Service guide (English) Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare of Japan For people, for life, for the future Live with safety and security Work with a purpose in life Support each citizen’s life For people, for life, for the future The Ministry of Health, Labour and Welfare addresses various challenges so that each citizen can live a fulfilling life through their lifetime. As the country with the highest life expectancy in the world, Japan should create a world-class model of the society with declining birthrate and aging population. The Ministry aims to create a country in which both men and women can continue working to any age if they wish, raise children with peace of mind, and live a healthy, longer life in their community. We believe that the happiness of each citizen will invigorate Japan in the future. To achieve this, the Ministry of Health, Labour and Welfare will provide detailed support for people’s lives. Profile Bureaus and Departments Review of Fiscal 2011 Organization Chart 老 健 局 Ministry of Health, Labour and Welfare 3 4 Ministry of Health, Labour and Welfare Supporting Various Scenes in Life Health, labour, and welfare administration is directly concerned with people’s lives. The Ministry of Health, Labour and Welfare supports life at every stage of your birth, your own life, and the generation transition. Health, labour, and welfare administration is for the lifelong security of the people in Japan. Food safety Social welfare and relief assistance Insurance systems Support for persons with disabilities Medical care and drugs Promotion of health Support throughout life • Maternal and child health (medical care for premature infants) • Health checkups for infants • Measures for fertility treatment • Vaccination • Provision of various health services • Provision of child allowances • Prevention of child abuse • After-school children’s clubs • Maternity and childcare leaves • Support for life with a balance between work and family • Health checkups for pregnant women and issuance of maternal and child health handbooks • Support for re-employment • Securing employment of people until they become 65 years old using their knowledge and experience • Promotion of various employment styles and people’s participation in society • Provision of pension benefits • Provision of long-term care services using the long-term care insurance system • Ensuring appropriate working conditions • Development of a safe and healthy working environment • Compensation of industrial accidents • Lifestyles with a good work-life balance • Job-placement support for the unemployed • Support for career development • Securing equal employment opportunity for men and women • Employment measures for young people • Obligation to join the pension system Infants Children Marriage and childbirth Retirement Students Adults Post-retirement Ministry of Health, Labour and WelfareMinistry of Health, Labour and Welfare 5 6 Services of the Ministry of Health, Labour and Welfare (Abstract) The Ministry of Health, Labour and Welfare designs and implements social systems and structures that are closely related to people’s lives throughout their lifetime and entire life cycle. The Ministry of Health, Labour and Welfare covers a wide range of areas from medical care to employment and childcare support and each bureau/department of the Ministry serves “for people, for life, and for the future” on a daily basis. Services of the Ministry of Health, Labour and Welfare (Abstract) Protecting people’s lives Developing a safe working environment Supporting people’s daily lives Minister’s Secretariat Director-General for Policy Planning and Evaluation Equal Employment, Children and Families Bureau Health Insurance Bureau Social Welfare and War Victims’ Relief Bureau Health Policy Bureau Health Service Bureau Pharmaceutical and Food Safety Bureau Labour Standards Bureau Human Resources Development Bureau Employment Security Bureau Pension Bureau Health and Welfare Bureau for the Elderly Infants Infants Life Life Life Life Life Life Children Adults Adults Adults Adults Students Retirement Marriage and childbirth Post-retirement Post-retirement MinistryofHealth,LabourandWelfare MinistryofHealth,LabourandWelfare 7 8 International development of the health, labour, and welfare administration Bureaus and Departments Bureaus and Departments Minister’s Secretariat The helm of the Ministry of Health, Labour and Welfare The Minister’s Secretariat integrates health, labour, and welfare administration and coordinates general affairs including the establishment, revision, and abolishment of laws and regulations, budget compilation, organization and personnel management, etc. The Minister’s Secretariat also plays a role as the representative and liaison of the entire Ministry concerning the Diet, other government ministries and agencies, mass media, and the public. Review of law and regulation drafts Administrative activities are conducted based on laws and regulations. Establishment of laws and regulations (legislation, cabinet orders, ministerial orders, etc.) is therefore essential in order to put planned policies into effect. The Minister’s Secretariat reviews laws and regulations, which were made by bureaus and departments within the Ministry, to check whether policies are prescribed logically and clearly in the letter. Budget Management and supervision of regional bureaus Dissemination of health, labour, and welfare administration to the world  In recent years, the trend in the international community has become linked to domestic policies in many areas of health, labour, and welfare administration. The International Affairs Division, the Minister’s Secretariat, is involved in the international development of the health, labour, and welfare administration through international organization activities, international economic negotiations, policy dialogues with developed and other Asian countries, technical cooperation with developing countries, and amassing overseas information, etc. The expenditure budget of general account of the Ministry of Health, Labour and Welfare in fiscal 2012 is approximately 26.7 trillion yen (in addition, approximately 2.5 trillion yen of government bonds for pension funds). The budget is estimated based on the amount needed for social security including medical care, pension, long-term care, employment, and welfare, which are closely related to various scenes of people’s lives. Among Japan’s entire general account budget in fiscal 2012 (approximately 90.3 trillion yen), general expenditures (policy expenditures excluding debt servicing costs and local allocation tax grants) are approximately 51.2 trillion yen. The Ministry’s budget in the total general expenditures accounts for 52.1%, which is increasing year by year. Policymaking of the Ministry of Health, Labour and Welfare therefore has a significant effect on the budget compilation of the entire government. The social security-related expenditures for medical care, pension, and long-term care are expected to increase in conjunction with the growth of aging population. In order to implement necessary measures in an efficient and effective manner, the Minister’s Secretariat reviews the necessity of budget, etc. for each project and