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?