Hospital Special from the Tiger's Gate.

As my Ox Hammer is particularly fond of me, god knows why, she likes to use our trips to Japan to have my health checked. She claims that it is best to have the Japanese system do the job because, not to put too fine a point on it, she wouldn't trust an English doctor with a garden snail. She would also rather fly to Japan than enter what she considers to be the unclean territory of an English hospital. As regular readers will know, I have become a big fan of Japanese hospitals and now consider myself a "yellow belt" expert in their administrative systems.

As you will appreciate, the process and administration of a Japanese hospital is not something the tourist is invited to enter and photograph. However, in the interests of science and with a concern to advance the medical profession in the U.K., I was rude enough to obtain some covert snaps which I will share with you now.

Cost is always a factor in health care provision and one of the big costs in the NHS is collecting money it is owed for treatment. This may surprise you all when you believe that the NHS is a free state provision, however, there are procedures and circumstances which need to be paid for, not least our trade in hospital tourism. In Japan the system is a very, very simple one; you pay 30% of the cost. If you are sensible you insure that risk, if you don't want to do that then you rely on family savings. Of course there is social security to cover those in desperate need (I have had to shut the door and type those words "social security" very quietly because HMiL doesn't like them being used in the house) but the exact extent of its provision I am unsure of.

Two things I do know is that I actually like the idea of paying 30% of your medical bill. It seems to me to be a very sensible organisational posture, after all, when things are free people tend to use them liberally but when they have to put their hand in their pocket they tend to be more circumspect and that can only be a good thing. I believe it a very workable position because the charges are very low by comparison to the UK (by that I mean the amount of money the NHS is charged by doctors, drugs companies etc., for their services and goods.) I mean, at the moment a doctor in the UK wont get out of bed for less than the money it costs to fill the Bentley with petrol.

The other thing I know is that as a foreigner using a Japanese hospital I get to pay 100% and there is no negotiation or possibility of claiming a family tie. I am a foreigner therefore I pay full whack, don't like it, then go somewhere else. I also think that is reasonable and ever the more so because the costs are so reasonable. In England, when I want any private treatment, I need to see my financial adviser about a new mortgage on the house before I get anywhere near a doctor. In Japan I walk straight through the front door confident that the service will be great, the administration an example to be lovingly observed and the treatment is first class.

The Torranoman Hospital in Tokyo

The cause of my visit to the hospital was a concern over a couple of lumps which have appeared in my body. As a man of 55 you can start to imagine all sorts of stuff when odd formations appear but generally I am not that concerned as I was pretty certain that these were just "fatty tissue". Nothing to get excited about. But when you add into the mix that my father died in his mid sixties from aggressive lympoma then there are some grounds for a general level of concern. As far as the Ox Hammer was concerned it was a medical emergency.

My visit to my GP ended briefly with him saying "I am not concerned about this at all.". Rather than provide any explanation of the possible condition he decided to then investigate whether I had been actively searching for "lumps". This particular tack was so insulting to me that I just left. I had woken up that morning and, as you do, scratched my chest with an accompanying yawn and found a lump that I hadn't known was there before. So I slipped down to the GP Surgery to get it checked out. What I got was a rather arrogant man with a dismissive attitude suggesting that I might be a hypochondriac . Not a single question about why I might have a concern or an inquiry about family history, no discernible concern for the patient.

Ox Hammer's verdict: "I will get you checked by proper doctors when we are in Japan."

So at 08.45 a.m. (regular readers will remember that on entering a hospital in Japan I make detailed notes) we entered the lobby as shown above. This is the reception area and differs from the English hospital experience immediately. As you can see above there are a range of counters in the entrance but these are just the inquiry desks. The reception itself is around the corner to the immediate left of this image. There I counted 7 reception staff at the counter dealing with people as they come in. Maximum waiting time about 6 minutes if there is a queue. They take details, provide relevant form, co-ordinate a file which is colour coded and filled with the information before being passed to one of the fifteen staff sitting behind the counter working on computer terminals.

As I stood at the counter observing the process I noticed one key point, nobody appeared to be having a private conversation. Everyone was working away at the task in hand. Within 9 minutes of my un-announced arrival at the hospital I was on my way to see a doctor and before I left reception my notes were slipped into the transport system and were sent to that department.

I don't want to go on too much about the process here because I have written about it before, suffice it to say, within two hours I had seen a doctor and had two medical procedures including an ultrasound scan. The doctor had pronounced all to be ok but only after he had explained in detail what the situation was. He then also said that I should be referred to another department just to make sure all was ok.

We returned to the reception, a further appointment was made and we then proceeded to leave. Now, for my medical friends who I know have a keen interest in these stories, now we get to the crux of this tale from Tokyo. before you leave you pay for your treatment. Once again the photos here are blurry and shot on the sly but I did want to show you a level of organisation which is just the finest example of sensible management I can think of.

As you can see in the image above there is a "Fees" counter which is in the entrance/exit lobby. My visual calculation was that there were about 1500 people receiving walk in services that morning (150 doctors on duty and 10 people in each queue). As you can see in the image above there were three people at the counter but if you peer you will see the heads and screens behind them. Obviously I made the head count and there were twelve desks with computer terminals and ten of them were manned. As the counter staff take the record provided by the reception as you leave or book further treatment, they then provide you with a ticket number and pass the record back for processing at one of the desks.

You then walk across the lobby to where a row of ten machines await to take your payment. A big screen has the ticket numbers flashing when the account is ready to be paid. We waited less than two minutes before our number flashed on the screen and we walked forward to the machine where the Ox Hammer presented the hospital card issued in my name.

This slips into the machine and up on the screen comes the details of the treatment and a breakdown of the cost.

Then all you have to do is select whether you want to pay cash or credit card. So there you have it, comprehensive attention to detail, superb customer service, friendly faces, genuine respect for the incoming patient, speed of service and an holistic prevention based approach all capped off with a management of the finances to ensure payment is swift. Imagine, in well under three hours from just walking in, hospital reception, two medical procedures, doctor meeting, book further investigation and payment made into hospital bank account. Well just like any English hospital I suppose, except for a few points, ahem!

And the cost, well it was 7000 yen, about £49 and that was the 100% rate.

