Challenges and Solutions for Enrolling Children Requiring Medical Care in Daycare and Preschool

"When you get pregnant, take maternity and childcare leave and then return to work."

Many women may be planning their lives with this in mind.

As of 2024, the number of dual-income households has increased to 13 million, making it no longer unusual for parents to continue working while placing their children in daycare after childbirth.

Reference: "Figure 12: Households with Full-time Housewives and Dual-income Households, 1980-2024"

However, there are children who cannot be placed in daycare or kindergarten even if their parents wish to work. These are children requiring medical care, estimated to be around 20,000 nationwide.

Why can't children requiring medical care enroll in daycare or kindergarten?

In this article, we will introduce the results of our investigation into the reasons for this and consider how to address this enrollment issue.

We hope this will be helpful for those currently considering enrolling their child requiring medical care in daycare or kindergarten, or those planning to do so in the future.

1. Enrollment Issues for Children Requiring Medical Care in Daycare and Kindergarten

1-1. Difficult to Find, and Even Harder to Enroll in Daycare and Kindergarten

NHK's "Heart Net TV" reported on the struggles of families with children requiring medical care as they attempted to enroll their children in daycare.

Reference: "The Current Situation of Children Requiring Medical Care: Night 1 - A Place for Parents and Children" | NHK Online

This article highlights the difficulties and challenges of finding daycare that can accommodate children requiring medical care.

• Even when consulting with daycare centers in the area that accept children requiring medical care, they were already at full capacity.
• There are very few child development support facilities that can accommodate children requiring medical care.
• Even when a local daycare finally agreed to accept the child, the enrollment period was limited to just one year.

These heart-wrenching situations are a reality.

Moreover, this is not an isolated case. As far as I know, such situations are occurring across the country.

1-2. The Serious Issue of Nurse Shortages

A major challenge hindering acceptance is the shortage of nurses.

According to a survey by the Ministry of Health, Labor and Welfare, 70% of municipalities cited the inability to secure nurses capable of providing medical care as a challenge in accepting children requiring medical care.

Reference: "Guidelines on Supporting Children Requiring Medical Care in Daycare Facilities" P6 | Ministry of Health, Labor and Welfare

The key point is "nurses capable of providing medical care."

When someone other than the parent provides medical care, it must be done by a nurse.

However, not just any nurse will do. Experience and skills as a nurse are also required.

In the Heart Net TV article, Hisako Okamoto, the director of a facility in Takaoka City, Toyama Prefecture, said:

"It's very difficult to attract nurses from hospitals to welfare because of the significant differences in treatment. Therefore, hiring nurses is very challenging. While the recent revision of remuneration is very welcome, I wish the system were a bit more user-friendly."

Source: "The Current Situation of Children Requiring Medical Care: Night 1 - A Place for Parents and Children" | NHK Online

The main roles of nurses in daycare are "handling injuries or illnesses after arrival" and "determining whether a doctor's visit is necessary," so even if they have a nursing license, they may not have the experience or ability to provide medical care.

When nursing qualifications are combined with the need for knowledge and experience in medical care, it becomes difficult to find qualified nurses.

Thus, the enrollment of children requiring medical care in daycare and kindergarten involves complex overlapping issues such as "lack of information," "lack of personnel," and "lack of understanding."

So, what can be done if you still want to enroll your child in daycare?

2. How to Address the Enrollment Issues for Children Requiring Medical Care in Daycare and Kindergarten

2-1. Start with the Basics

Nationwide, there are few daycare and kindergarten facilities that accept children requiring medical care. However, with the enactment of the "Act on Support for Children Requiring Medical Care," some municipalities are showing proactive efforts by setting up acceptance slots and creating guidelines.

Reference: Promotion of Acceptance of Children Requiring Medical Care in Daycare Facilities | Yokohama City

Reference: Recruitment of Children Requiring Medical Care Slots in Daycare Facilities (April 2023 Enrollment) | Toyama City

First, it's important to understand the current situation by inquiring with your local government about whether there are daycare or kindergarten facilities that can accept children requiring medical care and how to find them.

