There are concerns that the Tokyo area, whose population is aging, may face a shortage of medical and nursing-care services in the future. The central and Tokyo metropolitan governments must share a sense of urgency and implement measures to deal with the problem.
Looking ahead to 2040, when the elderly population is expected to peak, the government's Local Government System Research Council has started studying how local governments should function in this respect. The council is discussing how administrative functions should be maintained in provincial areas, where depopulation is continuing.
Another important focus is how to brace for the graying of the population, which has become serious in urban areas, including Tokyo.
A generation who moved to urban areas from provincial regions during and after the period of rapid economic growth is entering old age. In the 2040s, the number of elderly people in Tokyo and the neighboring prefectures of Chiba, Kanagawa and Saitama will increase by about 2.7 million from 2015.
To accommodate rapidly increasing demand for medical and nursing-care services, it is vital to grapple with the problem from a medium- and long-term perspective.
Even now, there is a shortage of nursing-care facilities in Tokyo's 23 wards, with many people on waiting lists. The reality is that many people from those wards have been admitted to facilities in Tokyo's Tama area and neighboring prefectures.
The problem cannot be solved by the metropolitan government alone. To build facilities and improve the quality of home-based nursing care, the metropolitan and three prefectural governments need to cooperate with each other and coordinate their efforts from a broad-based viewpoint.
Disaster preparations vital
Although there has been a continued flow of medical and nursing-care personnel into the Tokyo area from provincial regions, the trend will reach its limit sooner or later.
It is essential to secure necessary personnel for a long period of time. It is also important to promote such measures as arranging for healthy elderly people to look after those who need nursing care.
There are many medical institutions for patients in an acute stage of illness within Tokyo. However, there tends to be a shortage of hospitals that deal with those in a chronic phase, although elderly people frequently use such facilities.
It is hoped that efforts will be made to bring about an environment in which high-quality medical services can be received in each community, including an improvement in the quality of home-based medical treatment.
There is also a pressing need to make preparations for an earthquake with its focus just below the surface of Tokyo. In the Tokyo wards, it is expected that there will be a shortage of evacuation sites that can accommodate hundreds of thousands of people. It is indispensable to establish an evacuation system that covers a wider area.
To handle these difficult administrative tasks, the government must responsibly work to increase cooperation among local governments.
Although the governors of Tokyo and adjacent prefectures and the mayors of government ordinance-designated major cities regularly meet for conferences, it is difficult to say that these meetings function sufficiently to resolve long-term issues.
It may be advisable for the central and metropolitan governments, as well as the three prefectural governments, to create a framework for discussions on such matters as medical and nursing-care services and disaster risk prevention. It is essential to work out the details of administrative matters related to effective actions and the division of roles.
With its dense population and industrial concentration, the Tokyo area also plays a role in leading the whole nation. It is important for the central government and relevant local governments to sufficiently facilitate better communication with each other and draw up a picture of the capital's future.
(From The Yomiuri Shimbun, Aug. 28, 2018)
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