**2.2 Deliberation on establishing no-fault compensation system**

Discussions on the establishment of a no-fault compensation system have been held by the Japan Medical Association (JMA) since the 1960s. In the report entitled "Report on the Legal Response to Medical Accidents and Its Basic Theory" published in 1972, the following recommendations were set forth [5].


The JMA physician liability insurance system was established in 1973 in response to (i), but the other two items were not materialized for decades that followed. With decades passing by, the shortage of physicians in obstetrics and gynecology and the declining birthrate became social problems. In January 2006, the JMA made a proposition in its report entitled "Aiming at the establishment of a disability compensation system for medical care" stating "Ideally, it is desirable to implement a no-fault compensation system for entire medical specialties" and "however, neurological sequelae related to childbirth (so-called cerebral palsy) is prioritized for no-fault compensation." In August of the same year, they presented the details on the novel system [6]. Furthermore, in November of the year, "A Framework for a No-Fault Compensation System in Obstetrics" (Study Group on Medical Dispute Resolution, Social Security

*The Japan Obstetric Compensation System for Cerebral Palsy: Novel System to Improve Quality… DOI: http://dx.doi.org/10.5772/intechopen.106760*

#### **Figure 1.**

*No-fault compensation/investigation/prevention system for cerebral palsy, 2009.*

System Study Group, Political Research Committee of the Liberal Democratic Party (LDP)) was published that was followed by growing anticipation to launch the system. It depicted that the novel system is equipped with two pillars such as compensation on no-fault basis and investigation and prevention. At the same time, relevant organizations and groups expressed their concern and requested that the JQ should be an operator of the system. Accordingly, the Preparatory Office for the novel system was installed in the JQ in February 2007 that served as secretariat for the Introductory Committee for the novel system. In March 2008, the Board of Directors of the JQ formally decided to be the operating organization. All in this way, the system has been in operation since January 2009 (**Figure 1**).