If you are a parent of a child requiring medical care, you may visit the government office for various welfare services or allowance applications. It might be a good idea to ask while you're there.

Even if it's not the recruitment period, gathering information in advance can help you prepare, so it's never too early to start. While contacting government offices may feel daunting, asking is the first step.

If you don't get any information from government agencies, it's worth trying to consult with others.

For example, you can consult with support coordinators, social workers, or centers for supporting children requiring medical care. They may have received consultations from people in various situations and might know of successful cases.

They might share examples like "We found a place using this method" or "This daycare has children requiring medical care," which you can try to replicate.

Additionally, they might introduce you to unlicensed daycare facilities that the municipality is not aware of.

While the term "unlicensed" might sound concerning, some daycare centers are expanding their acceptance of children by adopting an "enterprise-led" unlicensed model and are making efforts to accommodate children requiring medical care.

Given the current lack of acceptance facilities, it's important to consult with both municipalities and other consultation agencies. It's a challenging task that takes a toll on both body and mind, but it's a crucial effort.

2-2. Consider Utilizing Child Development Support

If you still can't find a place after consulting with various people, consider whether child development support facilities can serve as an alternative to daycare or kindergarten.

The Ministry of Health, Labor and Welfare's "Report on the Study of Support for Children with Disabilities" states that it is important to respond to needs due to parental employment even in child development support.

Reference: Report on the Study of Support for Children with Disabilities P10 | Ministry of Health, Labor and Welfare

Child development support facilities often have shorter hours than daycare, but since they are originally designed for children with disabilities, the hurdles are lower than those for daycare.

2-3. The Impact of the Act on Support for Children Requiring Medical Care is Evident

Even after exhausting all options, there may be no available places in some regions.

It is frustrating and disheartening not to be able to offer a universal solution to the enrollment issues faced by children requiring medical care, even while highlighting these issues in the article.

At this stage, the burden on parents is likely considerable.

While I understand this may not be comforting, I want to convey that the situation is gradually changing.

According to the Ministry of Health, Labor and Welfare, the number of facilities and children requiring medical care being accepted is increasing annually.

Reference: "Guidelines on Supporting Children Requiring Medical Care in Daycare Facilities" P2 | Ministry of Health, Labor and Welfare

Furthermore, the impact of the Act on Support for Children Requiring Medical Care is becoming evident.

Some daycare centers have begun accepting children requiring medical care due to actions taken by municipalities in response to the Act.

Reference: Early Start of Acceptance of Children Requiring Medical Care: The Thoughts of the Teachers at Chiyoda Seiga Nursery School | Medical Care Sitter Nancy

Additionally, the support law serves as a backing for parents, with some saying they waited for the law to be enacted before consulting with government offices.

Reference: The Path of Responsibility: The Current Situation of Children Requiring Medical Care / Middle - Preparing the Environment for Emergencies, Regions with Difficulty Accepting | Mainichi Newspaper

While the situation hasn't changed dramatically immediately after the enactment of the support law, it is gradually improving.

For those interested in learning more about the support law, there is an article explaining it in detail.

Reference:

3. In Conclusion

This article addressed the daycare and kindergarten enrollment issues that families with children requiring medical care inevitably face when they wish to work.

Unfortunately, many municipalities are still not prepared to accept these children, and there is significant regional disparity, making it difficult to find a decisive solution.

Although more than four years have passed since the enactment of the Act on Support for Children Requiring Medical Care, and support systems are gradually being established, further efforts are needed to fully realize the law's goal of "preventing family members from leaving their jobs."

In this current situation, the best course of action is to consult with as many people as possible.

By sharing with multiple people, there is a possibility, albeit not guaranteed, of gaining some hints or insights.

As a parent and mother of a child requiring medical care, I sincerely hope for an early resolution to the issue where parents have to go to such lengths to enroll their children in daycare or kindergarten, and I wholeheartedly support the efforts of parents striving to overcome this challenge.