(Aug. 10, 2008) The Yomiuri Shimbun
Reform welfare ministry from viewpoint of public
厚労省改革 国民や現場と意識を共有せよ（8月10日付・読売社説）
Restoring public trust in the nation's social security system is a task that the Cabinet must tackle to the best of its ability.
社会保障への信頼回復は、内閣を挙げて取り組むべき課題だ。
The government's panel of experts on health, labor and welfare administration held its first meeting last week, launching a "comprehensive review of the administration of health, labor and welfare affairs from the viewpoint of the people.
政府の有識者会議「厚生労働行政の在り方に関する懇談会」がスタートした。
" The task is part of the "Five Free-from-Anxiety Plans" announced last month by Health, Labor and Welfare Minister Yoichi Masuzoe.
先月、舛添厚労相が打ち出した「五つの安心プラン」に掲げられた「国民の目線に立った厚生労働行政の総点検」を始動させるものだ。
The panel of experts originally was scheduled to be established at the ministry, but later was upgraded to a panel under the Prime Minister's Office.
有識者会議は当初、厚労省に設置される予定だったが、首相官邸の会議に格上げされた。
This made sense as reform measures discussed by the panel would not be able to win public trust if the ministry--the target of reform--had control over the panel. This is the most basic point that the government must respect so it can see eye-to-eye with the public on issues involved.
当然の措置だ。改革されるべき厚労省が取り仕切るのでは、信用されない。「国民の目線に立つ」ための基本中の基本であろう。
Since the minister's goal is to carry out a comprehensive review of health, labor and welfare affairs administration, discussions must be conducted on all relevant matters related to reforming the organization of the ministry.
総点検、というからには、厚労省の組織の在り方を、すべて俎上に載せなければならない。
There has been an endless series of revelations of misconduct related to the administration of health, labor and welfare affairs, such as scandals at the Social Insurance Agency, sloppy handling of pension records and belated responses to the problem of patients who contracted HIV or hepatitis through tainted blood products.
The ministry also has been blamed for confusion over the introduction of a new medical insurance system for elderly people aged 75 and older, and the inadequate assessment of the current circumstances affecting them, including the shortage of doctors.
社会保険庁の不祥事、ずさんな年金記録、エイズや肝炎など薬害問題の対応の遅れ、後期高齢者医療の混乱、医師不足など現状認識の甘さ――。厚労行政の不始末はキリがない。なぜ、このような状態になったのか。
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Divorced from reality
（現場感覚の欠如）
Why has such a situation emerged?
（何が原因か？）
The main reason is the lack of understanding on the part of ministry officials about the actual situation of the nation's medical and welfare services.
People working in medical and welfare services and municipal governments complain that "elite officials at the Health, Labor and Welfare Ministry don't know the real situation on the front line."
医療や福祉の現場、自治体などから、「厚労省のエリートは第一線の実情を知らない」との声が噴出している。
Most of the ministry's fast-track career bureaucrats are dispatched to municipal governments or other entities handling medical and welfare services for a short period when they are young.
厚労省のキャリア官僚が自治体などの現場に出向するのは、大半が若手時代の一時期に限られる。
For the ministry, gleaning information from concerned individuals through its committees is not the same as sharing a firsthand understanding of the problems that concern it.
審議会を通じて関係者の声を吸い上げるだけでは、皮膚感覚で問題を共有することはできまい。
gleaning＝収集した、拾い集めた
Furthermore, there is a special group of ministry officials who are licensed doctors. It is true that the administration of medical affairs requires highly specialized knowledge, but their presence tends to make the ministry behave in a self-righteous manner.
さらに、医師の資格を持つ「医系技官」という特殊な官僚グループもある。医療行政には高度な専門知識が必要とはいえ、独善に陥りがちだ。
A major overhaul of the ministry's personnel system is necessary. The wall between officials with the doctor's license and other officials handling administrative work must be removed. There must be exchanges of a large number of ministry officials with those working at municipal governments, in medical services and other entities at various levels.
人事制度を大胆に見直す必要がある。事務官と医系技官の壁を取り払うことはもちろん、自治体や医療現場などと、あらゆるレベルで多数の人材を交流させるべきであろう。
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New mind-set needed
Meanwhile, the ministry is very poor at explaining and publicizing its policies to the public. The confusion over the new medical insurance system for people aged 75 and older is a case in point.
国民に対する説明力、発信力も貧弱過ぎる。後期高齢者医療の混乱ぶりがいい例だ。
Although the new medical system is headed in a positive direction, the ministry lacked the imagination and willingness to assiduously try to win the understanding of elderly people by taking their feelings into consideration.
制度の目指す方向性は良いとしても、高齢者の気持ちに配慮して、丁寧に理解を求めようという発想もなければ、態勢もなかった。
assiduously＝間断なく、せっせと
Unless the ministry changes its attitude, the public will continue to harbor feelings of dissatisfaction and distrust, no matter what it tries to do.
こうした姿勢を改めない限り、何をしても、国民は不満と不信を抱き続けるだろう。
It should not be forgotten that revamping of the ministry will not be enough.
役所の立て直しだけでは不十分なことも忘れてはならない。
Part of the reason the ministry's implementation of policies is neither stable nor trusted is because the nation lacks reliable financial sources to support its social security system.
厚労省の施策が右往左往し、信頼されないのは、社会保障の確固とした財源が確保されていないためでもある。
Along with the ministry's reform, the government must expedite its efforts to overhaul the social security system--with the introduction of a social security tax as one possible reform measure.
組織改革と同時に、社会保障税の導入など、制度改革も急がねばならない。
(From The Yomiuri Shimbun, Aug. 10, 2008)
（2008年8月10日01時58分 読売新聞）
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