How a Local Public Hospital’s Termination Occurs

Abstract

This article clarifies how a local public hospital’s termination occurs. Preceding studies stress that political actors’ attitudes or the characteristics of the policy determine whether policy will be terminated. Politicians object to a local public hospital’s termination on the basis of local residents· objections. Moreover, these hospitals are difficult to terminate because they provide employment to their staff. However, some local public hospitals have ceased operations in recent years. Why did this happen?

This article focuses on the influence of a hospital’s raison d’être. When on the basis of their policy knowledge, a council determines that there is no raison d’être for a hospital, political actors find it difficult to oppose its termination because of the possibility that voters will judge the political actor as not having worked for the public interest. This article analyzes the reformation of Fukuoka Prefecture’s public hospital. This is the least-likely crucial case, as most of these hospital’s operations have terminated. Yet, this case study shows how a council’s opinion changed political actors· attitudes and led to a local public hospital’s termination.