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

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

Many women may plan their lives with this in mind.

As of 2024, with the number of dual-income households increasing to 13 million, it is no longer unusual for parents to return to work after childbirth by placing their children in daycare.

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

However, some children 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 this issue and consider how to address the enrollment problem.

We hope this will be helpful for those currently considering enrolling their medically dependent child 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 Unable 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 in finding daycare that accepts children requiring medical care.

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

Reading these accounts is heart-wrenching, but this is the reality.

Moreover, this is not an isolated case. As far as the author knows, similar situations are occurring nationwide.

1-2. The Serious Issue of Nurse Shortage

One 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 for Supporting Children Requiring Medical Care in Daycare Centers" P6 | Ministry of Health, Labor, and Welfare

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

When someone other than a 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 necessary.

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

"It's very difficult to attract nurses from hospitals to welfare due to significant differences in treatment, making it challenging for the welfare side to recruit them.

Therefore, hiring nurses is a great struggle.

The recent revision of compensation is very welcome, but it would have been more helpful if it were a more user-friendly system."

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 "treating injuries and illnesses after arrival" and "determining whether a doctor's visit is necessary," so even with a nursing license, they may not have the experience or ability to provide medical care.

When both a nursing license and experience in medical care are required, it becomes difficult to find qualified nurses.

Thus, enrolling children requiring medical care in daycare or kindergarten involves complex overlapping issues such as "lack of information," "shortage 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 centers and kindergartens that accept children requiring medical care. However, with the enactment of the "Medical Care Support Act for Children," some municipalities are showing proactive attitudes by setting up acceptance slots and creating guidelines.

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

Reference: Recruitment of Children (Medical Care Slots) for Daycare Centers (April 2023 Admission) | Toyama City

First, it is important to contact the local government to understand the current situation, such as "Are there daycare centers or kindergartens in my municipality that can accept children requiring medical care?" and "How can I find them?"

If you are a parent of a child requiring medical care, you may visit the local government for various welfare services and allowance applications. It might be a good idea to ask during those visits.

Even if it's not the recruitment period, gathering information in advance can help you prepare mentally, so it's never too early to start. Although contacting the local government may be a daunting task, asking is the first step.

If you cannot obtain any information from the government, it is worth trying to consult with others.

For example, consultation support staff, social workers, and medical care support centers for children. They are likely to have received consultations from various situations and may know of successful cases.

They may introduce you to precedents such as "We found one by searching this way" or "This daycare has children requiring medical care," allowing you to try similar methods.

Additionally, they may introduce you to unlicensed daycare centers not recognized by the municipality.

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

Given the current lack of acceptance facilities, it is important to consult with both the municipality and other consultation agencies. Although it is a physically and mentally demanding task, it is a crucial effort.

2-2. Consider Utilizing Child Development Support

If you still cannot find an acceptance facility after consulting various people, consider whether child development support facilities can be an alternative to daycare or kindergarten.

The Ministry of Health, Labor, and Welfare's "Report on the Examination of Support for Children with Disabilities" states that "responding to the needs of parents' employment through child development support is important."

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

Although child development support facilities often have shorter hours than daycare centers, they are originally facilities for children with disabilities, making them less challenging than daycare centers.

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

Even after exhausting all options, there may still be no available places to enroll your child, depending on the region.

It is frustrating and disheartening that, despite highlighting this issue in the article, we cannot provide a universal solution to the enrollment problem for children requiring medical care.

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

While it may not be comforting, we want to convey that the situation is gradually changing.

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

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

Moreover, the impact of the Medical Care Support Act for Children is becoming evident.

Some daycare centers have started accepting children requiring medical care due to actions taken by municipalities in response to the Medical Care Support Act for Children.

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

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

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

Although the situation did not change dramatically immediately after the support law was enacted, 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 unprepared for acceptance, and there are significant regional differences, making it difficult to find a definitive solution.

Although more than four years have passed since the Medical Care Support Act for Children was enacted, and the support system is gradually being established, further efforts are needed to fully achieve the law's goal of "preventing family job loss."

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

By conveying your situation to multiple people, there is a possibility, though not guaranteed, of receiving some helpful hints.

As a parent and mother of a child requiring medical care, I sincerely hope for an early resolution to the issue where parents must strive so hard to enroll their children in daycare or kindergarten, and I wholeheartedly support the efforts of these parents.