compiles the budget of the Ministry of Health, Labour and Welfare. Personnel Division Finance Division International Affairs Division General Coordination Division Regional Bureau Administration Division Health Sciences Division Regional bureaus of the Ministry of Health, Labour and Welfare include Prefectural Labour Bureaus (Labour Standards Inspection Offices, Hello Works, and Equal Employment Offices) in 47 prefectures and Regional Bureaus of Health and Welfare (branch offices) in 8 prefectures. The Prefectural Labour Bureaus implements labour standards, and secures employment security and equal employment administrations in a comprehensive and community-based manner as regionally based general labour administration agencies. Meanwhile the Regional Bureaus of Health and Welfare play the role of ensuring the safety and security of people’s daily lives, improving their welfare, and maintaining and appropriately implementing the social security systems, which includes providing guidance to and inspecting insurance based medical institutions, supervision of health insurance societies and employees’ pension funds, and various health and welfare related approvals and authorizations, etc., in locations that are close to citizens. In addition, the bureaus are also responsible for the regulation of narcotics and stimulants. The Regional Bureau Administration Division manages the budget and the number of personnel of these regional bureaus and provides comprehensive supervision with respect to their compliance with laws and ordinances, etc. The number of individual disputes (over dismissal, conversion of work-position, wage cuts, bullying, etc.) between employees and employers (individual labour-related disputes) has been increasing in recent years, as economic situation changes. In order to promote the resolution of these disputes, the Act on Promoting the Resolution of Individual Labour-Related Disputes was established. The following services are provided to promote the prompt and appropriate resolution of disputes: (1) provision of information and counseling at 300 General Counseling Corners nationwide, (2) provision of advice and guidance by the chief of the Prefectural Labour Bureau, and (3) mediation by Dispute Coordinating Committees. International Affairs Division In order to maintain people’s health and stability in their lives the Ministry of Health, Labour and Welfare actively takes part in negotiations with international organizations that include the World Health Organization (WHO) and International Labour Organization (ILO) as well as being involved in bilateral discussions.  Many countries are facing an unprecedented declining birthrate and aging population. The Ministry of Health, Labour and Welfare is in charge of medical care, pension and long-term care administration and is therefore responsible for addressing this issue by sharing ideas concerning the direction of policies and system planning with other countries in the world.  Moreover, there are increasing opportunities in which Japan should contribute to the improvement of the welfare of the world using its experiences in the areas of social security and employment. Japan is required to transmit information and contribute to the world including developing countries using its technology and know-how. Building a sense of “security” in people’s lives is a common major goal of the world.  In this context, there have been a dramatically increasing number of opportunities for international talks and cooperation as well as cooperation activities for developing countries, in which the Ministry of Health, Labour and Welfare should participate. China-Japan-Korea Ministerial Meeting on Health (China, November 13, 2011) Through various channels The Ministry of Health, Labour and Welfare manages international affairs through various channels. The main affairs include the participation in activities such as taking measures for infectious diseases and food safety (by WHO), setting up and monitoring decent work (work worth doing with human dignity) and international labour standards (in cooperation with ILO), and comparison and analysis of systems (by the Organisation for Economic Co-operation and Development (OECD)). It is important to use the great power of such international organizations to create a trend in the world. Hard negotiations are taking place toward Economic Partnership Agreements (EPAs) in the area of health, labour, and welfare administration including the “movement of natural persons” (nurses, certified care workers, etc.). For Japan’s national interests, the Ministry is also engaging in bilateral talks with Western and Asian countries including China, which involve issues concerning regulations in the areas of drug and food.  Besides this, the Ministry supports the development of personnel and systems in developing countries in the areas of health and medical care, social welfare, labour, and waterworks by dispatching experts from Japan and accepting trainees from these countries.  In order to implement such various international policies, the Ministry of Health, Labour and Welfare dispatches officials to international organizations, Japanese diplomatic offices, etc. in over 20 countries, who are active on the diplomatic front. The knowledge and experience of the Ministry of Health, Labour and Welfare are now linked to overseas countries and Japan’s health, labour, and welfare administration should be disseminated to the world. International Labour Conference (June 2011) © International Labour Organization Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare 9 10 Bureaus and Departments Minister’s Secretariat Bureaus and Departments Health Sciences Division Promotion of health and labour science and responses to people’s health risks The responsibilities of the Ministry of Health, Labour and Welfare are to promote and disseminate science and technology in the area of health, labour, and welfare in order to ensure good health and high quality of life with safety and comfort, and to safeguard people’s daily lives by promptly taking measures against the threats to people’s health. In order to accomplish these missions, the Ministry of Health, Labour and Welfare conducts overall planning and coordination of science and technology matters within the Ministry. Various administrative policies implemented by the Ministry of Health, Labour and Welfare, including health and medical care, welfare, environmental health, and industrial safety and health, should be based on scientific basis. By promoting research on health, labour, and welfare administration, the Ministry supports health, labour, and welfare administration in a theoretical and scientific manner in order to develop appropriate rules. In particular, the development of technologies in health area such as medical care and long-term care is expected to be one of the main pillars that support the nation’s economic growth. The Ministry aims to raise the level of technology by promoting research activities in order to improve people’s health. The Ministry of Health, Labour and Welfare promotes health and labour science in order to eliminate concerns about health and safety and ensure the good health and quality of life of the people in safety and comfort and