Finally, the point I love to make across the blog is about Japanese customer service. I am back here again and in every interaction I have as a customer I am left open mouthed at some of the small instances of care and concern. here, as I have said before, the customer is king, back in the UK the customer is just the cattle herd of the consumer slaughter yard, where the merciless stripping to the bone of the customer is managed for the sake of the shareholder.

Happy New Year: Next up, the trip to the Fox Temple ( a real treat for the true follower of this blog).

Me and My Ox Hammer

I love wandering around Tokyo with my Ox Hammer (see above) and do try to speak as much Japanese as my fluency level permits. Of course my cockney accent is a bonus as it helps with with some of the technicalities of this relatively easy language to pick up. True, the fact it uses three different sets of characters, Hiragana, Katakana and Kanji, rather than one simple alphabet does provide a bit of a challenge but for a seasoned man of culture like myself this presents no obvious challenge.

A seasoned man of culture in Mushashi Koyama

Take for example the word for wife, 奥さん ; okusan, which when used with the more formal ending sama produces the appropriate word oxhammer with cockney pronunciation. I often wonder if this word is the finest example of the subtlety of Japanese humour or actually a statement of their literalism! There are other ways of saying "wife" such as 妻 ; tsuma but I have a preference for 山の悪魔 ; yama no kami, which refers to the fact that your wife will grow horns if you make her angry!

The Hat that Keeps the Horns In

The hat of the traditional wedding dress of Japan also makes a cautionary point of naming itself appropriately. Japanese language is for me, a wonderful journey of discovery. What it is I am actually discovering though is anyone's guess!

Poster on the wall

For example, this poster on the wall in the tube (metro) caught my eye today. The graphic style is just so Japanese and carries a really charming naive quality but tells it like it is. If you see a little green man jump onto the track and turn orange with bubbles coming out of his head as he lays before an oncoming train then scream and press the emergency button. One could wonder why it is we don't have such buttons every three meters (like they do in Tokyo) on the London Underground. Such an obvious and useful aid to civilised life, you would have thought, would be an essential of station safety furniture. No doubt there is a good reason for their absence!

Boris to ban yobs on grounds of intellectual copyright

Next up from Tokyo will be a journey around the Fox Shrine and some more hospital adventures with dramatic photographic evidence. Wishing you all a Happy Christmas. J & A

Japan, Nagano and Honourable Mother in Law

Compensation is a very strange idea when you get to think about it. Essentially it is about an idea of one thing which gets replaced by something else and thereby satisfies a sense of loss. For example, my house burns down and the whole of my extensive collection of 20th century antique toothpicks, some hardly used, are destroyed. After a certain amount of strife and argument with the insurance company, who fail to understand the value to history of my collection, I am given a lump of cash, not a big lump, more of a bump actually, but it is my compensation for my loss. The toothpicks were my idea of an important historic collection and they were replaced by an electronic transfer to my bank account and thereby one idea is replaced by something else and I am compensated. Hmmmm.

We have just returned from the very, very best ryokan onsen  I know of. Yep, I have provided a link there but it is only to distract the unworthy. In order to get to this ryokan, just north of Nagano, you can go by train, a very good choice, or you can drive from Tokyo. I have the privilege and honour of being able to drive Honourable Mother in Law (HMiL) and on this occasion was fortunate enough to be joined by her brother, Honourable Uncle in Law (HUiL). This addition to the entourage was very welcome for two reasons, firstly that I was driving his car rather than hiring one and secondly because he served as a distraction for HMiL. This latter point is actually crucial.

You see, my wonderful wife, for all her superb qualities, couldn't navigate her way out of a paper bag. HMiL also has a certain difficulty with geographic location. My wife has a habit of lacking to plan ahead when she sits in the passenger seat and directs as an acre of map is tussled with. What this means in practice is that I can arrive in the right hand lane at a set of traffic lights, the first car on the grid so to speak, and as we are sitting waiting for the lights to change she will say, "We need to turn left here.". I have sort of got used to this over the years and so don't even bother to stress when faced with such dilemmas. Well that is not always true because my wife has one other problem, when she says left she can actually mean right and vice versa. She does tend to confuse these two complex philosophical notions.

I put this down to the fact that being Japanese she has no real concept of left such as "left field" or "left wing" or, in the case of food, "left overs". Japanese people really tend to like things that are right, both in fact and in nature. Everything else to them is really wrong and that just wont do, so when my wife says left she probably means right, but not always. Consequently, driving in rush hour Tokyo can prove somewhat challenging.

The challenge is enhanced when HMil is in the car as well. As mother and daughter the pair of them disagree as a matter of course. The reason for this disagreement is that in reality it is only the ability to conflict which separates them from each other, any worthy study of character and behaviour may well conclude that they are the same person disconnected by some weird temporal flux. Obviously they disagree in Japanese, they disagree with rising voices and they can even start to get really snappy with each other. Honourable wife will tell me to turn right when she means left, HMiL will disagree and say I need to turn left when she means right and the map will be waving around across the windscreen as lorries and buses are thundering either side of me down a three carriageway road.

Sometimes I find this a bit stressful. But there are compensations!

The picture above shows you exactly where I was at 09.30 this morning. High up in the mountains north of Nagano, in an old a venerable ryokan, a Japanese style hotel, and sitting in one of the outside onsen baths, a stone lined pool of volcanic hot water filled with minerals which soften the skin and mellow the soul. I am going to guide you around this little piece of heaven and tell you all about it from my own perspective. If ever you are in Japan, if you are a traveller who seeks culture rather than familiarity, then this is one of humanity's special places and a visit is strongly advised.

Understanding Japan and Japanese people is in itself an art form for us from our grubby western "civilisations". Remember what Gandhi said when asked what he thought about western civilisation. He responded that he thought it would be a good idea.  The picture you see above is the starting point for breakfast in the Sekiya Ryokan, a study of this picture (you can click on it to enlarge) will reveal a standard of presentation which is crafted from within a deep love of food. The chef at this Ryokan supplemented his Japanese cuisine by also training in Italy and so the table at this heavenly palace has the most subtle undertones of a European style but only as a brush stroke of mastery rather than a palette.

Perhaps we need to look at our own standard offering, the Full English, as a comparison to begin to understand where it is we are slacking somewhat!

