To prevent the collapse of the pediatric healthcare system, Korea must enact a law that guarantees the right to health for children and adolescents, leading pediatricians said Saturday. They added that the proposed law should stipulate the state's obligation to ensure the right to health for children and adolescents and to link fragmented child healthcare plans.

However, others pointed out that the nation must take “emergency steps” instead of following the time-taking process of enacting a law.

Experts expressed these and other views on how to legislate the right to guarantee health rights for children and adolescents at a policy forum organized by the Korean Pediatric Society (KPS) at Seoul National University Hospital on Saturday.

The society said it had discussed the basic law with the Korea Children's Hospitals Association and the Korean Society of Pediatricians and Adolescent Physicians by forming a promoting committee.

The committee took note of Japan's basic law on rearing children.

Japan, which experienced a declining birthrate before Korea, promoted "Healthy Parents 21," a project to steadily increase the services needed by children and adolescents. However, it failed due to discontinuous policies, and the neighboring country formed a pediatric health law project team composed of pediatricians. The team managed to enact the basic law on rearing children in 2018.

Based on this, Japan established the Children and Family Affairs Agency this past April to respond quickly to low birthrates, child poverty, and child abuse. In particular, the agency under the direct control of the prime minister has the authority to make recommendations to ministries to improve children's policies, serving as a control tower over child-related policies with strong authority.

"The medical system for children and adolescents in Korea is in a mess," said Han Mi-young, director of legal and ethical affairs at KPS. "Whenever a problem occurs, the Ministry of Health and Welfare meets with professional organizations and announces that it will push for countermeasures without a hitch. However, pediatricians in the clinical field have felt little differences before and after such pledges."

There are about eight divisions related to pediatric healthcare in the Ministry of Health and Welfare, but there is none exclusively responsible for this area, Han pointed out. She added that pediatricians feel frustrated that no officials can make decisions quickly because there is no dedicated division.

“Korea faces a situation where none of the essential elements need to be to raise a child properly. So, we must think about a law that enforces a social situation that must be observed with the state's power,” Han said. “That is why I think a basic law on pediatric health is necessary."

However, another expert pointed out that given the long time it takes to enact a basic law and the near collapse of the pediatric healthcare system, a “Plan B” should also be considered, stressing the need to revise or supplement existing laws simultaneously.

"How to ensure the effectiveness of the Basic Law on Pediatric and Adolescent Health is also a big issue. We already have the Framework Act on Health and Medical Services. The government is supposed to set up a (healthcare) development plan and report it to the National Assembly every year. However, it has failed to establish the healthcare development plan," said Park Sun-woo, dean of Daegu Catholic University School of Medicine, a professor of preventive medicine.

He went on to say, “As a simple example, in the Basic Law for a Low Birthrate and Elderly Society, the president is the chairman of the Low Birthrate and Elderly Society Committee, but the birthrate is worsening, Park noted. There are many basic and comprehensive plans, but we need to reflect on how many are working properly. I feel quite skeptical due to the learning effect."

Park said the pediatric healthcare system has reached a moment that needs CPR. Korea faces a special situation in Korea, and it can be seen as a matter of national survival. It deserves to become a national priority. He added that it would be more efficient and effective to take a strategic approach to make the system work immediately by amending existing laws on child health policies instead of enacting a new law.

Shin Choong-ho, KPS's chairman of the Child Protection Committee, expressed a different view.

"The declining birthrate caused the collapse of the pediatric care system, but the underlying cause is the structural problem of not being able to reinvest the profits from medical treatment and the lack of protection for pediatricians, as revealed by the incident at Ewha Womans University Mokdong Hospital incident," Shin aid. “These problems were amplified and exploded."

It is difficult to maintain the healthcare system without the state's and society's support, Shin said. Look at the government’s essential healthcare measures. They are full of plans to do for the health of newborns, but organized programs back up none. He added that the nation needs a basic law for pediatric and adolescent health and a control tower for it.

Yet others opined that the government should speed up efforts to prevent the collapse of the pediatric healthcare system.

"We are facing a very bad situation in terms of children's health problems and medical treatment, so I am very worried about the effectiveness of making laws and promoting policies right now," said Choi Eun-hwa, director of Seoul National University Children's Hospital. “It took Japan 10 years to enact the basic law on rearing children. I think it would be good to revise the existing law to reflect parts that support the provision of medical services for children's health, doctors' duties, and government responsibilities."

Choi went on to say, “The responsibility of local governments in caring for children's health is also important. I would like to see it enacted or revised in a way that covers emergency, severe, and disabled patients and is linked to social services so that childcare, education, and healthcare are not separated."

KPS Chairperson Kim Ji-hong said, "In the face of the pediatric healthcare crisis, I wonder why only we pediatricians worry about the situation. The state, responsible for maintaining the health of children and adolescents, should be most worried, but it doesn't seem to grip their minds. I think it's because there is no sense of obligation. That's why we need a basic law. Even if it takes time, we should push for it."