according to their diverse needs. More concretely, the measures include the following main pillars: ■ Reconstruction/recovery and improvement of safety from disasters ■ Life innovations (described below) ■ Responses to other important matters, including the development of therapeutic drugs for intractable diseases and hepatitis B, etc. In addition, the Ministry also formulates various guidelines to be followed by researchers as ethical guidelines when conducting human genome/genetic analysis and epidemiologic studies, etc. Health, labour, and welfare administration and science Promotion of health and labour science Promotion of life innovations Health emergency preparedness and response In consideration of the New Growth Strategy and comprehensive social security and tax the Ministry of Health, Labour and Welfare promotes the development and practical application of therapies, etc. and international-level clinical research for diseases with high needs, including intractable diseases and cancer. Through these efforts the Ministry promotes life innovations that also aim to achieve economic growth through the establishment of a longevity society with a healthy population and the strengthening of global competitiveness by the creation of innovative drugs and medical devices, etc. It is impossible to predict the occurrence of risks that threaten people’s lives and health such as new infectious diseases including pandemic influenza and large-scale health hazards caused by drinking water and food. In order to take every possible measure to address these risks, the Health Sciences Division conducts the management and coordination of the system for initial responses of the Ministry of Health, Labour and Welfare regarding the prevention, precaution of the spread, and medical treatment of health hazards.  After the occurrence of the Fukushima Daiichi Nuclear Power Plant accident in 2011 the Health Sciences Division conducted the management and coordination of the system used in the various initial responses of the Ministry.  List of recent domestic incidents concerning health risk management 1995 1996 1998 1999 2000 2001 2002 2004 2005: April 2007: July 2008 2009 2011: March Statistics and Information Department Statistics and IT that support health, labour, and welfare administration The Statistics and Information Department implements key statistical surveys on demographics, households, health, social welfare, employment, wages, and working hours, etc. that form the basis of the health, labour, and welfare administration. The Ministry is also promoting the informatization of their administration through IT (information and communication technologies) utilization in order to improve its convenience for the people and to simplify, speedup, and improve the accuracy of administrative operations, etc. Statistics are important for people Promotion of e-Government Public statistics developed by administrative agencies are deemed as “important information that is a basis of rational decision-making for people.” They are used as important indices that support rational decision-making by business entities and individuals in relation to economic actions and the society and as basic materials for policy evaluation. These statistics are also essential for academic research and mutual understanding in the international community. Public statistics can be used not only for individual administration purpose but for a wide variety of entities in the society in an effective way. To achieve this, the “Basic Plan Concerning the Development of Official Statistics” was formulated, and the whole government is making a structured approach for the improvement of statistics in a comprehensive and systematic manner. The Statistics and Information Department has the central role in managing statistical issues in the Ministry of Health, Labour and Welfare, and conducts statistical surveys including seven fundamental statistics that are defined especially important in planning and implementing policies and approximately 30 other statistical surveys (approx. 100 statistical surveys are conducted in the Ministry of Health, Labour and Welfare). All of these statistics are the basic materials of health, labour, and welfare administration. The Department is also making efforts to meet new statistical demands, which includes commissioning statistics production and provision of anonymous data that is obtained by processing individual data to prevent it from being identified. IT utilization by administrations is essential nowadays in improving people’s convenience and making administrative work more efficient. The entire government aims at the realization of being a top international level electronic administrative nation based on the “Basic Policy on the Promotion of e-Government” and the “Action Plan for Expanding On-Line Use.” This, however, requires the establishment and operation of efficient and safe information systems. In order to promote the informatization of administrations within the Ministry of Health, Labour and Welfare the Statistics and Information Department is responsible for the general coordination within the Ministry with respect to the informatization of administrative matters, and the planning and development of the necessary information systems. The department contributes to improving the quality of the online applications/notifications used in the social insurance and labour insurance procedures, promoting the optimization of work and systems in thereby ensuring the efficiency of the time and cost of work processes within the existing systems of the Ministry, and implementing information security measures within the Ministry. The department also establishes and operates internal LAN systems used to share and exchange information within the Ministry, along with the information systems that are the basis of information being provided and applications/notifications accepted through an integrated network which is connected with regional bureaus and the internet. The Great Hanshin Awaji Earthquake; Tokyo subway sarin attack O-157 food poisoning in Sakai City, Osaka Curry poisoning incident in Wakayama City Tokaimura Nuclear Accident Eruption of Mt. Usu; Food poisoning of dairy products by Snow Brand Milk Products; Eruption of Miyakejima volcano Akashi fireworks incident, Hyogo Outbreak of severe acute respiratory syndrome (SARS) Powerful typhoon (typhoon No. 23); Niigata Chuetsu Earthquake; Sugihiratake mushroom encephalopathy JR Fukuchiyama Line Amagasaki Rail Crash Niigata Chuetsu-oki Earthquake Poison dumplings from China, etc. Pandemic Influenza (A/H1N1) Great East Japan Earthquake; Fukushima Daiichi Nuclear Power Plant accident Policy Planning Division Employment, Wage and Labour Welfare Statistics Division Vital, Health and Social Statistics Division Information System Division Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare 11 12 老 健 局 Key Word Bureaus and Departments Bureaus and Departments Health Policy Bureau For the provision of safe and high-quality medical services With its universal health insurance system and free access, the medical care provision system in Japan has enabled Japan’s average life expectancy to reach the highest level in the world, and the system has received high