Contracting for population-based activities also lays the foundations for primary care specialists to take on a leadership role in local and national health systems. They would be ideally suited for this through having a clear idea of local health needs, as well as weaknesses in local service delivery (particularly concerning issues at the interface between primary and secondary care). Japan should take the establishment of a primary care speciality in 2017 as opportunity to develop a new cadre of health service leaders. In 2012, Japan had the highest number of hospital beds among OECD countries with 13.4 beds per 1 000 population compared to 5 per 1 000 population across OECD countries.