The future belongs to the youth, but perhaps not in Netherlands
Three professors voice their concerns about a vulnerable group in our society: children who come into contact with youth care.
The VGR, a Dutch association for the promotion and study of health care, has asked Mirjam Sombroek, Ton Liefaard, and Mariëlle Bruning to reflect on the Dutch youth care system and the children that come into contact with it. Together, they wrote two preliminary advices intended to provide more information and to contribute to the debate. Sombroek and Liefaard conclude that the Netherlands does not do enough to enable children to exercise their rights, especially when it comes to their right to health care. According to Bruning youth aid and youth protection are currently in a state of crisis.
Compilation of recommendations
The recommendations of Sombroek, Liefaard and Bruning are part of the compilation ‘De jeugd, de zorg en het recht’ (Youth, care, and law) together with four other contributions. In collaboration with other experts, including a juvenile court judge and inspectors of the Dutch Health and Youth Care Inspectorate, they reflect on issues that are currently not functioning properly in youth care and how to improve them. The compilation shows how youth law and health law are intertwined.
For the compilation’s introduction, Sombroek and Liefaard collaborated on writing a reflection on the right to health from the perspective of international juvenile law. Bruning provided the final observation on youth care and youth protection in the Netherlands. The other articles focus on financing and access to youth care, the quality of youth care and its supervision, enforced care for juveniles, and a reflection on the dilemmas faced by a juvenile court judge.
The right to health and the Children’s Rights Convention
The authors believe that States are not fully aware of the fact that the Children’s Rights Convention gives each child an independent right to heath. Children should be able to grow up and develop into healthy human beings. And this does not only refer to access to health care, although a great many countries seem unable to even provide just that.
In the Netherlands, things are definitely not as they should be. The UN Children’s Rights Committee has recently shown that the rights of the child will require a lot of attention in the Netherlands. According to the Committee, unequal opportunities and factual discrimination prevent children living in the separate countries of the Kingdom of the Netherlands from exercising their right to health equally. The Netherlands should put more effort into providing care for children with mental health problems, while improvements should also be made to the prevention of mental health problems.
Listen to the children and give them a say
Sombroek and Liefaard argue for a comprehensive approach to children’s rights in relation to health and youth care in the Netherlands and in the Kingdom. In which important provisions from the Children’s Rights Convention play a crucial role, such as ‘the interest of the child’ (art. 3), the right to health (art. 24), and the right of the child to be heard (art. 12). The authors take the time to address all these individual topics and provide suggestions as to better give children a say – based on the right of the child to be heard – and better include children in decisions regarding their own health. The focus should be on shared decision making (SDM). Parents obviously play an important role in the decision-making process, as does the doctor, but this should also apply to the child, especially as they grow older.
But there is still a lot of work that needs to be done. Sombroek and Liefaard: ‘Although there are sufficient legislation and regulations available in the Netherlands intended for children, the government and other authorities fall short when it comes to the implementation and enforcement of those rights. They notice that the child itself, especially when it comes to young children, is often overlooked.’
Preliminary advice Brunings: youth protection in a state of crisis
In her contribution Bruning reflects on five previously issued recommendations and concludes: ‘youth aid and youth protection have been in a state of crisis since November 2022. This is the result of, among other reasons, the financial and organisational limitations within the youth care system.
More young people with psychological problems because of Covid
Bruning points towards the increase of psychological problems among young people since the pandemic. As a result, both the number of crisis reports as well as the escalation of psychological problems for young people has risen. Most of these problems relate to suicide attempts, eating disorders, and complex issues with children and young people.
No youth aid also means no custodial placement
Bruning addresses the government’s obligation to protect children in case of severe threats to their development if their parents are unable to do so. The Inspectorates Health Care & Youth and Justice & Security have been sounding the alarm about the state of the youth protection system since 2019. Bruning: ‘Government interventions into family life, such as custodial placements, should no longer be possible without corresponding guarantees that suitable youth aid is also available.’ With these types of interventions, the government is not fulfilling its obligation to protect children in situations where their parents are unable to do so.
Emergency measures in youth care
Bruning believes that the Netherlands is currently unable to provide the right to youth aid because of the enormous shortages in youth care and the long waiting lists. It is clear to her that there is a vital and urgent need for emergency measures to be taken in youth care and youth protection. She argues for bringing health law and youth law even more closely together when it comes to the care of minors. The legislation and regulations in both legal areas should be coordinated more closely.
You can order the compilation (in Dutch) here: Preadviezen Vereniging voor Gezondheidsrecht, Den Haag: Boom Juridische Uitgevers, 2023
On 14 April 2023 all authors will present and defend their preliminary advices in front of the VGR.
Photo credits: Devin Avery via Unsplash