福祉ふくしの相談そうだん支援しえん 人員じんいん確保かくほが困難こんなんに 機能きのう集約しゅうやく化かで特例とくれい制度せいど創設そうせつへ

It has been revealed that the Ministry of Health, Labour and Welfare has decided to establish a special system to consolidate functions, as securing personnel for welfare consultation and support—assigned to each field such as nursing care and disability welfare—is expected to become particularly difficult in rural areas due to the declining population.

According to national estimates, it is said that by 2050, the population of about 30% of the approximately 1,700 municipalities nationwide—excluding some towns and villages in Fukushima Prefecture—will be less than half of what it was in 2015.

Amid these circumstances, the Ministry of Health, Labour and Welfare has decided to establish a special system to consolidate certain functions, as it is becoming difficult, especially for local governments, to secure welfare personnel who are currently assigned by sector.

Specifically, the functions for receiving consultations from residents and connecting them to support will be consolidated into one for the four areas of nursing care, child welfare, disability welfare, and support for people in need.

For families in need of support, there are often complex issues such as the so-called 8050 problem, where elderly parents support their children, and double care, where people are caring for both children and elderly family members. It is said that this will make it possible to provide support that goes beyond the boundaries of existing systems.

In addition, the Ministry of Health, Labour and Welfare plans to include in the budget request for next fiscal year the costs for dispatching advisors from prefectures and strengthening cooperation with local residents, with the intention of implementing these measures on a trial basis in some municipalities.

Professor Yu Nagata of the Faculty of Sociology at Doshisha University, who specializes in social welfare studies, said, Especially in areas with small populations, it is becoming increasingly difficult to secure the required number of professionals whose placement is mandated.

In order to eliminate the vertical divisions within the administration, consolidating functions is a necessary choice, but it is also important to carefully consider a solid backup system for supporters so that the burden does not fall on them, he said.

Expert: Support to prevent supporters from becoming isolated is also necessary. Regarding the centralization of consultation support functions, Professor Yu Nagata of the Department of Sociology at Doshisha University, who specializes in social welfare studies, said, In depopulated mountainous and rural areas, there is a particular shortage of people available to provide consultation support.

For example, at Community Comprehensive Support Centers, which accept consultations from the elderly, it is mandatory to assign professionals such as social workers and public health nurses. However, securing such professionals is a particular challenge, and in reality, even when recruiting, people do not apply.

In recent years, similar concerns have been heard even in suburban areas, and he mentioned that in the near future, this could become an issue in urban areas as well.

On top of that, with changes in family structure, weakening community ties, and increasing job insecurity as the background, new difficulties such as the 8050 problem, which had not been anticipated before, are emerging, and the current systems are no longer able to provide adequate support.

By consolidating the functions of consultation support, it was pointed out that a shift in thinking is needed to use this as an opportunity to turn the vertical system into a more comprehensive framework.

On the other hand, “when consolidating, if a single supporter is expected to handle all consultations for elderly people, people with disabilities, etc., it may not function well, so support to prevent the supporter from becoming isolated is also necessary at the same time.”

For example, it is important to thoroughly consider ways to provide backup, such as cooperating with neighboring municipalities to establish bases, or having prefectural governments dispatch specialists that small municipalities cannot secure on their own, he said.