You can of course also click on this picture to enlarge it but I would suggest that it is probably best not to. These two images begin to demonstrate the gulf in not only our understanding of food but our appreciation of it and before any of you food lovely middle class neo gourmets start tossing off a few radishes in my direction I have a culinary tip for you: get stuffed. Maybe the Full English as shown is the lowest common denominator and there are Japanese equivalents of junk food but the point is that food in England is a business, at all levels, whereas in Japan it is a cultural obsession. That is something an English foodie wouldn't understand unless they read it in an article in a quality newspaper's lifestyle magazine right next to the adverts for very expensive restaurants. No, in Japan food ranks equally with Buddhism,  Shintoism and money as being an essential element of a healthy cultural life.

The cultural experience of Japan is what the Ryokan is all about, it is a traditional Japanese hotel wherein there is precious little accommodation, if any, for European standards. If such provision is made then it would usually cost a hefty premium and really underlines how stupid such people are that would search out the genuine Japanese experience and then ask for it to be adapted to their needs. The picture above is of the "cleaning stations" where you sit on your stool and thoroughly clean yourself before you enter the pool of volcanic hot spring water. There is something really strange about this practice when you come to it as a European. Bizarre if you are English and used to soaking in your own dirt and calling it a "bath". Personally I find this process of cleaning almost akin to spiritual cleansing. Sitting on that small stool, all the necessary soaps, shampoos, conditioners etc., at arms reach, hot water pumping out of the shower, do you know, getting really clean is just such a pleasure before you have the luxury of bathing.

 

This picture is of one of the indoor onsen pools. That water is beautifully hot and the minerals it brings forth from the earth as it bubbles up directly into the Ryokan makes the skin soft and warm. On the wall you will find a notice advising that it is very dangerous to enter the onsen if drunk. The problem here is that if you spend more than fifteen minutes in the water you can actually start to loose consciousness. The rest I can leave for you to work out. There is something in the onsen experience which is deeply spiritual, it is a moment of calm in the rush of life, and this point being understood then it is natural for the Japanese to ensure detail in the experience:

One of the two outside terrace onsen pools at  Sekiya Ryokan and is that not just a picture of delight.

The above picture is of the tub, one of my favourites, as it looks out over the mountain side. Laying back in this really does make you think that it is possible to feel at one with the world and leave all the little troubles of life behind.

But should you feel the need for a more completely private moment then you can always slip into your own private onsen bath set just against the verandah of your room. Now really, isn't that just a peach?

And, of course, the rooms in the Ryokan are rich in the simplicity, an oxymoron I know but when you experience it you will know what I mean, of the traditional Japanese architecture. Here, Honourable Uncle in Law, Jiro-san, takes a cup of green tea as we sit enjoying being there.

Futons on a tatami mat floor, if you have never slept this way then you are missing something special. On the right are the cupboards in which the sleeping equipment is stored. In the evening, you go to dinner and when you come back your futons are all laid out and the tables moved into the ante room. When you go to breakfast you return to your room to find the futons all packed away and the tables back in place. There is a quiet magic in the way it all works, it is so easy, so seamless and you, as the honoured guest, are undisturbed by the necessities of the day, for you there is only the purpose of relaxation and comfort. Should you have any stress whatsoever then the massage chair is there for you to sit in and enjoy a thorough and detailed massage. But now I am going to return to the subject of food.

We are called to dinner and shown to our own private dining room. Each of the Ryokan's rooms has its own private dining room, this is just the standard set by Sekiya Ryokan and it is not a standard which rests solely with architecture. Most impressive is the absolute courtesy, good manners and genuine politeness of all of the staff, they make you feel as though you are in a space where you are the centre of all attention. This is of course a great skill but they exceed because you are left in no doubt that their concern for your well being is absolutely genuine. These are people with a gift in hospitality.

So sit tight whilst I take you through the evening meal. Our Japanese friends who read this blog will not enjoy what is to follow. Currently most of them are trapped in a land where the concept of "fresh fish" is not known and food is presented as a slosh on a plate by surly staff. For them the pictures which follow are torture. For us, they are a memory of the last two days and for some of you they are a future you have yet to meet.

Parma Ham, smoked salmon and a selection of vegetables.

Sashumi of an unknown river fish

Seafood soup

Red Mullet with vegetables

A croquette of prawn with lentils and a wasabi mooni mash

Two scallops with a raddish and potato mash

Oh yes and the dishes keep coming and can't you just see that genuine hospitality

A fishcake and vegetable clear soup, rice and pickled vegetables

This desert was just bliss, a pear mousse with a peach ice cream 

And here we see the example of what hospitality means in Japanese. I am not showing you anything particular to this Ryokan just an artefact of culture, an artefact of generosity. You see, to fill a glass properly, without skimping, so that your good nature and spirit of hospitality is plain to see, you need to fill it to the brim. And just so there is absolutely no doubt it is only right and proper to place the glass in a small wooden box which can then catch the overflow of your hospitality and bear witness to the honour you do your guest. This allows the guest to fill his glass again from the surplus in the box. Tell me, where else in the world is the bounty of the host manifested in such an artefact.

As I said at the start of this article, there are compensations. On the way home this afternoon we managed to get lost in the Tokyo traffic. Mother said left, My Honourable wife said right, the traffic thundered by but I remained calm, at ease and slowly brought us home. After all, what exactly was there to stress about?

Watching the paint dry.

Well there are just four more days left until we get on the plane and fly out to Haneda. After the year Takayama and I have had we are both yearning for our first onsen (volcanic hot water bath). We will be in our favourite Riokan by the 15th December and no doubt I will report to you regarding the stresses and strains of having to soak for days in steaming water whilst looking out over the verandah at the most amazing mountain views.

What is also exciting my "pen" is the idea that we are flying with British Airways. Now you can call me a cynic if you like but I just know that we are going to have a hell of a time with surly staff and shortage of supplies. Still, they would have to go some to beat the disaster which Virgin Atlantic have become. Our last flight with them, and I do mean my last flight, we were informed one hour into a twelve hour flight that they had run out of tins of beer. The explanation for this shocking failure of customer service was that the flight out from London had drunk all of the beer for the return journey and as they don't stock up in Tokyo that was that.

