Statsbudsjettet

Statlig unngåelsesatferd

En kan lære mye av å lese statsbudsjettet. Det er bare så synd at statsbudsjettet er realpolitikk og ikke en eksempelsamling i departemental retorikk.

Statsbudsjettet gir en anledning til å studere hvordan en kan unngå å ta opp problemer. Helse- og omsorgsdepartementet flagger at det skal det finansieres 2000 leiligheter i omsorgsboliger i 2020. Som vanlig betraktes dette som en styrking av eldreomsorgen. Detpartementet nevner ikke at nettopp slike satsninger er hovedårsaken til reinstitusjonaliseringen av utviklingshemmede. Departementet nevner heller ikke at FN anbefalte Norge å innføre en deinstitusjonaliseringsplan (se pkt. .32a).

Husleiene i de nye kommunale institusjonene kan være ekstremt høye. Den statlige bostøtten forsvant som følge av uførereformen. Regjeringen har ikke ønsket å gjeninnføre statlig bostøtte for dem med trygdeytelsen "Ung ufør". Dette kan en ikke lese om i statsbudsjettet. Derimot skriver Kommunal- og moderniseringsdepartementet om boligsosial politikk og styrkingen av bostøtten, men det gjelder helt andre grupper enn unge uføre,

I de tilfellene problemer tas opp, vil statsbudsjettet vise hvordan en kan unngå å løse dem. Når det gjelder Helse- og omsorgsdepartementets omtale av bruken av tvang og makt overfor mennesker med utviklingshemming, så slås det fast at svært mange har slike vedtak, uten at en vet årsaken til dette. Departementet viser at det i hovedregelen gis dispensasjon fra kompetansekravene for utøvelse av tvang. Videre viser departementet til oppsummeringen av Helsetilsynets nasjonale tilsyn med tjenestene til mennesker med utviklingshemming i 2016, rapporten Det gjelder livet.  Rapporten dokumenterer at mennesker med utviklingshemming får for lite tjenester og at tjenestene i liten grad er individuelle. Det ble avdekket lovbrudd i 75 prosent av tilsynene. Helsetilsynet stiller spørsmål med om en på forsvarlig vis kan fortsette med dagens måte å organisere tjenestene på.

Departementets løsning på problemet er:

"Statens helsetilsyn har i 2018/2019 sluttført revidering av tre retningslinjer for fylkesmennenes arbeid med saker som omhandler bruk av tvang og makt. Det blir laget et opplæring-/kvalifiseringsopplegg for fylkesmennene som skal gjennomføres fra 2020, og som skal være en del av Helsetilsynets tilsynsskole. Målet er å oppnå bedre harmonisering av hvordan fylkesmennene jobber med slike saker."

Mye kan sikkert gjøres både med Helsetilsynet og fylkesmennene, men tilsynsorganet kan ikke gis ansvaret for mangelfulle tjenester i kommunene.

Videre kan en lese:

"I 2018 startet Helsedirektoratet arbeidet med en nasjonal veileder om kommunale helse- og omsorgstjenester til personer med utviklingshemming. Veilederen skal tydelig formulere hva som er forsvarlige tjenester til personer med utviklingshemming, og hva som skal til for at tjenestene er individuelt tilrettelagt der brukerne medvirker i utvikling og gjennomføring av eget tilbud. Plan for ferdigstillelse er juni 2020. "

Veiledere styrer ikke kommunene, det har Stortinget bestemt og KS-advokatene har lært det. Forsvarlighetskravet kan gi mening når det gjelder sårstell og meniskoperasjoner. Selv Helsedirektoratet vil ha problemer med å etablere forsvarlighetsnormer for omsorgstjenesten. Hvor ofte er det faglig forsvarlig å treffe kjæresten? Hvor mange kvelder per uke er det forsvarlig å delta på aktiviteter? Når tid på kvelden er det faglig forsvarlig å måtte legge seg? Spørsmålene er mange og betraktninger om faglig forsvarlighet hjelper en ikke frem til noen av svarene.

En kan lære mye av å lese statsbudsjettet. Det er bare så synd at statsbudsjettet er realpolitikk og ikke en eksempelsamling i departemental retorikk.

Jens Petter Gitlesen

7 oktober 2019

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