Act on Support for Children with Medical Needs Local governments are establishing bases, but there are challenges in accepting them

On the 18th, it will be one year since the law to promote support for children with medical care was enacted.

When NHK interviewed each prefecture about the support and consultation bases that are required by law to be established, nearly 80% of the municipalities have established them so far, but many of the municipalities that have established them are "medical care." The problem is the lack of local resources such as daycare centers and schools that accept children," he said, highlighting the challenges in promoting support.

It is estimated that there are more than 20,000 children nationwide who require medical care, such as sucking sputum and using artificial respirators. The "Medical Care Child Support Law" was enacted.

In July this year, NHK announced the status of the establishment of the "Medical Care Child Support Center", which is a support base required by law to handle consultations from families and coordinate with related organizations for support. We conducted a questionnaire to the prefectures.

As a result, as of the end of July, 31 prefectures, or 66% of the total, answered that they had installed After that, it was installed from August to September, and it turned out that it was installed in 36 prefectures, which is nearly 80% of the total.

▽ On the other hand, 4 prefectures answered that "the timing of installation is undecided."

When we asked the four prefectures why, they all answered that they were "considering the center's functions, etc.," and ▽ the municipalities that said they were "planning to establish the center from this fiscal year onwards" said they were "considering the center's functions, etc." It takes time to select and adjust "is the most common.

In addition, when we asked the municipalities that answered "already installed" in the questionnaire about the issues with multiple answers, they answered that "local resources such as day care facilities, nursery schools, and schools that accept children requiring medical care are inadequate." 71% of the local governments did, and 55% of the local governments said that it would take time to resolve consultations due to a lack of local resources. It became clear that

In Gunma Prefecture, who responded that "the timing of installation is undecided"

Gunma Prefecture, which answered that "the timing of establishment is undecided," continues to consider the system and management method of the support center, but since the support covers various fields such as medical care, welfare, and education, it is necessary to adjust personnel and budget. It means that it takes time to secure it.

The prefectural government hopes to finish the study by the end of this fiscal year and decide on the timing of installation.

Atsushi Takahashi, head of the prefectural disability policy division, said, "I'm sorry for being late, but it would be a lie if I said I wasn't in a hurry. I want to show the direction for the installation as soon as possible."

While the timing of the installation has not been decided, families of children with medical care in the prefecture continue to support each other, such as responding to consultations from other families.

Chika, 10, the eldest daughter of Kyoko Ishikawa, who lives in Takasaki City, developed bacterial meningitis shortly after birth and became cerebral palsy. You need a gastric fistula, which feeds you through a tube.

Seven years ago, Ms. Ishikawa started a circle for her parents to create a place where parents of children requiring medical care can support each other and raise their children.

At a club luncheon held this month, when other families complained that they were having trouble deciding whether to send their daughter to a local elementary school or a special support school, Ms. Ishikawa sent her daughter to a local school. He gave advice based on his experience.

Ms. Ishikawa said, "Parents of caregivers want to hear and share not only their worries but also the joy of their children growing up. I hope that a center where we can talk about such things will be established soon." .

What is the consultation situation after the support center is established?

Many consultations have been received at the established support center, but there are also cases where it is difficult to respond due to the lack of local resources.

At the support center set up in Yamagata City in July this year, two people such as medical social workers are stationed and provide consultations with a pediatrician who is familiar with medical care children.

In the first month after opening, there were ▽ 15 inquiries about things necessary for accepting children with medical care from day care facilities for children with disabilities and public nursery schools, and ▽ admission to local nursery schools, etc. It is said that seven consultations were received from family members and others about admission to elementary school.

Some of the families asked for advice, saying, "I was refused admission to the nursery school. What should I do?" is.

Under these circumstances, training is also being conducted to increase the number of personnel who can support children requiring medical care.

In August, at a training session held at a nursery school in Yamagata City, 10 nursery teachers learned how to suck sputum and inject nutrition through the nose, and how to operate a ventilator. .

The director of the nursery school that participated said, "Knowing how to deal with it will eliminate my anxiety, so I've been able to take a positive approach to accepting children."

Dr. Kazuyuki Nakamura of the Yamagata Prefectural Support Center for Children with Medical Needs, who supervised the training, said, "Families of children with medical needs want to improve their child's development, and we are working to meet their needs." The goal is to establish a system that allows children to participate in the training.In the future, we would like to approach more nursery schools so that they can participate in the workshops.”

Local governments that continue to employ nurses

Some local governments are actively working to secure nurses to provide medical care.

Kani City, Gifu Prefecture continuously employs nurses to accept children requiring medical care at nursery schools and kindergartens.

Three years ago, the city hired two nurses to accept a girl who needed sputum suction at a nursery school in the city. We continued to hire them in preparation for the future, and one of them is now working at another nursery school in the city.

Although there are no caregivers at this nursery school, we are working on creating a manual on how to treat children who complain of poor physical condition and how to deal with allergies and suffocation.

Mio Amaya, a nurse who still works at a nursery school, said, "If there are children who need medical care and want to continue working as long as they need to go to kindergarten, I would like to help them again."

Kani City currently employs five nurses, including Ms. Amaya, at nursery schools and kindergartens in the city, and a total of two children are receiving medical care.

Koji Umeda, director of the Kani City Children's Division, said, "It is difficult to predict the needs of children who need medical care to go to kindergarten, so we would like to continue hiring nurses and accept them as soon as possible if they wish." .