Thankfully we will arrive in the land of customer service where the comfort and security of the paying client is the first and foremost concern. I will be assuming the position of the eager, hungry and thirsty customer keen on being served and kept satisfied. All the time I will watch and learn and then communicate to you the small humble insights into this culture on the edge of the world. In the meantime, I am sitting here watching the paint dry.

And finally, why am I so excited to be flying into Haneda? Well from our balcony we can see the planes climb into the sky and when the get about 20 seconds above the ground after take off they have to bank a severe right turn and spin around to face out to sea. I can't wait for that on our return. Other than that, as the map below shows, we are about 25 minutes by taxi from the airport and that is just brilliant.

Escaping the madness?

The other day I was on the tube amidst the rush hour madness of London...yes, I know but it couldn't be helped. What struck me about this experience was the amazing insensitivity and rudeness of youth in the capital. No doubt the product of a single parent family, no doubt a rioter of some sort, no sooner had I struggled onto the train than some sallow faced youth with his trousers around his ankles and music rapping out of his headphones accosted me with the offer of a seat. The impudence of it all! I know my beard is grey and that my years are advancing, I also realise that I was struggling a bit with my luggage but really, to be assumed old enough to merit such bald faced cheek is just an insult. The worst of it all is that this was not the first time ill mannered youths have offered me a seat on the train in recent weeks.

As most of you will be aware we have not had a summer trip to Japan because of the stresses of a house move so we are looking forward to our forthcomning journey to the sanity of Tokyo. At least there I can feel a man again as gereatric old ladies shove past me when the train doors open, elbow me in the ribs and race towards any available seat. The well mannered youth of Japan would never think to offer me a seat no matter how grey my beard, after all I am a foreigner.

Consequently you can imagine my great happiness to know that we will be flying, for the first time, into Haneda airport which is just five kilometres from Honourable Mother in Law's (HMiL) home (rather than the two hours away from Narita). We arrive at 4 a.m. because all the best arrival times are snagged by Japanese airlines and their American overlords. We also have to travel on B.A. which is never a pleasant prospect. However, the chance to land at Haneda cannot be passed over and I intend to be in a volcanic hot spring bath in Mushash Koyami by midday.

This will no doubt give me something to write about!

How to Make a Fortune from the Japanese Tsunami

by
Felix Columbidae
author, poet, journalist, entrepreneur, businessman, humanitarian.

The regular readers will know that my main contention about Japanese National Psychology (JNP) is that it is based upon pragmatism. Therefore I have full faith in the belief that my Japanese friends will understand that ever since the Tsunami struck I have been very busy trying to make money from the results of natural disasters.

On my five screens I have had Bloomberg monitoring the movement of company stock, I have had CNN reporting every blip in the market, I have been watching NHK reporting on the human cost, I have been desperately monitoring the opinions of experts regarding the aesthetic values of friction on frozen water and, most importantly, I have been transfixed by the BBC's Damien Grammaticus's arms waving like windmills as he describes a disaster for which, no doubt, he deserves a media award.

Crass though it may seem, I am focused on how to make a lot of money out of this. Obviously the play here is about the problems facing the Nuclear Industry. Thousands of people have lost their lives, many thousands, and the world has been turned upside down but the BBC seems to have identified the real issue; the failure of the Japanese Atomic Energy Programme.

After all, once we have been swept away with the initial news item the 29 year old producers from Cambridge halls have to find the "new angle". They are diligent enough to scrabble around and find that real issue.

As befits the intellects from the hothouse, they would never make the comparison between British Nuclear Engineering and our Eastern counterparts. If such an event had happened anywhere near a British Reactor (Engineered by Oxford and Cambridge people) then we would all be fluorescent by now. Thankfully our media is quick to point out that in the event of one of the most awesome displays of nature's power, and our hopeless inadequacy, the Japanese Nuclear Programme has failed disastrously.

Facts have never spoilt a good media story in Britain, especially for the BBC. Whilst it may well look like an impending nuclear calamity the fact is that predominantly the Japanese design has worked well and never before have nuclear installations been tested by a 9.0 Richter scale quake right beneath them.

So as the stock price of Japanese Steel, Jtekt and others have been driven down, we have been busy buying them up in the sure and certain knowledge that there is no better Nuclear Technology than that which can survive a 9.0 Richter scale earthquake and Tsunami capable of killing 40,000 human beings. That is the sort of test standards we free market capitalists love to see and whilst we are at it we will sink some cash into any food exports going Japan's way. There is certainly a profit in that trade.

No doubt we will make a lot of money out of this but I do wonder what happened to our friend who lived in the area where the tsunami smashed home. We still don't know if she survived but at least we have the film we made with her in Tufnell Park. Hey, perhaps we can make money out of that?

The Shinkansen Test

Well I am sure that some of you may have noticed that the output on the Japanese Blog has been somewhat Saharan. This has been due to both myself and the honourable Takayama absolutely scythed down by a viscious virus picked up on the plane out here. The problem has been that as we were more or less completely out of action for the first two weeks of this particular trip all of our normal workload turned into a bit of a mountain.

This having been said, I did manage to further my research into the effects of volcanic spa water on cold tins of lager with a trip into the mountains last week. Further research into this pressing subject will urgently be conducted before we leave in ten days time but that is not what I want to write about today.

Before leaving England I was asked by a person I had met if I saw Japan through rose tinted glasses. I believe not and whilst this blog generally takes a humourous but respectful look at the land of the rising sun as seen through the eyes of a stranger, in truth I haven't found that much to be hyper-critical of. This is about to change but before I unleash my critical voice I would like to clarify a position first.

There is absolutely nothing worse than arriving in another culture and giving it the "high hat". Looking down your nose at the workings of other peoples' way of life and criticising the country in which you are a guest. This is a particular problem seen in ex-patriot communities. I saw it in Spain in the early nineties when my very late father and his group of friends, British settlers, would sit and discuss all that was wrong with Spain and the lazy Spaniard. After many a brandy this group of retired "business-men" would inevitably conclude that "What Spain needs is another Franco." Not really a surprising outcome from men who had pictures of Margaret Thatcher on their white villa walls and amongst whom some of which had made their fortunes from her prison building programme.

