These suggest that community services may be struggling to provide adequate care. This chapter explores the extent to which current arrangements are aligned with this ambition and what more needs to be done, particularly in terms of quality monitoring and improvement, to achieve it. The chapter argues that work should start now to professionalise and define a speciality of primary care, based upon a clear, consensual vision of how the speciality will be different in knowledge, skills, roles and responsibilities from current community generalists. Strengthening of the information infrastructure, possible reforms to payment systems, and close attention to primary care specialists’ role in co-ordinating care will also be needed. Section 2.4 describes the challenges, including a super-ageing society that primary care would be expected to address and Section 2.5 considers the extent to which current arrangements are well placed to meet these challenges. Sections 2.6 and 2.7 describe the steps that Japan should take to develop a distinct and specialist primary care workforce and embed quality monitoring and improvement from the start.