Proposition 52K1845

Proposition de résolution relative aux soins pédiatriques à domicile.

General information ¶

Authors

Ecolo Muriel Gerkens
Groen Tinne Van der Straeten
LE Véronique Salvi
MR Florence Reuter
Open Vld Katia della Faille de Leverghem
PS | SP Camille Dieu
Vooruit Maya Detiège

Submission date

March 2, 2009

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

child resolution of parliament home care public health

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo LE PS | SP Open Vld LDD MR FN VB

Contact form ¶

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Discussion ¶

June 4, 2009 | Plenary session (Chamber of representatives)

Full source

Ms. Percriaux refers to this in her written report. The same goes for mr. Otlet who is co-rapporter.

Mrs. Speaker, dear colleagues, I would like to emphasize the importance of the text on pediatric care at home, which is submitted to you today and which is ⁇ important to me.

It is based on Article 1 of the EACH Charter on the care of hospitalized children adopted by the European Parliament. The article says this: "Admission to the hospital of a child shall be carried out only if the care required by his illness cannot be provided at home, in external consultation or in the day hospital."

It is now necessary that in Belgium young patients and their parents have the choice to go home when the treatment that is given to them in the hospital could be at home. Initiatives already exist, local solutions as well, but there are no solutions at the national level. This is the lack that the resolution proposal aims to address.

No, it is not about installing the hospital at home, but rather to offer an alternative to hospitalization, when all conditions are met for the comfort of sick children. It is a response to the needs of families, but it is not a compulsion. There is no question of imposing home care if families do not feel large to face such a choice. The goal is to give everyone, regardless of the hospital and region of the country, the opportunity to choose home care.

Today, inequalities exist especially depending on the place of residence. Children who could receive home care are sometimes forced to stay in the hospital, which is an additional test for the disease. A well-prepared return home can, on the contrary, be a relief. This often avoids the rupture with the family environment and this participates in the child’s healing process. This is why a legal framework is now needed to guarantee patients adequate home care structures, as well as quality and safety.

In order for this to work, it is imperative to establish partnerships between the hospital and extra-hospital world. It is imperative that a specific multidisciplinary team for complex pediatric care be established. It is imperative that pediatric care projects rely on existing structures.

But beyond these arguments and the human argument of benefits for young patients and their families, the financial argument must be taken into account. Home care could allow INAMI to make savings. The estimated savings are almost half for hospitalization and almost a third for daily hospitalization. And yet today, as no legal framework exists, the cost of a home hospitalization supported by parents is much greater than the cost of the same care provided in the hospital.

Therefore, it is important to lay the foundations for a framework that aims solely at the well-being of the child, while guaranteeing care as efficient as in the hospital.

This text is the result of in-depth research work carried out with all relevant field actors: doctors, hospital and non-hospital pediatricians, nurses, but also families of sick children and home care associations.

That is why, dear colleagues, I ask you to support this proposal for a resolution, knowing that this is the starting point of a long work that will be the responsibility of the government. It is a response to a real need. This is a logical follow-up to the measures already in place to humanize the hospital. It is also the result of teamwork, between parliamentarians who have managed to overcome their political differences for the well-being of children. It is not unnecessary, I think, to emphasize this.

First of all, I would like to remind you how, for the CDH, support for families as well as access to health care and the well-being of patients are always, and for a long time, priorities.

A child’s illness always comes unexpectedly and is always an extremely difficult time experienced by families, which need to be supported. In this context, the CDH also submitted a bill to improve medical care leave.

We have been working on this resolution since the beginning, we have supported it. It contributes to the improvement of the situation of the sick child and his parents, which is one of the objectives of our group in federal policy and health.

In our view, this evolution goes through three fundamental elements: the humanization of care, the conciliation of parental care of disease with the continuation of professional life and, finally, the importance of ensuring the coverage of the costs of care given to children suffering from serious or chronic diseases.

That’s why I thought it was important this afternoon to draw the government’s attention especially to three requests made in the proposed resolution: putting and ⁇ ining patients at the center of healthcare devices for both the quality of care and their well-being; providing adequate funding for coordination, complex equipment and specific care not currently provided in the nomenclature; and finally, making significant progress on the social and tax status of the assistant, which is now part of a part of the federal agreement.

It is important for the CDH to be able to work on improving this tax and social status for the close assistant.

I could not fail to comment on this proposal. It is the result of a collective work of parliamentarians from different political families and field actors. It is the Ecolo-Groen group. has invested in this work and supported this resolution proposal for the following reasons.

First of all, it is true that the care to be given to children must almost generally include the obligation to limit their hospitalization to the necessary minimum because it is vital for them to maintain a normal relationship with their family and their social environment.

Then, another element highlighted by this project is the need to coordinate and develop a networking practice between proximity care actors and those of more specialized care in hospital structure. The text of the resolution accepted and incorporated the fact that this organization of pediatric care services at home should be realized within the existing coordination structures, for example the SISDs to mention only those, which need to be valued as they bring together all health actors. This does not prevent the extension of these coordination tools so that all health and social assistance actors can be integrated.

Finally, this practice of complex pediatric care at home already exists and is the result of the mobilization of nurses, pediatricians, family support and generalists. There are several formulas currently: some have organized this care from pediatricians and pediatric nurses from the hospital, others from the home care service. They all share intervention practices around common values and a common project.

This is what we want to emphasize. We believe that through this resolution, the form will derive concretely from practice; we insist on the need for this collaboration and this coordination between hospital and nearby stakeholders. This has been known for a long time and goes beyond the scope of pediatric care: this will require a revision of the care nomenclature and the position of health actors, specialists and generalists – in hospital structures or outside. Interesting in patients that especially attract our attention, such as children, will allow to open a construction site. It is in this perspective that Ecolo-Groen Group! We will support this resolution.