When researching support for children requiring medical care, you may often come across the term "Medical Care Child Support Act."
As the name suggests, it is a law to support children requiring medical care, but some of you might wonder, "What kind of law is this?" or "What changes will occur (or have occurred) with its implementation?"
In this article, the author, who has read the entire law, will explain its contents, the background of its enactment, and what is expected from it.
Even if you've heard of the "Medical Care Child Support Act" but aren't familiar with the details, let's resolve those questions together.
1. What is the Medical Care Child Support Act?
1-1. What kind of law is it? What are its contents?
The Medical Care Child Support Act is officially named the "Act on Support for Children Requiring Medical Care and Their Families." It is commonly referred to as the "Medical Care Child Support Act" and is often mentioned as such in newspapers and websites.
What kind of law is it? You can understand it by reading Article 1.
This law, considering the increase in children requiring medical care due to advances in medical technology and the diversification of their situations, aims to ensure that these children and their families receive appropriate support tailored to the physical and mental conditions of each child. It establishes basic principles, clarifies the responsibilities of the national and local governments, and stipulates necessary measures such as the expansion of childcare and education and the designation of medical care child support centers. The purpose is to promote the healthy growth of children requiring medical care, prevent the resignation of their family members, and contribute to the realization of a society where children can be born and raised 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 objectives of the law, the means to achieve them, and the background of its enactment clearer.
1-1-1. Objectives: What does it aim to achieve?
- Promote the healthy growth of children requiring medical care and prevent the resignation of their family members
- Realize a society where children can be born and raised with peace of mind
The law not only addresses the growth of the children themselves but also mentions support for their families. The inclusion of language about preventing resignation, essentially "expanding the choices for family lifestyles," in the law is seen as highly valuable.
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 measures related to the expansion of childcare and education, other necessary measures, and the designation of medical care child support centers in the law
Support for children requiring medical care is designated as a "responsibility" of the national and local governments. This law has created a situation where municipalities must engage in support efforts.
Moreover, a concrete change brought about by this law is the establishment of "Medical Care Child Support Centers." This will be discussed later in '2. What Changes Have Occurred with the Implementation of the Medical Care Child Support Act?'
1-1-3. Background: Why was the law created?
“With the increase in children requiring medical care due to advances in medical technology and the diversification of their situations, ensuring that these children and their families receive appropriate support tailored to the physical and mental conditions of each child has become a significant issue.”
The increase in children requiring medical care and the resulting diversification of lifestyles. This is somewhat vague, so let's delve a little deeper into this.
1-2. Why was the Medical Care Child Support Act enacted?
The number of children requiring medical care has nearly 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 one of the lowest in the world.
The infant mortality rate (the probability of dying within one year of birth) is also extremely low at 1.8, ranking among the lowest globally.
Reference: Overview of Vital Statistics (Confirmed Figures) 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, it can be said that being able to give birth in Japan is quite fortunate. This is a pleasing fact for those of us living in Japan.
However, it doesn't end with just saving lives.
Children who had to undergo surgeries like tracheostomy or needed feeding tubes because they couldn't take nutrition orally, and their families, face various challenges the moment they are discharged.
First is the feeling of exhaustion. Parents may experience chronic sleep deprivation and physical and mental fatigue due to the need for 24-hour care.
Then there's the sense of loneliness and isolation. Even when reaching physical limits, some families have few places to turn to and must bear the care responsibilities alone. Some feel socially isolated due to having to leave their jobs because there are no places to leave their children requiring medical care.
Economic anxiety also arises from the lack of work options.
Despite the lives saved, the lack of societal support systems forces families to bear the burden alone. The Medical Care Child Support Act was established to create a system where society as a whole can provide support.
2. What changes with the implementation of the Medical Care Child Support Act?
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 main points.
It was very challenging for children requiring medical care to attend daycare or school alone. This is because only qualified personnel like nurses or care workers can perform the necessary medical care.
In reality, even when consulting with administrative offices, cases are often rejected due to reasons like "no available facilities" or "lack of personnel."
As a result, parents often have no choice but to care for their children at home or accompany them to daycare or school.
To improve such situations, the Medical Care Child Support Act aims to create an environment where necessary personnel are assigned, allowing children to receive childcare and education (corresponding to points ① and ② above).
By improving the childcare and educational environment for children, it is expected to contribute to one of the law's objectives: preventing parents from leaving their jobs.
Additionally, the establishment of Medical Care Child Support Centers, which provide a one-stop consultation place for support related to children requiring medical care, is a significant change (corresponding to point ④ above).
Previously, even if there were issues or needed support, parents had to contact each relevant organization, such as hospitals, government offices, facilities, and businesses, directly.
Since not everyone in these organizations is knowledgeable about children requiring medical care, there were times when parents were passed around or had to explain the same thing multiple times, making it difficult to reach the necessary support.
The Medical Care Child Support Centers are expected to improve this situation.
When parents consult, the centers provide comprehensive support, including contacting relevant parties as needed, acting as intermediaries with parents, and providing training to facilities.
By legally defining the support content and making the environmental improvements for children requiring medical care a "responsibility" rather than a "duty of effort," it is expected that each facility and administrative body will actively work on environmental improvements.
3. Future Challenges of the Medical Care Child Support Act
The fact that the support law explicitly states that municipal support is a "responsibility" serves as a significant basis in negotiations.Even if the desired response is not obtained, persistently working through support centers and coordinators can propel the regional support system forward.
参照：医療的ケア児等とその家族に対する支援施策｜こども家庭庁
4. List of Medical Care Support Centers for Children Nationwide
We have compiled a list of medical care support centers for children nationwide.
Contact information is provided, so if you have any concerns, please consult the medical care support center for children in the relevant prefecture.
055-287-8209 |
0957-27-6360 |
※1 Generally, the centers operate from 9 AM to 5 PM on weekdays, but some centers may extend their phone consultation hours.
※2 Consultations are accepted not only from the individuals and their families but also from supporters such as nursery schools, schools, and businesses.
5. Conclusion
The support for children requiring medical care is a responsibility of local governments, aiming to prevent family members from leaving their jobs and to create a society where children can be born and raised with peace of mind.
The establishment of a law that clearly states this is likely a welcome development for children requiring medical care and their families.
However, immediate improvements are not guaranteed, and this is just the beginning.
As a parent of a preschool-aged child requiring medical care, I have been actively seeking a nursery school and securing support for enrollment over the past few months. It required extensive discussions with local governments and a significant investment of time and effort.
I have personally felt that the environment is not yet fully developed. Nonetheless, I have also appreciated the value of medical care support centers and the strength of supporters who negotiate assertively, saying, "Because the support law is in place."
"Even though the law exists, things are not yet in place," and "Because the law exists, things are improving somewhat."
We might currently be at an intermediate stage where both of these realities coexist.
We hope to see changes that allow all children requiring medical care and their families to achieve the lives they desire, and we will continue to watch and support these developments.
