Japan Press Weekly

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2019 March 27 - April 2 [LABOR]

Labor Ministry panel imposes on doctors monthly overtime cap twice as high as gov’t-set danger line for ‘karoshi’

A Labor Ministry panel on March 28 compiled a report which proposes to set an upper limit of overtime for doctors at 155 hours a month, nearly twice the amount that the government established as the danger line for death from overwork (karoshi). This overtime cap will be applied to trainee doctors and doctors working at specified medical institutions which play a role in local healthcare services.

The Abe government stance to legally allow physicians to work extremely long hours and to ignore the doctor shortage issue will inevitably be called into question. Even now, Japan needs to raise the number of doctors by more than 100,000 in order to achieve the same number of doctors per 1,000 population as the OECD average.

The ministry panel has discussed a “work-style” reform for doctors. However, during the panel’s discussion, an increase in the number of doctors did not become an agenda item due to the government policy to curb medical spending. The discussion ended up imposing overtime nearly two times higher than the so-called karoshi line on trainee doctors and doctors working at regional medical centers.

The ministry’s investigative commission had experienced a situation in which a vice chair suddenly resigned in protest against the Labor Ministry's reluctance to tackle the issue of doctors’ exhaustive working conditions while recognizing the labor crunch as a major cause of overworked general practitioners.

The Labor Ministry has calculated that the number of physicians will reach about 350,000 by 2028, which will lead to a supply and demand balance. The ministry’s calculation also predicts that oversupply will occur after that.

As a way to solve the issue of doctors’ excessive hours of work, the ministry has hammered out a plan to transfer a portion of hospital tasks from doctors to nurses, promote consolidation of hospitals, and reduce the number of hospital beds. This measure, however, is not a practical solution because the imposition of new tasks on nurses will force them to accept excessive workloads, and the consolidation of hospitals will undermine people’s right to access locally available medical services.

In addition to physicians, trade unions, and bereaved families of karoshi victims, the Japan Medical Science Federation which represents one million doctors in Japan has been demanding government measures to drastically improve doctors’ working conditions which include a measure to increase the number of doctors. Even the labor ministry panel in its report stated that it is necessary to implement a measure to secure the quality and safety of medical services in tandem with a measure to ensure doctors’ health.

The government should change its healthcare policy to one contributing to an increase in the number of doctors and an improvement in doctors’ working conditions.

Past related articles:
> Physicians’ union: Labor Ministry proposes putting ceiling on doctors’ overtime which exceeds official gov’t-set danger line for ‘karoshi’ [January, 18, 2019]
> Doctors in rotating shifts work 64 hours of overtime a month: union survey [November 11, 2017]
> 30% of male hospital doctors work more than 60 hours a week: Labor Ministry [April 9, 2017]