老いる大都市圏 介護の担い手をどう確保する

The Yomiuri Shimbun April 13, 2013
EDITORIAL / Secure nursing care staffers as major urban areas go gray
老いる大都市圏　介護の担い手をどう確保する（4月12日付・読売社説）

How to respond to the need for medical and nursing care in major urban areas, which will sharply rise in coming years, is a grave theme in social security policy.
　大都市圏で急増していく医療・介護のニーズにどう対応するか。
　社会保障政策の重い課題だ。

In the 30 years from 2010, Tokyo and the prefectures of Kanagawa, Saitama, Chiba and Aichi, among others, will see huge jumps in the number of residents aged 65 or older. This was revealed in a recent survey by the National Institute of Population and Social Security Research on population projections for specific regions.
　東京、神奈川、埼玉、千葉、愛知――。２０１０年から３０年間で、６５歳以上の人口が増える比率の高い都県だ。国立社会保障・人口問題研究所がまとめた「地域別将来推計人口」で明らかになった。

In Saitama and Kanagawa prefectures, the number of residents who are 75 or older--a group with higher need for medical and nursing care services--will double during the period.
　中でも埼玉、神奈川両県では、医療や介護の必要性が高まる７５歳以上の人口が倍増する。

Urban areas will gray as generations who moved there from regional areas during the period of rapid economic growth become senior citizens. Rural society is already graying as depopulation has steadily continued in farming village areas, and the trend will spread to major urban areas.
　都市部の高齢化は、高度成長期に職を求めて地方から都会に出てきた世代が高齢期を迎えるためだ。過疎化の進む農村部で先行していた地域社会の高齢化の波が、大都市圏にも押し寄せる。

In such a situation, it is indispensable to improve facilities for the aged, including special nursing care homes for the elderly. Such facilities have the advantage of being able to take care of many elderly people with a limited number of nursing care staff.
　特別養護老人ホームなど高齢者施設の拡充が欠かせない。限られた介護職員で多数の入所者をケアできるというメリットがある。

However, it is not easy to construct new facilities in urban areas, where land prices are high. The lack of facilities for the aged will worsen in the future.
　ただ、地価が高い都市部で施設の新設は容易でない。施設不足は今後一段と深刻になるだろう。

We hope each local government will wisely prepare facilities for the aged by, for instance, utilizing the buildings of schools that are no longer in use.
　各自治体は、廃校になった校舎を活用するなど、施設整備に知恵を絞ってもらいたい。

Home care needed

It is also important to create an environment in which people can receive sufficient medical and nursing care at their homes. Expectations are running high for the 24-hour home-visit nursing care service that the government launched last year. Nurses or nursing care staff visit the homes of aged people several times a day, and can also respond to emergency calls.
　在宅で十分な医療・介護を受けられるようにすることも重要だ。政府が昨年始めた「２４時間型訪問介護サービス」への期待は大きい。介護職員や看護師が高齢者宅を１日数回訪問し、緊急の呼び出しにも応じる仕組みだ。

However, this service has not been used widely: Less than 10 percent of local governments in the nation have introduced it so far.
Nursing care service providers are hesitant to adopt the service due to such burdens as responding to midnight calls. Difficulty securing nurses, a condition for entering the market, is said to be another cause.
　ところが、このサービスは普及していない。導入した自治体は全体の１割に満たない。夜間の呼び出しなどが負担で事業者が敬遠している。参入条件である看護師の確保が難しいのも一因という。

The Health, Labor and Welfare Ministry must study measures to improve the situation, such as easing conditions for participating in the market.
　厚生労働省は、参入条件の緩和などを検討すべきだ。

It is also important to secure nursing care staff. Even people who have experience in this area often stop working due to marriage and childbirth. An environment has to be created in which such people can continue to work in nursing care while rearing their children, by solving the problem of the long waiting list to enroll children in licensed day care centers, among other things.
　介護職員の確保も重要である。介護のノウハウを持っていても、結婚や出産で辞める人は多い。保育所の待機児童の解消など、子育てをしながら働き続けられる環境を整えねばならない。

It is also necessary to improve salaries in this business sector, which are lower than in other industries.
　他の産業に比べ低い賃金水準を改善する必要もある。

Single men face isolation

The number of elderly men living alone in urban areas will sharply increase in the future, much more than single elderly women. This is going to be a big problem.
A major reason is that the percentage of unmarried men currently in their 30s and 40s is rising due to such factors as the increase in non-regular employees, who are paid less than regular full-time workers.
　都市部では今後、独り暮らしの高齢男性が女性以上に急増することが大きな問題となろう。収入が低い非正規雇用の増加などで、現在３０～４０歳代の男性の未婚率が上昇していることが要因だ。

Single people cannot expect family members to provide nursing care when they become old. They tend to have tenuous connections to their neighbors and become alienated.
　単身者は家族による介護が期待できない。近隣との結びつきが乏しく、孤立しがちだ。

The urban graying problem must be discussed, including such factors as employment, salaries and an appropriate way for the public to bear the burdens. We hope the government's National Council on Social Security System Reform will deepen its discussions on these issues.
　都市部の高齢化問題については雇用や賃金制度、さらに国民の負担のあり方も含めて検討することが欠かせない。政府の社会保障制度改革国民会議は、こうした視点からも議論を深めてほしい。

(From The Yomiuri Shimbun, April 12, 2013)
（2013年4月12日01時42分  読売新聞）