East meets west: What the UK and Japan can learn from each other in healthcare

The United Kingdom and Japan, while being on opposite sides of the world, with starkly different culture, history, and language, share many similarities. They are both island monarchies that emerged from feudal beginnings to become global powers in technology, business, and arts and sciences. Their healthcare systems reflect a similar trajectory: the UK’s National Health Service (NHS) and Japan’s Social Health Insurance (SHI) are internationally recognized for delivering high-quality, accessible care. Yet, both systems now face mounting pressures from aging populations, rising healthcare costs, and workforce shortages. As they navigate these shared challenges, the UK and Japan have much to learn from each other, not only in terms of advancing treatments and training physicians, but also in innovating sustainable models of care for the future.

Both the UK and Japanese systems offer universal coverage to their citizens, with both being born in the aftermath of World War 2, with devastating tolls on both national economies and infrastructure. Naturally, there was significant social, economic, and political change in both Europe and Asia. The health services of both countries were born out of necessity, collaboration between politicians and the medical establishment, and careful alliances and negotiations [1, 2]. The results speak for themselves to this day, with no patient or their family in either country needing to worry if they will be treated.  Japan maintains a strong emphasis on preventive health and chronic disease management, while the UK—despite a historically robust public health system—has faced recent challenges due to reduced investment in prevention and community care.

Both systems are not without their drawbacks, however, and have much to learn from each other to make patient quality of life and health outcomes better for everyone, including the doctors who treat them. The Japanese SHI system is world renowned for its efficiency and patient outcomes. A core philosophy in Japanese medicine is “patient-centeredness,” with emphasis on tailoring medical care to individual needs. Japanese physicians and trainees practice with a “Medical Bushido” mindset, trained in almost every aspect of patient care, from conducting their own bedside tests to interpreting their own imaging orders [3]. They are guided by additional virtue known as “Shinmi,” which involves trying to connect with patients as though they are close family members [4]. Improved patient communication and empathy has been shown worldwide to improve patient outcomes and tendency to access healthcare, which is something the UK NHS is attempting to improve upon [5].

In Japan, patients also have greater flexibility and freedom to choose their healthcare providers, without needing a GP referral first, as is common in the UK. Even without the gatekeeping approach of GPs, the Japanese system is considered extremely efficient and spends less per capita than the UK. The UK has also struggled historically with patient waiting times for both GP and specialist appointments. Improving patient choice and freedom may not only help with waiting times, efficiency, and patient satisfaction, but make patients more active in their own healthcare, leading to improved treatment compliance and fewer health complications [6].

While the centralized approach of the UK NHS does have its downsides, it does have certain advantages over Japan. The Japanese system involves multiple independent insurers operating under a unified framework, creating more complexity in administration compared to a centralized, gatekeeping network. This can lead to variations in service quality and availability across Japan, with a higher shortage of specialists and doctors in rural areas compared to the UK, requiring long journeys to large urban hospitals [7]. However, the UK has more recently begun restoring elective and subacute services to local or neighbourhood levels to improve access and reduce regional disparities. The workforce structures also differ significantly, with NHS responsibilities being more diffusely spread out. Nursing assistants play a vital role in the UK for example, with no equivalent position in the Japanese system, where registered nurses perform routine tasks themselves. The Japanese system may be more efficient and place more roles directly in the hands of doctors and nurses, but it comes at the cost of higher burnout rates [8].  

The UK and Japan have already learned much from one another—Japan’s community-based elder care system has informed UK social care reform discussions, while the UK’s hospice-led palliative care model has shaped end-of-life services in Japan [9]. Japanese robotics and AI are being piloted in British care homes, and academic exchanges continue to enrich medical training across both countries [10]. As both nations confront aging populations, chronic disease, and workforce challenges, deepening collaboration, especially in clinical innovation and care delivery offers a powerful path forward. Improving healthcare together isn’t just aspirational. It’s already happening.