Health care for children and young people in community care – an evaluation
In 2017, changes to the law came into effect which entail an obligation for regions to, at the initiative of the municipalities, offer health examinations of children and young people in connection with the start of community care. In order to strengthen and clarify the forms of cooperation with regard to these children and young people, legal requirements were added at the same time for municipalities and regions to enter into agreements on cooperation. Although it has been five years since the changes in the law came into force, the intended changes regarding health examinations have not been achieved, either in number or scope. The offer of health examinations differs depending on where in the country the child or young person is placed and on which regulations the placement is based. Another problem is that mental and oral health is examined to a significantly lesser extent than somatic health. Only one region's health examinations seem to be in line with the National Board of Health and Welfare's regulations and general advice on health examinations. Others see it as impossible to offer health examinations in line with the regulations, for example due to a lack of child psychologists or paediatricians. The evaluation highlights several reasons why it has been difficult to get an impact on the changes to the law. Despite shortcomings, there is a great deal of commitment at municipal and regional as well as national level. Knowledge of the statutory more comprehensive health examinations has increased and the work to develop new or revise old agreements is ongoing. The National Board of Health and Welfare works continuously with material on cooperation for children in need of interventions from several actors. Finally, the evaluation indicates that the shortcomings are part of a larger problem and that the problems are similar to those that existed during the introduction of e.g. the rules for coordinated individual plan (SIP) that the social committee previously evaluated.
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project report
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Evaluation and Research Secretariat (ERS) of the Swedish Riksdag (ERS)