茨城県議会は、各常任委員会審議初日を迎えました。
私の所属する保健福祉委員会は、午前中に病院局、午後に保健福祉部の付託案件を審議しました。
私は、病院局審議において、3点について質問。一つは、県中央病院永井病院長に「医療同意について」、こころの医療センター土井病院長に「認知症患者への身体拘束と薬物治療について」、高橋経営管理課長に「県中央病院の執務スペースについて」伺いました。
「医療同意」にせよ「身体拘束・薬物治療」にせよ高齢化社会にあってこれから数多く対処しなければならない事案です。医療は患者の身体や精神を治療するものですが、その前提に「身上監護」がなくてはなりません。
つまり、高齢者の自己決定の権利を擁護しつつ生き抜く方法を見出すことが必要です。そのための行政的なスタンスとリーガルチェックの必要性を訴えたいと考えました。
午後の保健福祉部審査では、「地域包括ケアシステムと介護保険住所地特例の整合性」と「認知症と成年後見の今後について」を質疑しました。
「住所地特例」の無秩序な濫用は、地域とともに過ごす高齢者ケアと矛盾する側面があります。特に、サービス付き高齢者向け住宅はその品質に落差がある場合も多く行政の監視監督機能が発揮それなくてはなりません。現に火災発生棟もあります。そして、中に住所地特例者が入居していると対応の差異があることが懸念されます。優良な事業者により適切に運用されることを望みます。
更に、「認知症と成年後見」は、実施主体が市町村であることから、県の役割は努力義務となり、影響力も限定的になりがちです。しかしながら、厚労省は全市町村に市民後見の人材育成を求めておりねけんは県内に不公平なく適切な進に助言指導する必要があると考えます。
これらが高齢化社会に向けで人として生きるために大事な施策になる考えます。
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