Regulating risks in healthcare in Japan: Between new politics and the tradition of liberal practice in medicine

Liberal practice in the medical professions has long been the tradition and de-facto position of the Japanese government. However, accountability and transparency in healthcare governance have recently drawn scrutiny, primarily due to several adverse events in hospitals. While New Public Management and risk-based approaches have not penetrated the design of regulatory management and compliance strategies, there has been increased institutional capacity and a search for a new mechanism of regulating risks in healthcare. This paper attempts to identify the directions of policy developments in Japan. It questions whether the conventional model of professional self-regulation in medicine is eroding, as in many English-speaking countries. The article demonstrates that while we may identify some common trends such as greater transparency and the creation of arm’s length bodies, policy decisions prove deeply embedded in governance arrangements, and professional self-regulation in healthcare remains resilient, particularly in Japan.