The point I am making is that it is simply bad manners to arrive in another country and then start to pick holes in the way things are done. I notice that in English language newspapers published in Japan there are often letters from Americans critical of how the Japanese do things and I wouldn't want to be seen in such a dim light. As all who know me I hope will tell, I love Japan, I love the people, I respect their culture and am constantly amazed by its resilience and ability to marry progress with tradition.

A national icon: The first Shinkansen

Japan is a land known all over the world for producing innovation. The latest Shinkansen which travels north from Tokyo to Aomori is a fine example. Recent news on this amazing technical innovation told how the post war steam engines took 26 hours to make this journey. By the late sixties and the advent of the first generation of Shinkansen the journey time was down to 10 hours. As the world famous bullet train design improved the time came down and down and by the end of the nineties it was only a 5 hour trip time to this northern outpost. The new Shinkansen which commenced its timetable this year now does the trip in about 3 hours.

Shinkansen Innovation and Progress

One could comment on how we have yet to build a Shinkansen service in the UK and the much politically promoted "West Coast" line, our first attempt, will no doubt take four times as long to build as the project planners tell us, cost six times over budget and then come in with a great fanfare of political trumpets and an immediate speed restriction due to adverse weather conditions! Perhaps that is why Hitachi, Shinkansen train specialists, pulled out of the bidding for the contract!!!

This train technology is iconic in Japan and represents the Japanese nation at its best speaking volumes about Japanese culture. Any delay in the service whatsoever results in an item on the headline news of the state broadcaster, NHK, accompanied by a Shinkansen official bowing low and apologising publicly to the Japanese people. As previously reported on this blog, the worst snow in 70 years in 2009 saw a delay in the service of 25 minutes which was deemed to be only just acceptable through circumstance but questions were asked in the Japanese parliament about the issue. The Shinkansen carries the pride of the nation, it is fast, it is reliable, it provides a service to a need and it is throughout its construction a statement of quality. The Shinkansen serves the Japanese people and serves them well.

I make all of these points because I am going to propose that we use the Shinkansen as the ideal benchmark of how things should work in Japan. I would even propose that it provides strong evidence of how things can work in Japan. Let's call it the Shinkansen Test; is it speedy, is it efficient, is it reliable and does it serve the people?

This is the test which I am now going to apply to the Japanese legal system, specifically the management of criminal investigations. Unfortunately I am going to have to be critical as the evidence I have uncovered this past two weeks is quite frightening. Before I explain let us have a sense of balance rather than just fall into the ex-pat trap of prejudice. Japan has 120 million people, it is the third largest global economy and it is, in my opinion, a wonderful place and culture to visit and live amongst. In a human organisation of such numbers and complexity it is unimaginable that everything works perfectly, human beings are not perfect. So the fact that 120 million of them appear to get so many things right has to be weighed in the balance of this critique.

However in the administration of criminal justice Japan would appear to have a severe problem which does not sit well with its proud record of being progressive whilst holding dear tradition. In the U.K. I have been involved in recent years with the issue of miscarriage of justice. On HumanRightsTV you will find the Innocence Network UK channel and testimonies from Paul Blackburn and Susan May together with material on the current cases of Sam Hallam and Simon Hall. Our own justice system has much to be concerned about when viewed through the lens of these cases. All of this work has led me to become involved with a project to bring together exonorees from all around the world at a conference in Cincinatti in April 2011. And that involvement led me to the case of Mr Sugaya, a man released from prison in 2009 after having spent 17.5 years in police cells and prison as a result of a dreadful miscarriage of justice.

Yesterday we visited this quite, small and seemingly gentle man to video his testimony and that of Mrs Nishimaki, an equally seemingly unremarkable woman who appears to have single handedly been the catalyst which saved Sugaya-san from an unjust destiny. We will be posting this dramatic and challenging material on a new HumanRightsTV Japan channel within the next month together with an interview with one of the lawyers instrumental in the case. I will leave a lot of the incredible story we have heard until this work is complete and for now just concentrate on the bare facts of the case as it has been told to us.

Our first meeting was with the lawyer and he revealed an interesting insight into the Japanese management of criminal cases. He expressed the view that once a suspect is arrested a conviction is more than 98% guaranteed. He also questioned the procedure which allows the police 27 days custody from arrest for questioning without any legal representation for the suspect. In this matter of unrepresented custody he was of the strong opinion that Japan lagged behind the world in its administration of criminal justice. The lawyer also noted that this long period of questioning was not the subject of any video recording or audio recording and the methods employed by the police in interrogation remain unscrutinised.

In our interviews yesterday we first met Mrs Nishimaki who diligently took us to the scene of crime and walked us through the terrain of events. She explained how the case involved a 4 year old child who had been abducted, sexually abused, murdered and dumped by a river. She told how the police investigation appeared to take a long time and that initial enquiries focused on known offenders, people who watched child pornography and those around the area at the time.

As the investigation faltered the police began to ask about "suspicious people" requesting that the public report anyone of concern. This is Japan of the early 1990's, this is provincial Japan, this is a place where neighbours know each other and family bonds are strong in a way we probably haven't seen in the UK for a few of generations. Within this social framework Mr Sugaya was suspicious. He seemingly lived alone, he didn't speak to his neighbours and he was only at home at weekends in his small flat where he watched videos.

This reported behaviour was enough to place Sugaya-san on the list of suspects. The suspicion of the police was apparently intensified because a recent child sex offender prosecution had been successful and in that case the accused also had a large video collection. Please note that there was no indication made that any of the material in such a collection was of a criminal nature, the connection is simply that the video collection was large.

As the investigation progressed the police collected human fluid samples from Mr Sugaya's rubbish outside his flat and from that were able to show that he had the same blood group, B positive, as the murderer. This was enough to propel matters to an arrest.

Sugaya-san disclosed the moment of his arrest in the interviews yesterday. He told how police burst into his flat, violently pushed him into the corner and began shouting at him. He said that they had a photograph of the victim which they waved in his face and shouted, "This is the face of the young girl you killed, you killed her so now we are arresting you."

That is some statement to make based on a large video collection and membership of a blood group. The other evidence was that he didn't talk to his neighbours, he lived as a single man alone and he appeared to only be at home at weekends. In addition, police investigations had revealed that his occupation was as a school bus driver for kindergarten children.