acclaim for it. On the other hand, circumstances surrounding medical care have been changing significantly such as the rapid progress of the declining birthrate and aging population, the advance- ment of medical technology and changes in people’s aware- ness about medical care. As a result, rebuilding a medical care provision system has become the key issue. General Affairs Division Life Rebuilding the medical care provision system When compared with other major developed countries the medical care provision system in Japan can be characterized by the large per capita number of beds and the long average number of days of hospital stays. In order to facilitate the smooth discharge and return to home of patients after hospitalization and provide support for their recovery stage with limited medical resources the reinforcement and division of hospital and hospital bed functions needs to be promoted. With the aim of rebuilding the medical care provision system, the Health Policy Bureau is the promoting division of hospitals and hospital bed functions via medical fees and is securing a system that can provide the necessary medical care in a seamless manner throughout regions based on a “Medical Care Plan” formulated by the respective prefecture and according to the actual regional situation. Responses to the shortage of doctors As for the problem concerning the shortage of doctors, it is pointed out that besides the shortage in the absolute numbers, the number of doctors in mountainous and rural areas is less than that in urban areas, and the number of emergency physicians, obstetricians/gynecologists, and pediatricians is less than that of doctors in other departments. In response, the Health Policy Bureau has been taking measures to secure doctors through increasing the enrollment of medical university every school year since fiscal 2007 (and in fiscal 2012 to a record high level). In addition, the Bureau provides financial incentive to doctors who receive clinical resident training in remote areas, and for benefits to emergency physicians, obstetricians etc. Moreover, the Bureau promotes further measures including support for the establishment of “regional medical care support centers” that can be a “control tower” for the efforts of prefectures to balance the number of doctors in each region. Establishment of Emergency/Perinatal Care Systems As a result of the increase in the number of people who are taken to hospital by ambulance and the shortage of doctors due to overworking, there have been cases where it took a long time to find a hospital that could accept patients and expectant mothers during ambulance transport. This has become a social problem and has raised concerns about emergency/perinatal care systems. Under these circumstances, the Health Policy Bureau aims to improve emergency/perinatal care systems, firstly, by providing financial support to emergency medical centers that accept severely ill patients around the clock and comprehensive perinatal maternal medical centers that are the center of perinatal care. Secondly, the bureau established a nighttime telephone counseling system in which parents of pediatric patients can consult with local pediatricians in order to supplement the pediatric emergency care system. The Bureau is also working to expand the use of “doctor helicopters” that send doctors to rural areas and remote islands to provide treatment at early stage. Activities of medical teams in the disaster-stricken areas of the Great East Japan Earthquake Promotion of team medical care In order to improve the quality and efficiency of medical care, the Health Policy Bureau is working to disseminate the concept of “team medical care” in which medical professionals such as doctors, pharmacists, nurses, etc. increase their expertise and provide medical care while dividing the work and mutually cooperating/complementing each other. The Bureau is also working to improve the work environment at medical sites for supporting the medical professionals who are at the front line of medical care. In addition, the Bureau is implementing a “clinical training system” in which doctors are trained for two years after receiving medical licenses to acquire basic clinical skills over a wide range of areas. In accordance with the “Act on Advancement of Dental and Oral Health” that was approved in 2011, the Bureau is working in the area of dental health medical care by enhancing health checkups and providing healthcare guidance through the “8020 campaign,” which aims at people retaining at least 20 teeth by the age 80, etc., and promoting in-home dental based on care medical cooperation. Promotion of team medical care based on multi-occupational cooperation Promotion of the pharmaceutical industry and research and development Pharmaceutical product and medical device industries are expected to play a leading role in the economic growth of Japan. In order to promote “medical innovations” that lead to the creation of innovative pharmaceutical products and medical devices originating in Japan, the Health Policy Bureau is working to promote research and development and vitalize clinical trials through providing concentrated funding for research expenses and the establishment of hospitals as centers for clinical trials and research. It also implements industrial policies in order to increase market size with international appeal and strengthen Japan’s international competitive power of pharmaceutical product and medical device industries. This is aimed at providing people with high quality pharmaceutical products at reasonable prices. Promotion of medical policies National Centers for Advanced and Specialized Medical Care are being established as core institutions for developing and disseminating advanced and pioneering medical care, clarifying causes and symptoms, developing and researching new diagnosis and treatment methods, training for specialized medical professionals, and providing information in a comprehensive and unified manner on diseases for which finding cures has been a national issue, including cancer, cerebral apoplexy, and heart diseases. The National Hospital Organization aims to provide medical care, promote clinical studies, and provide training to medical professionals, and has one of the best hospital networks in Japan that consists of approximately 60,000 beds and approximately 50,000 medical professionals. Advanced and pioneering medical care has been studied and provided at the national level in cooperation with these institutions. National Cancer Center Over 60% of citizens wish to reach the end of their lives in their own homes, but in actuality 80% die in hospitals. Promoting in-home/long-term care has been an urgent issue in responding to the wishes of the people and securing places for their recuperation and when reaching the end of their lives. The Ministry of Health, Labour and Welfare designated fiscal 2012 as “In-Home/Long-Term Care 2012” and supports efforts made in developing human resources that can provide high quality services, establishes bases for cooperation between medical and long-term care, and various studies, etc. which will enable people to receive the necessary medical/long-term care services in the places they live. In-Home/Long-Term Care 