relevant entities

O Provide cooperative support for medical professionals in securing regional medical care [Medical Care Act, for above]

### 4. Securing Medical Safety

O Establishment of medical safety support centers and obligation to establish a system for securing medical safety [Medical Care Act]

O Obligation of re-education for administratively punished doctors, dentists, pharmacists, and nurses and revision of the types of administrative punishments, etc. available [Medical Practitioners Act, Dental Practitioners Act, Pharmacists Act, Act on Public Health Nurses, Midwives and Nurses]

### 5. Quality improvement of medical professionals

Obligation of re-education for administratively punished doctors (aforementioned)

O Establishment of a new provision for exclusive qualified name in addition to the existing provisions for exclusive qualified services with regard to nurse and midwife services, etc. [Act on Public Health Nurses, Midwives and Nurses]

Inclusion of foreign nurse, emergency life guards technician, etc. as subjects to the advanced clinical training system [Act on Advanced Clinical Training of Foreign Medical Practitioners, etc.]

### 6. Reform of medical corporation system

Aim for improved transparency and efficiency in medical management.

Create a medical corporation system to take care of areas that were previously handled by public hospitals, etc.

Improved non-profitability by limiting the ownership of residual assets in the event of dissolution

Creation of a new type of medical corporation (“social medical corporation”) for providing medical services in remote areas and emergency medical services for children as stipulated in the medical care plans, etc [Medical Care Act, for above]

### 7. Others

Revision of the purpose and structure of the entire current Medical Care Act, which has the characteristic of being more like a facility regulation law, so that it becomes more of a law for respecting patients' views

Revision of the regulations on clinics with beds and other required revisions [Medical Care Act, as above]

## I I Date of Enforcement

● Basically on April 1, 2007

* January 1, 2007 for revision on clinics with beds

$ ^{*} $ April 1, 2008 for obligation of re-education for pharmacists and nurses, etc. and revision of the types of administrative punishments, etc.