(1) Decentralization and welfare administration
The health and welfare services are particularly close related to the living of people and thus need to be elaborately provided in detail by the nearest municipality. They are at the same time essential in all phases of living and therefore it is necessary to assure the provision of more than a certain level of such services throughout the country. This leads to a necessity for promoting proper decentralization of administrative power so that local public entities can assume the provision of such services backed up by an effective support from prefectures and the Government. The Ministry of Health and Welfare has so far been making an active effort at the promotion of decentralization by establishing the system that allows a uniform provision in communities of in-home welfare services and maternal and child health services.
(2) Past movement regarding decentralization
The Government as a whole established the Decentralization Promotion Law in May of 1995 and started the Decentralization Promotion Committee in July of the same year. The committee has made surveys and deliberations on the basic matters regarding the promotion of decentralization and has also made five times of recommendations.
In December 1996, a recommendation was made that suggests the system for authorizing agencies be abolished under which the heads of local public entities were subject to the supervision of the Government. Recommended along with this were new clerical service areas (autonomous clerical services and clerical services by statutory commissioning) (The first recommendation). Recommendations made in July of 1997 included the improvement of clerical service sections, the review of the rules by which the Government obligates local public entities to establish administrative agencies and staff them with personnel with special qualifications, and the rationalization of state subsidy contributions (the second recommendation). The recommendation made in September of 1997 was about the review of the local officials system (the third recommendation). The recommendation made in October includes the further improvement of clerical service areas, the scheme for the settlement of disputes between the Government and local entities and authorization of powers, etc. (the fourth recommendation).
Another recommendation followed in November of 1998 about the desirable public works in response to the request made by the Prime Minister to the Decentralization Promotion Committee that urged further review of the authorization of power from the Government and local public entities (the fifth recommendation).
With the utmost respect for these recommendations made by the Decentralization Promotion Committee, the Government decided in its cabinet meeting the Decentralization Promotion Plans. The plan for the matters regarding the first through fourth recommendations was agreed in May of 1998 and that for the matters regarding the fifth recommendation was agreed in March of 1999. The Government embarked on taking statutory and financial actions necessary for the general promotion of measures for implementing decentralization.
As for the former plan, the Bill on the Improvement of Related Laws for Promoting Decentralization (temporary name) was submitted to the Diet in March of the same year.
Regarding the welfare administration, the improved autonomous clerical services include clerical works related to certification of medical corporations and permissions of sales, and clerical works related to the provision of health and welfare services which had so far been handled by local public entities (work by commissioning). On the other hand, the clerical work related to public assistance, aid to wounded and sick retired soldiers, and communicable diseases control are consolidated into the clerical work by statutory commissioning.
Table 7-5-1. Autonomous Clerical Works and Clerical Works by Statutory Commissioning
2. Promotion of Deregulation
(1) Deregulation and welfare administration
Most of the regulations that are related to welfare administration are not economic regulations aimed at controlling supply and demand. They are social regulations for protecting the lives and health of people. Deregulation in this area has so far been promoted so as to make those regulations minimal enough to meet its policy purpose from the viewpoint of preventing the regulations from unreasonably interfering with the free activities of private sectors. The deregulation has so far been promoted with a focus on the areas of drug and food.
(2) Past movements regarding deregulation
The actions taken by the Government as a whole include the establishment in January of 1998 of the Deregulation Committee under the Headquarters of Administrative Reform Promotion of the Government. Also the matters to be addressed from 1998 to 2000 were agreed as the Three-year Plan for Promoting Deregulation in the cabinet meeting held in March of the same year. The plan includes more than 100 items that fall under the responsibility of the Ministry of Health and Welfare. They include a study on the enterprise-run hospitals, the participation of the private sector in welfare services related to childcare, and the deregulation of self-management of the Employees' Pension Fund, etc. According to this plan, specific measures have been taken. Fifteen product groups of pharmaceuticals such as vitamin pills, stomach refreshing pills, and skin antiseptics were shifted to the category of quasi-drugs so as to be sold in convenience stores and other retailers. Because these products have moderate effects on human being and thus require no obligation of venders for providing customers with information
In December of 1998, the Deregulation Committee released the First View on Deregulation. According to the View, the Government modified the Three-Year Plan for Promoting Deregulation in March of 1999. This included matters related to the Ministry of Health and Welfare such as the review of the particular care expenses system, the establishment of social welfare foundations, and the relaxation of requirements on management. The Ministry will further proceed on its action.
Table 7-5-2. Movements of Deregulation