2012 Medical Professions Division Nursing Division Research and Development Division Guidance of Medical Service Division Dental Health Division Economic Affairs Division National Hospital Division Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare 13 14 介 紹 局 部 老 健 局 Key Word Bureaus and Departments Bureaus and Departments Health Service Bureau For healthy and hygienic daily life In addition to taking care of one’s own health the development of social environments where people can live healthy lives is also important. The Health Service Bureau is working to ensure public health by making our lives more healthy and hygienic through health promotion, prevention and treatment of various diseases, improvement of environmental health, and the provision of safe water supply systems, etc. General Affairs Division Response to the Great East Japan Earthquake The occurrence of the Great East Japan Earthquake negatively affected the health of the disaster victims who were forced to live at evacuation shelters and due to a lack of nutrition and exercise and change in their living environments. This led to a concern over their reduced health levels. There was also the concern of the occurrence of infectious diseases. The water supply was cut off to approximately 2.3 million households. The burial/cremation of the remains of the many victims was also a major issue. The Health Service Bureau has been working to secure the health of the disaster victims and solve public health issues in the disaster-stricken areas while also supporting the reconstruction of the disaster-stricken areas immediately after the occurrence of the earthquake disaster up to the present time in cooperation with local governments and the relevant organizations nationwide, including securing the health of disaster victims via public health nurses and registered dietitians and supporting the restart of laundry businesses, etc. Efforts toward health promotion, measures against cancer/lifestyle-related diseases Approximately 60% of deaths in Japan are caused by lifestyle-related diseases including cancer, heart diseases, stroke, and diabetes, and it is extremely important to prevent these lifestyle-related diseases. The Health Service Bureau has therefore been promoting the “National Health Promotion Measures for the 21st Century (Health Japan 21),” which has had the set goal of improving people’s lifestyles, etc. since fiscal 2000. The Bureau is also working to prevent lifestyle-related diseases and improve people’s health by launching the National Campaign for Healthy Lifestyles, which focuses on “proper exercise,” “appropriate dietary habits,” and “smoking cessation,” in fiscal 2008, along with the “Smart Life Project” in cooperation with companies and organizations in fiscal 2011. “Health Japan 21” will end in fiscal 2012, but a new National Health Promotion Measures is scheduled to be commenced in fiscal 2013. In recent years the effort to not only change the behavior of individuals but also to change society into an environment that is suitable for health promotion is considered important. The new National Health Promotion Measures will respond to issues from this point of view. In addition, recent surveys have revealed that members of low income households tend to skip breakfast, have the habit of doing no exercise, and habitually smoke. The new campaign is also expected to respond to these issues. Cancer is a disease that half of the population suffers from during their lifetime and of which 30% of them die. The Health Service Bureau is working to improve cancer medical care such as radiotherapy and chemotherapy, disseminate palliative care, promote a cancer registry, and raise the percentage of people having cancer screening, etc., being based on the “Basic Plan to Promote Cancer Control Programs” that was formulated in 2007. The next plan following the “Basic Plan to Promote Cancer Control Programs” is also scheduled to be decided by the Cabinet in the first half of 2012 which will prioritize cancer measures for the working generation and children. Measures against infectious diseases Infectious diseases significantly vary in their infectivity, route of infection, incubation period, symptoms, and the domestic and overseas situation with their spread. Certain cancers, such as cervical cancer, have been identified to be caused by viral infections. Based on the latest scientific knowledge, the Health Service Bureau is taking measures against these various infectious diseases, including monitoring the situation with infections, quarantine inspections, dissemination and education on preventative methods, vaccinations and health checkups, and the development of the appropriate medical system. The Bureau is taking measures against the spread of influenza every winter. It is also working on crisis management, including formulation of the national action plan, the stockpiling of antivirals, and the development of vaccine production system in anticipation of the occurrence of highly pathogenic pandemic influenza due to virus mutations. With regard to hepatitis, one of the major infectious diseases in Japan, the Bureau is promoting measures that include researching treatment methods, establishing an examination system, and subsidies for medical costs. It is also taking additional measures against various other infectious diseases, including tuberculosis, HIV/AIDS, measles, and human T-cell leukemia virus type 1 (HTLV-1). In addition to periodic polio and Japanese encephalitis, etc. inoculations implemented in accordance with the law the Bureau has established a project to promote three vaccinations for cervical cancer, Hemophilus influenza type b (Hib) and pneumococcus in fiscal 2010 while also reviewing the overall national vaccination system. Intractable disease measures, organ transplantation, and relief for atomic bomb survivors, etc. The Bureau is promoting comprehensive measures, including researching treatment methods, subsidies for medical costs, the establishment of a consultation system, and support for in-home care, etc. for diseases of uncertain causes (intractable diseases) and for which effective treatments have yet to have been established. From July 2010 a person’s organs can be provided to other patients once they have been diagnosed brain dead and even if a patient’s willingness to donate organs is uncertain provided a letter of approval is obtained from their family members. The number of organ transplantations has been increasing but the Bureau has been making the effort in its dissemination/education and appropriate implementation. It is also working to secure donors for Bone Marrow and Umbilical Cord Blood transplantations that can be effectively used to treat leukemia, etc. Special attention is being paid to the victims of the atomic bombs that were dropped on Hiroshima and Nagasaki and who are thus victims of the health hazard posed by radioactivity and hence are being provided with medical care benefits. Environmental health, water supply systems The Bureau is working to promote the operation and improve the hygiene of environmental health-related businesses that support the hygiene of people such as barbers, beauty salons, laundry shops, public bath houses, hotels, and inns. In the water supply