The Japanese health system. Another success story?

Although there has been considerable interest in the Japanese style of management in business circles, little attention has so far been given to the equally remarkable record of the Japanese health sector. Life expectancy at birth has risen from 63.6 years for males and 67.7 years for females in 1955 to 73.8 years and 79.1 years, respectively, in 1981, while the infant mortality rate has decreased from 39.8 to 7.1 deaths per 1,000 live births during this period. The proportion of the gross national product devoted to health expenditure, though rising from 3.7 per cent to 5.1 per cent still remains low when compared with most western countries. Could all this be ascribed to the way the health care system is organised in Japan? Is there any unique Japanese hospital management practice which could be readily introduced in the NHS context? In order to answer these questions, it is necessary to first describe so called 'Japanese' style management and then the Japanese health system, in an attempt to differentiate between the myth and the reality.