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Sunday, Nov. 1, 2009
Ministry insider speaks out
By TOMOKO OTAKE
Health ministry bureaucrat Moriyo Kimura made headlines in late May just after the H1N1 flu outbreak sparked a massive mask-buying spree across the nation. Appearing before a Diet committee as an expert witness, the 44-year-old quarantine officer sharply criticized her own ministry — and especially its head, then-Health Minister Yoichi Masuzoe — for their handling of the outbreak.
Back then, some 200 doctors were mobilized at Narita Airport to interrogate anyone with a high temperature arriving there. The declared purpose was to keep the virus "offshore."
"Those quarantine officers at Narita Airport running around with their protective masks and gowns on were used for a 'performance' act (by Masuzoe) to win sympathy from the public," Kimura said, visibly outraged.
Kimura may well feel she has good reason to be harsh regarding her employer. She has seen her career nosedive over the years, despite her stellar academic training and work in the United States. After being moved from one post to another, she is now stationed at the Haneda Airport quarantine office, which she regards as an outpost. Her job entails screening out passengers running a temperature — only to recommend that they consult a doctor immediately.
"I'm in a prefab building, very close to planes," Kimura said sardonically during a recent interview.
However, despite being skeptical of the work of her own office, she has recently found success as a writer — and as a sharp-tongued pundit on TV talk shows. Her book, unambiguously titled "Koseirodosho Hokai" (Collapse of the Health, Labor and Welfare Ministry), has clocked up print runs totaling 11,000 copies since it came out in March, according to its publisher Kodansha.
In the book, Kimura details how she, as a young, enthusiastic epidemiologist at a state-affiliated research institute, was transferred to the health ministry headquarters in Tokyo's Kasumigaseki district because, she says, she was judged too eager to do research. She tells how she was shunned at the ministry for being too outspoken, and was told by her bosses not to "speak a word" while attending international conferences.
Kimura says her experience with ministry bureaucrats has convinced her that ikei gikan (medical officers) are corrupt and self-serving.
Such officers, who number 250 within the ministry, are licensed medical doctors who are usually hired after only a few years of clinical practice. Once they become bureaucrats, though, they never again get to treat real patients, so their skills and knowledge quickly become obsolete, Kimura says. She cites this as a major reason why Japan's public health policy lags behind those in other developed countries — "by decades."
"Those health ministry medical officers have little clinical practice experience, and have no clue as to what public health is," declares Kimura — herself an ikei gikan. Yet these officers — because of their licensed status — have dominated key positions in the ministry, she says, adding that the handful of highest-ranking officers "have ¥30 trillion to ¥40 trillion (in health care budgets) at their disposal."
Citing a few of the bureaucrats by name, she even charges that some of the ministry's subsidies — which are dispensed to build new facilities or fund research projects — go into creating semi-governmental corporations that the bureaucrats themselves can migrate to after retirement through amakudari (literally, "descending from heaven"), which refers to the infamous, longstanding practice of retired bureaucrats landing lucrative jobs with state-affiliated organizations.
In connection with an H1N1 flu-shot program, she alleges the bureaucrats have unreasonably favored the four tiny domestic vaccine-makers, when it is clear those four alone cannot produce enough flu shots for the entire population.
On Oct. 1, the government announced that it will procure H1N1 vaccines for 77 million people, including imported vaccines — far too few to cover the country's 127 million people.
"Flu shots should be used as a tool, with understanding that there is no preventive measure or panacea for influenza," she says. "To prevent a panic, I think the government should distribute vaccines for everyone for free. And there is no doubt we would have a panic situation if we don't have enough flu shots. Isn't it strange they could not have foreseen it?"
But why would Kimura not, if she is so frustrated with the ministry, just leave?
Kimura, a single mother with two teenage daughters, who says she has been asked the question many times, claims that no matter what the backlash, she would rather be a voice from within.
"If I quit the ministry and make a fuss from the outside, who would take me seriously?" she says. "Because I'm a working bureaucrat, my comments are reported in the media and my views could affect public opinion. That's why I stay."
And why name names? She cites the late-1990s HIV tainted-blood scandal, in which, among the bureaucrats, only the "section chief" in charge of blood products was indicted and convicted of not having taken the dangerous blood products off the market. No senior officials in the ministry were taken to task legally.
"What the ministry officials really learned from that scandal was that, if they do something wrong, they could end up (in trouble), so let's all keep quiet and keep telling lies," she says. "They are not looking after the interests of the public."
Has she lost anything from being so confrontational? "No," she insists firmly. "If we don't change things now, my children's generation will suffer the consequences. And what am I going to lose for accusing officials by name? My amakudari post? So what?"