system area, it is promoting the development of more earthquake-resistant and secure water supply systems nationwide, which is based on the lessons learned from the Great East Japan Earthquake. According to the “National Health and Nutrition Survey” conducted in November 2010, the percentage of habitual smokers was 19.5% (32.3% of males and 8.4% of females). It has steadily decreased from 27.7% (46.8% of males and 11.3% of females) in 2003 and has now fallen below 20% for the first time. In addition to the progress made in raising awareness of the negative health effects of smoking and prohibiting smoking in public facilities the increased tax on cigarettes, which the Ministry of Health, Labour and Welfare requested, which commenced in October 2010, is considered to have had an effect. According to the aforementioned survey of November 2010, the percentage of habitual smokers who wish to quit smoking was 37.6%. Assuming that all of them were to quit smoking the smoking rate would then decrease from approximately 19.5% to 12%. The Ministry of Health, Labour and Welfare is taking anti-tobacco measures such as smoking cessation so that those who want to quit smoking can do so. Smoking rate Specific Disease Control Division Environmental Health Division Cancer Measures and Health Promotion Division Tuberculosis and Infectious Diseases Control Division Water Supply Division LifeInfants Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare 15 16 介 紹 局 部 老 健 局 Bureaus and Departments Bureaus and Departments Pharmaceutical and Food Safety Bureau The Pharmaceutical and Food Safety Bureau sets consistent regulations from production to sales and post- marketing safety measures based on the “Pharmaceutical Affairs Act,” in order to ensure the efficacy and safety of drugs, medical devices, etc. The Bureau is also working on various issues that are directly linked to people’s lives and health, including blood projects such as blood donation, and measures against drug abuse. General Affairs Division Life Ensuring the efficacy and safety of drugs and medical devices Companies that manufacture/market drugs and medical devices are required to ensure the quality, efficacy, and safety of the products and obtain approval of the Minister of Health, Labour and Welfare. After products are released in the market, manufacturers and medical institutions are obliged to report adverse reactions to the government. There is a relief system for those who developed an adverse drug reaction. Pharmacies and drug stores need to acquire a license from a prefectural governor in order to sell drugs. From June 2009, a system started in which drugs are categorized according to the level of the risk, and products with a high risk are sold by pharmacists or registered salespersons who can provide proper information. At the same time, it is important to establish a system to deliver effective and safe drugs and medical devices to clinical settings in a timely manner. The Bureau is working to speed up application reviews in order to eliminate “drug lag” and “device lag,” which means it takes longer until products are approved in Japan compared to the United States and European countries. In these ways, it is necessary to set regulations that respond to changes in social and economic situations, international trends, and advancements in science and technology. The way medical administration should be is being questioned in order to prevent the reoccurrence of accidents such as drug-induced hepatitis. Protecting people’s lives and health through ensuring the efficacy and safety of drugs and medical devices Promotion of blood donation Blood products, produced from donated blood, are essential for medical treatment. Blood donation from people is crucial to secure the stable supply of these products to hospitals and medical facilities. In recent years, the Bureau has been actively promoting further support for blood donation especially from young people whose donations is declining. Measures against drug abuse Illicit drugs, such as narcotics, stimulants, and cannabis, have been abused in a high level in Japan. In response to this situation, the Bureau has taken several measures, including top-to-bottom investigation, promoting advocacy, in order to prevent drug abuse. Safety Division Blood and Blood Products Division Evaluation and Licensing Division Compliance and Narcotics Division Department of Food Safety Ensuring the safety of food that the people eat in their daily lives for protecting their health Food is an essential part of everyone’s daily life. The Department of Food Safety has thus been taking various measures to ensure food safety in order to protect people’s health. People’s interest in food makes it important that food safety measures are based on the latest scientific knowledge and that information is shared between the relevant parties, including consumers, manufacturers, and food-related business operators. Responses to radioactive materials in food After the Fukushima Daiichi Nuclear Power Plant accident the Department of Food Safety promptly established provisional safety limits as an emergency measure and has since been conducting monitoring inspections and imposing shipment restrictions in order to ensure no food that exceeds the safety limits gets distributed. The new standard values that were enforced in April 2012, which replaced the provisional safety limits, are set to be stricter than the provisional safety limits to ensure greater safety and security and with children also taken into consideration. The Department will continue to take all possible measures to eliminate people’s worries, including the prompt disclosure of inspection results, etc. Ensuring the safety of imported food Japan depends on approximately 60% of its food supply on imports. In consideration of the globalization of food distribution the Department aims to improve the monitoring system of imported food quarantine stations to ensure the safety of imported food. It is also working to improve the hygiene measures of exporters by requesting the pertinent countries to follow Japan’s hygiene regulations through bilateral talks and implementing on-site investigations when needed. In particular, the “Japan-China Food Safety Promotion Initiative” was formulated in 2010, thereby strengthening the partnership with China. Testing (sampling) at a quarantine station Responses to food poisoning In recent years, there has been growing concern that food poisoning damage could spread over wider areas due to the development of distribution systems, etc. In April 2011, five persons died as a result of an outbreak of food poisoning due to enterohemorrhagic Escherichia coli over wide areas at rotisseries in Toyama prefecture, etc. In order to respond to larger scale/wider area food poisoning, the Ministry of Health, Labour and Welfare is therefore cooperating with local governments with respect to the dissemination/education of the prevention, early detection, and prevention of damage from it spreading. Establishment of food and additive standards Food and additives that do not meet the standards for ingredients and production methods, etc. that are based on the Food Sanitation Act cannot be imported, produced, or sold. Limits on the amount of