Not exactly what anyone would rationally call overwhelming evidence and perhaps that accounts for what happened next. Mr Sugaya was taken to a police station and interrogated for 14 hours non-stop. During this interrogation, according to his testimony, he was screamed at, beaten and dragged around the room by his hair. After those 14 hours he confessed to the crime and provided a detailed script of "what happened".

For an historian context is the grail and if we now look at who Mr Sugaya was before the police arrived maybe we can see why he confessed. Sugaya-san was a middle aged man who was single. He came from a family of no particular wealth who lived in quite a cramped space. He was not a character filled with either education or self-assurance, a rather ordinary little man who was quite and a gentle character. Shy is how he and other people described him. He worked conscientiously at his job in a very Japanese way, following the rules, being punctual, being polite and doing as he was told at all times. His one small luxury was that he was able to maintain a very small flat so at weekends he could escape from the cramped family home and watch videos in peace. Being a shy man, outside of his home and alone he did not have the confidence to speak with his neighbours.

Yesterday he claimed that the police interrogation terrified him to the state where he felt it was only possible to stop the intimidation by confessing. The police had got the man they needed to fit the crime.

At this point I would express the opinion that in the two years I have been working on miscarriage of justice cases I have been shocked to find that in all the cases I know of the police have made the evidence fit a vulnerable accused rather than use evidence to prove a crime. That this appears to be the case in Japan maybe illustrates something about a universality of the psychology of some of those who become police officers. What it certainly does show, and I also understand this from cases I know of in the U.S.A., is that this critique of the Japanese justice system is not their problem alone.

In Mr Sugaya's case even his defence lawyer told him on first meeting that he was guilty! According to Mr Suguaya's testimony the defence lawyer said, "You are now under investigation for three similar crimes so you must have committed one of them at least." When your defence lawyer effectively is working for the prosecution what hope can you possibly entertain. Publicly Sugaya stuck to his confession but privately from day one he was writing to his brother maintaining his innocence.

In this case the role of DNA evidence was pivotal both at trial and ultimately in proving innocence. At the time of his arrest the use of DNA evidence was something only big city forces had started using. The local police force were very keen on this new progressive tool to catch criminals and saw in the Sugaya investigation the possibility of validating the new methodology and thus attaining the funding so they could have such equipment and facilities. Therefore they pressed to substantiate the case with DNA evidence.

The DNA samples were taken from the unfortunate girl's clothing. These items of clothing had been in the river for at least 12 hours before they were recovered. The items, including a blouse and a skirt, had been kept in a police locker for months and had even started to grow mould. At first the regional police applications to a laboratory were turned down, it was the early days of DNA testing and the samples were initially believed to be unsuitable for the procedure. However the eager police persisted and persisted and eventually they talked a laboratory into providing a DNA test and used that to help establish Mr Sugaya's guilt.

Absolutely Innocent
Source: Japan Times

There is much more to this story but I am sure that you can all see how this case illustrates major concerns about the Japanese criminal justice system. If we add to the tale that in the lengthy and time consuming appeal process judge after judge refused to re-examine the DNA samples or physically look at the scene of crime preferring to find the confession to be compelling evidence, then we realise a problem which is deep rooted. Fortunately for Sugaya-san, Mrs Nishimaki stepped in where highly paid legal professionals failed so dramatically.

Nishimaki-san's only connection with the prisoner was that she too was a bus driver for kindergarten children. In a very Japanese way of thinking she found it impossible to reconcile how a person charged with the task of delivering children safely to school could possibly be a child murderer. She wrote to Sugaya and told him that if he did the crime he should apologise to the family of the victim and serve his sentence but if he was actually not guilty he should never give up proclaiming his innocence. Sugaya yesterday revealed how this letter saved his life. When he received it he was at the stage of complete mental collapse and surrender to his fate but the words of this woman breathed a spirit of resistance into him which gave him new found strength.

From that point Mrs Nishimaki set about building a campaign to save Sugaya. She mapped out the scene of the crime in such a way to demonstrate that the original confession was simply an impossible tale. In terms of the location and the terrain the sequence of events in the confession are simply not credible at any number of points and the proposed timeline of the confession was shown to be physically impossible to achieve. Most importantly, through the attention and support she gathered, the DNA tests were repeated and showed clearly that the DNA on the victim's clothes was not that of Mr Sugaya. The campaign pressed home and in 2009 Sugaya was released.

For him, the suffering he has endured has been immense. His father died not long after his arrest due to the shock of the situation. In provincial Japan, even today, to be the father of a child murderer would make it all but impossible to step outside the door of your house just to go shopping. Add to that a media which besieged his family from the onset and crucified their lives in the name of circulation figures and the physical and emotional stress could kill anyone. Sugaya's mother also died whilst he was in prison and besides the life time he lost we have yet to mention the experience of interrogation and imprisonment on a shy vulnerable man.

Hashimoto, a senior police officer in the case, allegedly refuses to accept that Sugaya is innocent even today. If this is true then it has to alarm the Japanese tax payer. If a senior police officer refuses to believe conclusive DNA testing and a pardon in favour of a large video collection and a forced confession then surely questions have to be asked. How can the intellectual capacity such a position represents be suitable for the precious and well paid role of public guardian?

That all of the senior appeal judges who refused to re-examine the evidence or look at the scene of crime claim now they cannot comment on the case as they have now retired also must stretch the patience of the Japanese tax payer. Those retirements rest comfortably on large pensions supplied by the Japanese citizen. Surely that citizen has the right to demand accountability of judges, retired or active, rather than be arrogantly denied due to an erroneous idea that retirement relieves responsibility for duties performed in public office.

Sugaya has asked all of these people for an apology and they have all failed to meet their moral responsibility. If those who created a miscarriage of justice are not prepared to face the consequence of their actions, if they are not going to accept the failings of the system, how then can any Japanese citizen hope for change? Those who do not possess the moral strength for high office should perhaps be considered as unworthy of a lucrative tax payer sponsored pension.

Today Sugaya asks for the simple respect of an apology, in times gone by some of those officials might have been told to wash their necks (non-Japanese readers I am sure will get the import of this euphemism). If the law wishes to preserve a rigid conservative methodology of the past then perhaps its officials should have old traditions applied to their failings!

