COVID, Co-Production and Governance in Japanese Healthcare

The Covid-19 pandemic underlines the importance of citizen support for and compliance with public health goals. This paper explores the contribution of governance to the staff’s work environment, and patient participation in public financed healthcare services. More staff control over their daily work-life tasks will promote greater work satisfaction and more satisfied staff will, in turn, provide better quality services than dissatisfied staff. Therefore, it considers three models for governing public financed services: a democratic, multi-stakeholder model; a stewardship model and a more traditional ‘command and control’ model. A participatory governance model allows the staff greater autonomy and promotes a multi-stakeholder dialogue that facilitates greater user/citizen participation. It also asks how public financed service providers can develop institutions that facilitate, foster and institutionalize user/citizen participation? It presents a case study from the Minami Medical Co-op in Nagoya and concludes that participatory governance can serve as a ‘best practice’ for other public and private providers of healthcare.