What is the Medical Care Support Act for Children? Changes Made and Future Changes Explained | Understanding the Age 18 Barrier and Current Evacuation Plans

When researching support for children requiring medical care, you may often come across the term "Act on Support for Children Requiring Medical Care."

As the name suggests, it is a law to support children requiring medical care. However, some may wonder, "What kind of law is this?" or "What changes with its enactment (or what has changed)?"

In this article, the author, who has thoroughly read the entire law, will explain its contents, the background of the bill's establishment, and what is expected.

For those who have heard of the "Act on Support for Children Requiring Medical Care" but don't know much about it, let's resolve those questions together.

1. What is the Act on Support for Children Requiring Medical Care?

1-1. What kind of law is it? What's in it?

The Act on Support for Children Requiring Medical Care is formally named "Act on Support for Children Requiring Medical Care and Their Families." It is commonly referred to as the "Act on Support for Children Requiring Medical Care" in newspapers and websites.

What kind of law is it? You can understand it by reading Article 1.

This law, in light of the increasing number of children requiring medical care and the diversification of their situations due to advances in medical technology, aims to establish basic principles and clarify the responsibilities of the national and local governments regarding support for children requiring medical care and their families. It also aims to promote policies related to the expansion of childcare and education, designate medical care support centers, and other necessary measures to ensure the healthy growth of children requiring medical care, prevent family members from leaving their jobs, and contribute to creating a society where people can give birth to and raise children with peace of mind.

Source: Act on Support for Children Requiring Medical Care and Their Families (Act No. 81 of 2021) | Ministry of Health, Labour and Welfare

Although it's a long sentence spanning multiple lines, breaking it down makes the purpose, means, and background of the law clearer.

1-1-1. Purpose: What does it aim to achieve?

• Ensure the healthy growth of children requiring medical care and prevent family members from leaving their jobs
• Create a society where people can give birth to and raise children with peace of mind

The law mentions not only the growth of the children themselves but also support for their families. The inclusion of preventing job loss, essentially "expanding life choices for families," is seen as a significant value.

1-1-2. Means: How will it be achieved?

• Clarify the responsibilities of the national and local governments regarding support for children requiring medical care and their families
• Establish policies related to the expansion of childcare and education, and designate medical care support centers in the law

Support for children requiring medical care is defined as a "responsibility" of the national and local governments. This law has created a situation where local governments must engage in support activities.

Additionally, a concrete change brought about by this law is the establishment of "Medical Care Support Centers." We will discuss this further in '2. What Changes with the Act on Support for Children Requiring Medical Care?'

1-1-3. Background: Why was the law created?

“Due to advances in medical technology, the number of children requiring medical care is increasing, and their situations are diversifying. Ensuring that these children and their families receive appropriate support tailored to each child's physical and mental condition has become a critical issue.”

The increase in children requiring medical care and the accompanying diversification of their lives. This may seem a bit vague, so let's delve deeper into it.

1-2. Why was the Act on Support for Children Requiring Medical Care enacted?

The number of children requiring medical care has approximately doubled over the past decade. This is said to be due to advances in medical technology, which have increased the number of lives saved.

As of 2021, Japan's neonatal mortality rate (the probability of dying within four weeks of birth) is 0.80, less than one in 1,000, making it the lowest in the world.

The infant mortality rate (the probability of dying within one year of birth) is also 1.8, one of the lowest globally.

Reference: Overview of Vital Statistics (Confirmed Numbers) for 2021 | Ministry of Health, Labour and Welfare

Reference: ‘The State of the World’s Children 2021’ Table 2: Indicators of Child Mortality | UNICEF

Looking at this data, giving birth in Japan might be considered very fortunate. It's a pleasing fact for those of us living in Japan.

However, it's not the end just because a life is saved.

Children who had to undergo surgeries like tracheostomies or needed feeding tubes due to an inability to take nutrition orally, and their families, face various challenges the moment they are discharged from the hospital.

First is the feeling of fatigue. When 24-hour care is needed, parents experience chronic sleep deprivation, leading to physical and mental exhaustion.

Then there's the sense of loneliness and isolation. Even when physically exhausted, some have few places to turn to and must handle care within the family. Some feel socially isolated, forced to leave jobs due to a lack of places to entrust their children requiring medical care.

Economic anxiety also arises from the lack of work options.

To change the situation where families must bear the burden alone without societal support, the Act on Support for Children Requiring Medical Care was established to create a system where society as a whole provides support.

2. What Changes with the Enactment of the Act on Support for Children Requiring Medical Care?

The specific methods for creating a system are outlined in the law as follows.

① Expansion of childcare systems
② Expansion of educational systems
③ Support in daily life
④ Establishment of consultation systems
⑤ Promotion of information sharing

These are the five items.

Reference: ‘Act on Support for Children Requiring Medical Care and Their Families (Act No. 81 of 2021)’ Chapter 2 | Ministry of Health, Labour and Welfare

It has been very challenging for children requiring medical care to attend nursery schools or schools alone. This is because only qualified professionals like nurses and care workers can provide the necessary medical care daily.

Even when consulting with administrative agencies, cases are often rejected due to reasons like "no place to accept" or "unable to secure personnel."

As a result, parents often have no choice but to care for their children at home or accompany them to nursery or school.

To improve such situations, the Act on Support for Children Requiring Medical Care stipulates the placement of necessary personnel to create an environment where children can receive childcare and education (corresponding to items ① and ② above).

By improving the childcare and educational environment for children, it is expected to also contribute to one of the law's objectives, "preventing parents from leaving their jobs."

Additionally, the establishment of Medical Care Support Centers, which provide a one-stop consultation place for support regarding children requiring medical care, is a significant change (corresponding to item ④ above).

Previously, even if there were issues or needed support, parents had to contact hospitals, government offices, facilities, and businesses directly.

Since not everyone in related agencies is knowledgeable about children requiring medical care, there were times when parents were passed around or had to explain the same thing repeatedly, unable to reach the necessary support.

The Medical Care Support Centers are expected to improve this situation.

When receiving consultations from parents, they provide comprehensive support, including contacting related parties and bridging with parents and facility training as needed.

By legally defining the support content and making the environmental improvement for children requiring medical care a "responsibility" rather than an obligation, it is expected that facilities and administrative agencies will actively work on environmental improvements.

3. Future Challenges of the Act on Support for Children Requiring Medical Care