A senior local bureaucrat described Japan’s alternative care system to me as having evolved as a kind of Galapagos. This is often given as an explanation for why Japan still uses baby institutions, including one housing over 80 babies run by the Red Cross, and why children are returned with minimal oversight to abusive parents who have tried to kill them. Yet it is often overlooked that there is significant variation across local authorities within Japan.

This book addresses both of these issues, the peculiarities of the Japanese system and the variation within that system. Chapter 8 first provides an overview of the book, explaining why Japan uses orphanage-style institutional care rather than family-based foster care, as well as the reason why there is regional variation in how policy is implemented here.

The chapter then reviews the main contributions of the book, from street-level bureaucrat literature, alternative care literature, and Japanese studies, particularly those on social services and the family. The chapter closes with policy recommendations, including that foster care is professionalised, so that it is no longer seen as a threat to the family-bond. The chapter also recommends that practice be more evidence-based, particularly with regard to attachment theory.