私の所属する保健福祉委員会の閉会中委員会が開催されました。委員会テーマは、「少子高齢化対策の推進」。保健福祉の将来政策の根幹にある課題への取り組みとなります。
平成25年1月1日現在の茨城県総人口は、2,944,115人。この総人口も、27年後の平成52年には、2,423千人と521千人(約18%)減少し、0才から14才の年少人口の構成比は10%に留まり、15才から64才までの生産年齢人口の構成比は約54%、65才以上の高齢者年齢は36%となる予想です。3人に1人を超える高齢者の皆さまが元気に暮らすし、予防の行き届いた社会を作らなければなりません。
その後数年で、高齢者人口の減少期がやってきて超人口減少社会に突入します。福祉社会を担う各種の施設等の事業所のあり方を考えると、40年超の耐用年数ある施設は事業性に欠けるものになっていると思われます。入所者を確保できない所が出てくると考えるからです。今は施設が不足、しかし、新たに作ると収支が取れないというジレンマが確実に有ります。つまり、施設入居型から在宅医療や介護への転換が急務です。とはいえ課題も山積です。在宅を推進するも単身世帯では難しい局面が多く見られるでしょう。日本社会が大家族主義を忘れ、世帯分離が進展したことは人が人を支える保健福祉の妨げのようにすら思えます。
また、私たちが資産として取得したストックが、もてあまし陳腐化することも考えられます。例えば家族4人で自宅を新築。数年後子供たちは独立し夫婦二人世帯に。高齢になって2階にはひざが痛くて行けない。夫婦の一方が認知症になりやむなく介護施設に入居。この夫婦にとっては自宅が2か所あるようなってきます。ストックを活かしきれない社会です。ストックがフローに転換できないことが課題になると思われます。
私は、福祉社会の構築は、事業性の確保を綿密にして、在宅と施設入居のバランスを取りながら、在宅事業の採算性の確保を企図した政策の必要性を感じます。
この日の委員会では、少子化対策の中で、年収300万以下を場合の結婚率の低位が指摘されました。これから広がる介護と医療を担う人材に将来を担うに足る収入の確保を政治の力で実施すべきだと考えます。
その上で、保健福祉の行き着くところは、各人の生き方の追究であり、死生観のあり方のように感じます。長期展望と事業性の観点からの審議をしたいと思います。
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