As the country faces a need to streamline the medical sector amid soaring medical expenses, the health ministry has sent notices to prefectures requesting discussions on possible mergers of publicly run local hospitals.

The move came after the ministry announced the list of 424 public hospitals that were judged to be in need of realignment discussions last September.

When it sent the notice Friday, the ministry removed seven hospitals in Tokyo and six other prefectures from the list. Meanwhile, the ministry plans to add about 20 hospitals to the list to eventually to have it name around 440 institutions. The changes made to the list stemmed from data entry and other clerical mistakes by health ministry officials.

The ministry plans to notify prefectures this summer when their discussions should be wrapped up.

The ministry will not disclose the names of the newly added hospitals to the public, unlike the initial list that was made public.

“Whether or not to disclose the names is not a fundamental issue since we are equally requesting mergers and realignment of all the hospitals (on the list),” a health ministry official said.

The ministry also provided to prefectures data on the outcomes of medical treatment given by about 3,200 private hospitals for use as a basis of their discussions about public hospital realignment.

The way the ministry announced the hospital list drew strong opposition from local governments and target hospitals. The backlash prompted the ministry to offer an apology and forced it to delay the timing of sending the notice.