19th september 2019
  • The Institution recommends the development of a national socio-health strategy for acquired brain injury, including a section specifically dedicated to child acquired brain injury.
  • Many shortcomings identified in the report published in 2006 still exist.
  • The Ombudsman recommends establishing an identification and registration code for the DCA for the entire National Health System.
  • He calls on the various regional administrations to set up hospital units specialising in neurorehabilitation of brain injury with a reserve of beds for paediatric care.
The Ombudsman (e.f.), Francisco Fernandez Marugan, today submited to the NationalParliament a monographic report on the care of brain injury acquired by children in Spain. Fernández Marugán believes that it is essential to establish a national socio-health care strategy for acquired brain injury (DCA) that includes a specific dedicated section to brain injury in childhood and adolescence. In 2006 the Institution already published the report Brain Injury: an epidemiological and socio-health approach which includes a number of recommendations to the different public administrations which, unfortunately, in most cases have not been implemented. In the new study, the Ombudsman has focused on the existing shortcomings in the care of minors with DCA, since, although the acquired brain injury more habitually affects adults, the experts agree that the situation of these children must be made visible in order to obtain an adequate response from the different spheres. Furthermore, since the previous report came out, the Institution has found out that resources have indeed increased to deal with the reality of DCA in adults. Proof of this are the actions promoted within the framework of the Stroke Strategy of the National Health System and the implementation of the stroke code. However, specific attention to child injury has been neglected. For this reason, the effective access of children with acquired brain injury to the best specialized resources is the main issue addressed in this study. At present there are no solid epidemiological data on cases of acquired brain injury, adult or child, so for Fernández Marugán it is essential to establish for the whole of the National Health System an identification and registration code for the DCA that is known and shared by all the administrations involved (health, social and educational). On the other hand, the Institution has verified that in Spain there is a very reduced number of beds and hospital care places destined to neurorehabilitation specialized in the attention to the DCA of adults and, in the case of minors, this availability is almost non-existent. The Ombudsman recalls that “this situation constitutes a breach of the duties laid down in the portfolio of common services of the National Health System”. For this reason, he has recommended to the different autonomous administrations that, if they do not have hospital units specialised in neurorehabilitation of brain injury, they should create them with a sufficient number of beds and places specifically dedicated to paediatric care. In addition, today, many affected people are forced to obtain the much needed multidisciplinary treatment from private specialized centers, if any, , entailing a high financial cost. The Ombudsman also considers that until pending structural improvements are in place, administrations should take responsibility for these situations by implementing agile reimbursement procedures. Coordination with the educational administration The Institution has also detected that there are no adequate mechanisms for coordination and cooperation between the different health, social care and educational administration departments , with regards to the needs of minors affected by the DCA. In order to provide a better care for these children it is necessary to have a structured and sufficiently endowed social and health environment in which the educational sphere should also be integrated. For the Ombudsman, the autonomous administrations must have a body specialised in approving itineraries of individualised attention that deal with the clinical follow-up of the affected minor, their social needs and their educational inclusion. These bodies, after an individualised evaluation of the DCAI cases, should determine the intervention plan or programme, assigning a reference professional with coordination functions to each patient. This practice is already being developed in some autonomous communities.