Tokyo's special grant for hospital work-environment reform sets a base amount of ¥133,000 per bed, and ¥266,000 per bed for hospitals that meet extra working-hour conditions, according to the programme's application form. Applications for it and for the ordinary programme run to 31 March 2027.
Two programmes, one rule change
Both programmes respond to the cap on doctors' overtime and holiday work that took effect in April 2024. The Tokyo Metropolitan Government says the aim is to keep regional care available while shortening doctors' hours, through team-based care and ICT-led changes that cover other staff as well as physicians.
The ordinary programme's listing leaves eligible items and requirements to its implementation and grant guidelines, and states no amounts.
The special programme is aimed at hospitals that build a teaching structure for training doctors in advanced skills and that improve working conditions during that training.
How the special grant is built
The application form sets the base amount as the maximum number of beds in use, excluding long-term care beds, multiplied by ¥133,000. A hospital that meets the stated conditions can claim ¥266,000 a bed. The form ties that higher rate to either a university hospital reform plan or extra measures on working hours for doctors under the special hours tiers.
The subsidy covers all of an eligible cost outside asset formation, and nine-tenths of asset-forming costs. Applicants must assign spending to one of five categories: shifting tasks between staff, reviewing doctors' duties, other work-environment improvements such as ICT and equipment, managing the hours of doctors with outside jobs, and making training more efficient for doctors under the C-1 tier.
The form also screens hospitals on conditions such as employing doctors with 720 to 960 overtime hours a year and running a plan to shorten doctors' hours. It flags applicants that do not meet the requirements, so not every hospital will qualify.