chemical and pollutant content (including that of pesticides) that are retained in food are also set as ingredient standards. These standards were established by the Minister of Health, Labour and Welfare after taking into account health effect assessments concerning food conducted by the Food Safety Commission. Risk communication In promoting food safety measures such as responses to radioactive materials, imported food safety measures, and BSE measures it is important to gain the understanding of both consumers and businesses in that these policies should be based on scientific knowledge and with a wide range of opinions taken into consideration. The Ministry of Health, Labour and Welfare is therefore promoting risk communication (interactive opinion exchanges and active information provision). Policy Planning and Communication Division Inspection and Safety Division Standards and Evaluation Division Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare 17 18 老 健 局 Key Word Bureaus and Departments Bureaus and Departments Labour Standards Bureau (Industrial Safety and Health Department, Worker’s Compensation Department) Adults For the protection of workers’ livelihoods, safety, and health The mission of the Labour Standards Bureau is to protect workers’ livelihoods, safety, and health as well as to ensure appropriate working conditions in which workers are able to work both securely and in comfort.The Department is also working to secure the safety and manage the health of workers engaging in the restoration/ reconstruction process after the Great East Japan Earthquake and the on-site decontamination and other work in dealing with the Fukushima Daiichi Nuclear Power Plant accident. Securing of minimum standards for labour conditions by labour standard inspectors The Labour Standard Inspection Offices across the nation receive many consultation requests about overworking, unpaid wages and dismissal from a number of workers and their family members. In Japan, minimum standards concerning working hours, wages, and industrial safety and health are set based on the Labour Standards Act, the Industrial Safety and Health Act, the Minimum Wages Act, etc. “Labour standards inspectors” are in charge of encouraging companies to follow these acts. They were assigned at the 325 Labour Standard Inspection Offices across Japan and provide inspection and guidance for businesses. If any violation is found, they request business owners to improve promptly. In case of a serious/vicious violation case, the inspectors conduct investigations and impose severe punishment “Dora Kohboku” Story by Junpei Orodani, Illustration by Saburo Ishikawa Appearing serially in the Big Comic published by Shogakukan such as sending the case to the Public Prosecutor’s Office. In order to realize working styles with a good work-life balance, the Department supports and promotes individual cooperative efforts of employers and employees for the reduction of working long hours and the encouragement of the use of annual paid leave. Dissemination and education of labour contracts, and reviewing the rules of fixed-term labour contracts Dismissals and worsening of labour conditions have a critical impact on workers’ lives. The Labour Contract Act was established with the aim of setting basic rules concerning labour contracts and preventing troubles between employees and employers. The Bureau is working to disseminate and educate these rules. Many non-regular workers (who account for one-third of all workers) are employed under fixed-term labour contracts. In actuality, however, the repeated renewal of their contracts has become ordinary practice. Issues do exist when they are compared to regular workers that include [1] unstable employment, [2] existence of disparities in terms of treatment, etc., and [3] insufficient vocational ability development. In order to respond to these issues and eliminate the worries of fixed-term contract workers so that they can continue to work both securely and in comfort, a bill to revise the Labour Contract Act was submitted to the Diet in March 2012 (as of April 2012).  Fixed-term labour contracts have been a common characteristic of the majority of non-regular workers Employers excluding officers (all companies): 51.11 million Regular workers: 33.55 million Non-regular workers (17.56 million) Contract/entrusted employees (3.30 million) Part-time workers (11.92 million) Dispatched workers (0.96 million) Others (1.37 million) Source: Ministry of Internal Affairs and Communications, “Labour Force Survey (Detailed Tabulation) (annual average)” (2010) * The number of fixed-term contract workers was estimated based on a “Labour Force Survey (Detailed Tabulation) (annual average)” of the Ministry of Internal Affairs and Communications and “2011 Survey of Fixed-Term Labour Contracts (Establishment Survey)” of the Ministry of Health, Labour and Welfare * Fixed-term contract workers (12.00 million) General Affairs Division Inspection Division Working Conditions Policy Division Workers’ Life Division Policy Planning Division Industrial Health Division Safety Division Chemical Hazards Control Division Workers' Compensation Administration Division Compensation Division Labour Insurance Contribution Levy Division Compensation Operation Division Industrial Safety and Health Department Workers’ Compensation Department Promotion of measures to prevent industrial accidents and efforts made in restoration/reconstruction after the earthquake disaster Although the number of industrial accidents has been decreasing in the long term, over 100,000 workers per year still suffer either an injury or illness that causes them to take four or more days off work, and over 1,000 people per year die. Aiming at creating a society with no industrial accidents, the Labour Standard Inspection Offices supervise companies for abatement of the violation, and encourage them to voluntarily implement Risk Assessment (investigation of exposure to hazard and reduction of risk). The Great East Japan Earthquake, subsequent tsunami, and the nuclear power plant accident resulted in an unprecedented amount of human/physical damage. Ensuring the safety and health of the workers that are still engaged in restoration/reconstruction work after the Great East Japan Earthquake, dealing with the Fukushima Daiichi Nuclear Power Plant accident on-site, and decontaminating the radioactive materials released from the nuclear power plant remain extremely important issues. The Labour Standards Bureau is putting in the utmost effort to ensure their complete safety and managing their health while reviewing the safety and health standards in thereby adapting to the ever-changing issues. Revision of the Industrial Safety and Health Act In recent years, the number of applications for workers’ accident compensation insurance has been increasing for mental disorders such as depression that are reportedly caused by stress at work, and thus measures concerning mental health in the workplace are becoming an important issue. A bill to revise the Industrial Safety and Health Act was therefore submitted to the Diet in December 2011 to respond to this issue and promote measures that will secure workers’ health (as of April 2012). Prompt and appropriate implementation