As we consider the public hospitals in our country as clusters in terms of their scales, the group of National Hospitals and Sanatoriums will be certainly ranked well with those of University Hospitals, Red-cross and Saiseikai Hospitals, and local community hospitals. The University Hospitals make their raison d'être for education and research works, The Red-cross and Saiseikai Hospitals take part in the medical services lined with the nature of social welfares. The local community hospitals put more emphasis on the regional health care services including emergency cases. What should be, then, the raison d'être or purpose of National Hospitals? In answering to this question, we may refer that the National Cancer Center, the National Cardiovascular Center, and the National Center of Neurology and Psychiatry have established their highly admirable reputation as pioneers of the specific medical fields and will continue to be the leading medical institutions both domestically and internationally. However, nearly all the National Hospitals and Sanatoriums fall one step behind the Red-cross Hospitals or the local community hospitals not only in the regional health activities but also in the emergency medical services. They seem to be somehow passe, mere government-attached facilities or affiliated hospitals of the universities. They appeared to be dominated by the University Hospitals in the aspects of medical research works and even personnel and educational administration. In 1985, the Medical Service Law was amended to start the regional medical plans and to regulate available numbers of beds in each prefecture based on the population. Furthermore, according to the second Amendment of the Medical Service Law in 1992, the National Hospitals, the nature of which is between the wings of “hospitals for highly specialized medical service” and “hospitals for long-term medical service ” are enforced to clarify its functional status, performance and future respect. So far as National Hospitals are concerned to be medical service organizations, they should not be deviated or aloof from any regional medical activeties. On the other hand, they should have some different characteristics from the regional medical facilities in order to play the leading roles for the advanced medical care. They should also pursue for the role of guiding the related regional medical service. What then are they actually involved in? The environmental conditions around the regional medical services have been increasingly changed since the last few years, and the medical business has been severely deteriorated. Under such circumstance, the time has come to a crucial point at which the National Hospitals must decide on what a role it has to play in the regional medical services, and what kind of philosophy and principle it has to abide by at the stage of entering the coming 21st century. The most important point of stepping forward practically for this object may be found in the making of one model national hospital, which will achieve its own innovation and to which direction is to be destined. Preparations for obtaining consensus among the national hospitals and for stepwise planning are required as a matter of urgency. In this symposium, Mr. Ito, the Director of the Health Planning Division in the Health Policy Bureau of the Ministry of Health and Welfare, mentioned as one of the medical planners, that the drastic reorganization of the National Hospitals and Sanatoriums will be expected to play a supplementary role in the secondary medical area in each prefecture. From the standpoint of a system planner, Mr. Sueyoshi, the Director of the Division of Human Environment Research at the Mitsubishi General Research Institute, advised that first of all National Hospitals should establish a definite geopolitical goal for several service areas such as “Kinki region”, “Hokkaido region” and so o