Certainly there has to be great shame when a very ordinary woman can clearly see a miscarriage of justice but highly paid police, lawyers, judges and courts, supposed experts, refuse to see anything wrong. However, when the citizen in the unassuming shape of Mrs Nishimaki can mount a successful challenge to these proud and supposedly erudite figures of authority then the spirit of Japanese justice will always ultimately be safe.

This is where we can leave this story, more will follow on HumanRightsTV and the forthcoming Japanese channel but before we go I would make two points.

Firstly, I apologise to all good Japanese people if any rudeness on my part is perceived here in my writing. I am a guest in your country and as I have stated see much more right in your culture than I see in error. I would also say that this problem is not exclusively a Japanese issue and whilst the details differ, miscarriage of justice is a cause we should all fight for in this new Age of Transparency.

Secondly, the Shinkansen test! For a nation which is so well known for its innovation and ability to hold onto tradition why should it be impossible to reform the criminal justice system? Legal representation from the moment of arrest and tape recording of all admissible interviews has to be a simple step that would immediately go a long way to protect Japanese justice from the shame of a miscarriage. The rule of law is the basis of all progressive human cultures but transparent justice is the hallmark of civilisation. If we pose the Shinkansen test on the Japanese criminal justice system as exposed by the Sugaya case then does it answer the questions:

1. Is Japanese Criminal Justice speedy?
2. Is Japanese Criminal Justice efficient?
3. Is Japanese Criminal Justice reliable?
4. Does Japanese Criminal Justice serve the people?

If and when Japanese Criminal Justice fails this Shinkansen test then the pride of the Japanese people should lead them to innovate without fear. They should be assured that they can lead the world with justice in just the same way as they lead the world with the Shinkansen.

Iconic Innovation Japanese Style

Tokyo 2011: No Sacred Cows

Additional Features! I am going to add to my postings a "heads up" notification regarding the content of each article. This, hopefully, will allow some selectivity for the audience. The following examples how this will work and in future each article with begin with such a "heads up header".

PDW

Medical * Administrative Detail * Mono-culturalism * David Cameron

This introduction might suffer from my usual attempts to break back into stride when I return here but once you churn your way through the opening I think I can promise a few gems for your enjoyment.

As many of you will know the last four months have presented some very obstinate challenges to both the Honourable Takayama-sama and myself. I wont bore you, for a change, with all of the details but suffice to say that seeing the back end of 2010 off nearly killed us both!

Oh how we both yearned to be back home in the comfort and security of Meguro-ku and enjoy working at a much more civilised pace. We arrived at Heathrow filled with expectation and a certain amount of relief that we were flying with ANA on the evening flight; just that bit more civilised.

How were we to know that we were about to face 11 hours of hell? And my dear friends, do you know what made that hell so exquisite? Throughout the most painful journey either of us have ever endured going East all around us was the most professional of customer service....why hadn't we flown B.A., at least we could have vented our frustration on the poor service from the cabin staff. But no, we had top quality service, good food, total respect as we both suffered tremendously.

The cause of the suffering was in the case of the most honourable of wives, a viscious onset of travel sickness where every tumble of turbulence exacerbated the problem. In my own case, the arm injury suffered before Christmas and then compounded by repetitive strain injury as a result of video editing over the holiday period, allowed me not one single position in my seat where comfort could be obtained. Add to this my own personal sloppiness in not putting the high strength pain killers prescribed by the quack in my hand luggage and what you have is a recipe for increasing levels of pain as connected muscle systems try to compensate for the stress in my right arm.

By the time we got off the plane, exactly 8 days ago, we were utterly exhausted and more than a little tetchy with each other. And that sore throat which had started to develop four hours into the flight had now become a sensation somewhat similar, I would imagine, to swallowing razor blades. That we made it home without contacting divorce lawyers was an absolute miracle but we got here and then we both collapsed onto our futon in the "Japanese Room".

My sore throat developed into a fever and has kept me housebound until yesterday when I managed to go to the local shops. Takayama has battled the same virus and today we were off to the doctors, which will now provide the substance of this article.

Let me pose you all a question first, imagine that you are new to an area and you need a doctor (I am talking about in the U.K. here). Let us further suppose that you are actually feeling unwell at the time, not bad enough for hospital but not slight enough to avoid the need for medical advice. Now I ask you all to picture what happens when you turn up at the local doctors surgery, which you have found through a Google search, and say, "I am new in the area and would like to see a doctor."

Please, conjure up the image in your mind, take your time, savour every detail your imagination can provide; the surly aggressive receptionist, the claims that you may not qualify to be at that particular surgery, the need to fill in forms and provide various forms of identity proof which you may or may not have on you. as I have said, take your time and let your creativity explore every conceivable response and then ask yourself if you stand a hope in hell of seeing a G.P. that day.

We arrived at the G.P. surgery at 12.07 hrs. The new readers to this blog will not be aware of the fact that when engaged in any form of administrative process in Japan, medical, social, corporate or otherwise, it is my unerring habit to check the time from the moment I am first served. Takayama-sama spoke to the receptionist who looked directly at her as she talked and smiled re-assuringly. The receptionist then looked at me and smiled, she took out a clipboard with a form attached and passed it over to my honourable wife.

As Takayama sat and completed the form I took my usual stock check of the surroundings. A gently beautiful tropical fish tank sat immediately besides the glass entry doors. This was filled with blue and green fish, sparkling coral and produced the most relaxing sound of gurgling water I had ever heard. I suspected that a specialist fish tank engineer had come in and somehow fine tuned the gurgle to the "medical establishment" setting. You may laugh!!!

Music was piped into the waiting room space and I took a few moments to assess this contrived ambiance. Orchestral renditions, pre-dominantly strings absolutely no horns, of gentle Japanese classic tones and melodies. I would describe the overall effect as being one of comfortable certainty.

The seating was of the usual high quality in the comfort department, powder blue, bench arrangement with very, very ample padding and all spotlessly clean. There were eight people already in the waiting room. Six of them were elderly and the two others wore very similar suits, I assumed them to be drug company reps waiting to see the GP once the surgery closed for lunchtime.

I was about to instigate an in-depth study of the available reading material and ancillary amenities but this was strangled at birth due to the fact that I was called through to the GP.