of worker’s compensation The Worker’s Compensation Department provides benefits of Workers’ Accident Compensation Insurance to those who have had industrial accidents and their surviving family members (in case of deaths). In principle, workers’ accident compensation insurance mandatorily applies to all businesses that employ a worker or workers. Insurance benefits apply to all workers regardless of employment status. Insurance benefits are paid for injuries and illnesses caused due to work, with or without the company’s responsibility. There are increasing numbers of industrial accident (occupational disease) cases including mental disorders, which are difficult to judge whether the injury/illness was caused during work. The Bureau is making efforts to promptly respond to workers who have had industrial accidents by reviewing standards for approval based on experts’ knowledge, etc. The number of administrative consultations regarding bullying/harassment in the workplace, or so-called “power harassment,” has been increasing. “Power harassment” is said to result in various losses to a company, including lowering the workers’ motivation to work and negatively affecting the morale of people around and the workplace atmosphere itself. Power harassment typically involves those of higher status than their subordinates but sometimes also between individual workers. It also involves the rather difficult issues of how far a company should intervene in their relationships and what acts actually constitute “power harassment” in the first place. The ideal ways of dealing with these issues were therefore compiled into recommendations at a “round table conference,” whose members included employees, employers, and experts, and dissemination/education activities aimed at companies and labour unions then commenced. Surveys on the efforts of individual companies and further discussions will also take place in the future. Responses to “power harassment” (the issues of bullying/harassment in workplaces)  Within the number of consultations concerning civil, individual labour-related disputes, the percentage involving bullying/harassment has been increasing Number of consultations concerning civil, individual labour-related disputes [A] (left axis) Percentage of “bullying/harassment” to the number of consultations concerning civil, individual labour-related disputes [A] (right axis) 2002 2003 2004 2005 2006 2007 2008 2009 2010 Fiscal Number of consultations concerning civil, individual labour-related disputes [A] Percentage of “bullying/harassment” to the number of consultations concerning civil, individual labour-related disputes [A] * Based on the “Enforcement status of individual labour dispute resolution system in fiscal 2010” (Ministry of Health, Labour and Welfare, May 2011) [...]... employees and employers) and in which important labour policies are deliberated To resolve various labour- related disputes between employees and employers, the government set up a prefectural Labour Relations Commission in each prefecture and the Central Labour Relations Commission as an extra agency of the Ministry of Health, Labour and Welfare Hearing at the Labour Relations Commission Ministry of Health,. .. Wage and Labour Welfare Statistics Division, Information System Division Affiliated Institutions Regional Bureaus Quarantine stations Regional Bureaus of Health and Welfare Regional Bureaus of Health and Welfare were established by integrating the previous Regional Medical Affairs Offices and regional narcotic control offices in conjunction with the establishment of the Ministry of Health, Labour and Welfare. .. Prosecutors Office Joint Court Building Ministry of Internal Affairs and Communications Ministry of Foreign Affairs Bar Associations Building Kasumigaseki Station (Hibiya Line) Ministry of Land, Infrastructure, Transport and Tourism Iwaida Street Sakurada Street Ministry of Justice Hibiya Park Kasumigaseki Station (Marunouchi Line) Ministry of Health, Labour and Welfare (Central Government Building No.5) Ministry. .. etc ○ Number of supporters: 3,021,430 (as of December 31, 2011) * Total number of Mate Supporters: 3,091,354 (As of December 31, 2011) Fiscal 27 Ministry of Health, Labour and Welfare Ministry of Health, Labour and Welfare 28 Bureaus and Departments Health 局 老 健 Insurance Bureau Life Handing down the universal health insurance system to the next generation Japan adopts a universal health insurance... Health, Labour and Welfare (Central Government Building No.5) Ministry of Agriculture, Forestry and Fisheries East Entrance Kasumigaseki Station (Chiyoda Line) Ministry of Economy, Trade and Industry Small and Medium Enterprise Agency Ministry of Finance Japan Japan Post Holdings Building Ministry of Health, Labour and Welfare of Japan Service Guide Chuo Godo Chosha 5 go-kan, 1-2-2 Kasumigaseki, Chiyoda-ku,... Bureaus of Health and Welfare (8) Labour Standard Inspection Offices (325) Regional Labour Bureaus (47) Public Employment Security Offices (437) Central Labour Relations Commission Executive Division, First Adjustment Division, Second Adjustment Division, Third Office General Affairs Division, Examination Adjustment Division, General Examiner As of April 1, 2012 37 Ministry of Health, Labour and Welfare. .. skills Adults Ministry of Health, Labour and Welfare 22 Bureaus and Departments Equal 局 老 健Employment, Children and Families Bureau Realizing a society full of children's smiling faces and in which people can display their abilities regardless of their gender or working style The Equal Employment, Children and Families Bureau promotes equal opportunities between men and women and the creation of employment... example, totalization of the periods of coverage in Japan and those in other countries As of March 2012, Japan has fourteen such agreements in effect Appropriate management of pension-related services The series of public pension-related services has been managed by a non-government public corporation, the Japan Pension Service, but under the supervision of the Minister of Health, Labour and Welfare with the... adjustments with the respective bureaus and departments, and cooperate/coordinate with the relevant ministries and agencies The Director-General also provides dissemination, publicity and education of social security and the formulation and publication of Annual Health, Labour and Welfare Reports, etc Expenses of and contributions to the social security systems The amount of social security benefit payments,... normal life and with a sense of security within their community The purpose of the health, labour, and welfare administration is to create a society in which all people can live with a sense of security The Department of Health and Welfare for Persons with Disabilities aims to realize that type of society by supporting the lives of persons with disabilities Improving mental health and medical welfare is . childbirth Retirement Students Adults Post-retirement Ministry of Health, Labour and WelfareMinistry of Health, Labour and Welfare 5 6 Services of the Ministry of Health, Labour and Welfare (Abstract) The. and Welfare. Hearing at the Labour Relations Commission Ministry of Health, Labour and Welfare 35 36 Ministry of Health, Labour and Welfare 35 Ministry of