In his room he sat, at a smallish desk and had what was clearly a standard form for consultancy. He wrote a few notes and then asked me a couple of introductory questions in English before moving onto the more complicated stuff in Japanese with Takayama translating.

I took the use of English to be for two prime reasons, firstly to impress me and secondly as an act of really good manners.

In very quick time the consultation was complete and we were back at the front desk. As Takayama attended to the business of completing the paperwork and paying the bill, I took time to give as thorough an examination of the operational nature of the surgery as the short window of opportunity allowed.

My first observation was that all of the female reception staff were dressed in a very soft pastel pink which included a rather tasteful light knitted cardigan of the same tone. There was an absence of noise, by that I mean that the telephone didn't screech, the receptionists never raised their voices above the gentleness threshold and all sounds appeared to have been set to whisper mode.

I also noticed that beyond the glass screen one of the reception staff received my notes and began to enter them into a computer data base. The notes were in a transparent plastic sleeve and already numbered and colour coded.

I expect that the most respected Dr Swift and Jonathon Deets just experienced pupil dilation!

Yes, colour coding and at first it completely stumped me as to the purpose. The first clue was in the cabinet behind the front counter. This was of the wooden pigeon hole variety and beneath each "box" there were numbers from 1 to 100. What was immediately interesting about the numbers on the wooden frame beneath each box was that they were matched to a colour: 1 was on a red sticker, 2 was on a yellow sticker, 3 was on a purple sticker and so on to 9 which was on a blue sticker. Each number associated with a distinct colour.

At first this system puzzled me and I struggled to work out why anyone would do such a thing. After all it is as easy to recognise number 32 as it is to recognise purple/yellow! Then I looked down the rows of files which, unlike the solitary cabinet behind the front desk, were on a hanging frame system all along the wall of the back office. The front edge of each folder numbered.

Then I realised, I could see where the files in the 7000's were. I could even see where the files between 4500 and 4800 were. Then the true moment of realisation, I could see file number blue-dot, yellow-dot, purple-dot, purple-dot (9233) from at least twelve feet away and looking through a glass window. Absolute Genius! With thousands of files you can spot the one you want in seconds. You can even see immediately if it is in the wrong section!!!!!!

Everyone has known misfiling, especially if you have had any dealings with the NHS, but misfile in this system and it stands out vividly in colour! Very important, I would suggest, when dealing with medical notes.

My sense of awe was disturbed by Takayama telling me we were done. I looked at the clock, 12.21 hrs, we had been precisely 14 minutes from first service to completion of visit. A visit by a new patient, who was a foreigner, admittedly with a fluent translator, all paperwork completed and medical examination delivered with opinion and advice.

Now recently someone asked me if my view of Japan was through rose tinted glasses? Obviously this person doesn't know me too well whereas my closer friends, I would hope, would know that rose tinting clashes with my eye colour.

So yes, I did have to pay for my visit and the critical may say, "Aha, you are not comparing like with like, the NHS is free!" And I would respond, "Correct, and even in some cases to foreigners who arrive in the country just to obtain treatment." I realise this last comment is a contentious one but just keep your powder dry because I haven't finished yet and if you found that contentious then you may need to get some heart attack pills in for later.

The Japanese health care system works on a part payment method. As a Japanese national or a bona fide member of the Japanese tax system you pay between 10 to 30% of the cost of any medical service. Takayama, oh yes, I forgot to mention, in those 14 minutes she was also examined, paid Yen300, about 12% of the cost and amounting to approximately £2.50. I had to pay the full amount of Yen3000, amounting to, obviously, about £25.00.

You see in Japan the idea of getting something for nothing is an absolute non-starter, it just isn't something Japanese people would understand. As the honourable HMil (Honourable Mother-in-Law) would say, "There is no more expensive word than Free!". That is why the whole idea of "social security" in Japan is radically different to the U.K. concept. If you asked about social security in Japan your most probable explanation of what that term meant would be "Keeping everything Japanese!" As for benefits, well yes, there are benefits but Japanese culture would also ask what the responsibilities were that are required in order to gain the benefits.

Let's put this into a slightly different perspective. If you told Japanese people that in Britain a young girl can get pregnant without a husband or supporting father and then get a free apartment paid for at the tax payers expense they would think that you were telling a joke of some sort. Please don't tell me that doesn't happen or it is a Daily Mail scaremongering tactic because I have worked on estates with gangs, worked with "deprived families" and sat and listened to many more than one young girl tell me her plans for the future: to get pregnant and get a council flat.

The point I am trying to make is the connection between benefits and responsibilities. In Japan the distinction is very clear; you don't get something for nothing. You certainly don't get anything if you are not a Japanese taxpayer and as Japan is a mono-cultural society then in 97% of the cases that means you are not just a Japanese taxpayer but also ethnically Japanese.

As a Japanese you buy into the one great idea of being Japanese, in the Japanese way as the Japanese identity. That is what a mono-culture is. And because everyone buys into this idea, admittedly to a greater or lessor extent, then social deviance is much more strongly resisted, both actively and passively, in families, in communities and in society. This produces that which the Japanese cultural psyche craves most, certainty.

Certainty in management, certainty in customer service, certainty in social order, certainty in social behaviour, all of which certainty provides the bedrock of social security, or as previously stated, keeping everything Japanese.

David Cameron's recent speech on the effects of multiculturalism was, in my opinion, absolutely spot on. People often make a dreadful mistake when they consider who I am. They look at my work as the Project Director of HumanRightsTV , they look at my appearance (which admittedly doesn't help) and they think I am placed somewhere in amongst the left wing do gooder brigade of airheads. Actually not! But that doesn't mean I support fascism or racism, I just believe that rights can only be sustained when responsibilities are met. If you have a community with different cultural values how do you sustain rights when responsibilities are interpreted without uniformity?

Let's be clear, no-one in their right mind wants to see the U.K. turned into moronic flag wavers who know an oath of allegiance but are crippled in the cognitive department (no names, no pack drill), but unless we consider the way forward carefully we are heading towards social catastrophe. I am not suggesting that the Japanese model is what we need but I am suggesting that as a comparative model it dramatically highlights what it is we have lost.

Coming Next: Economies of Scale, is bigger better?