Studying Access to Healthcare for Children in the Child Welfare System: the Health of Protected Children

Child Protection in France, defined by Article L.112-3 of the Social Action and Family Code (CASF), "aims to ensure that the child's fundamental needs are taken into account, to support his or her physical, emotional, intellectual and social development, and to preserve his or her health, safety, morality and education, while respecting his or her rights". It therefore covers many aspects : prevention, identification of situations of danger or risk of danger, and implementation of administrative or judicial protection measures for minors and adults under 21. This policy is largely entrusted to departmental councils and local authorities with special status, notably through their child welfare services (ASE)" (Reference 1). According to the report by the National Observatory for Child Protection (ONPE), by the end of 2022, the number of minors in care, all child protection services and measures combined, would be 310,577 minors, while the number of young adults in care would be 34,105 adults (Reference 2). Between 2011 and 2022, the estimated number of minors will increase by 13%, while the estimated number of young adults will rise by 62% (Reference 2). The assessment of a child's health preservation during a child protection measure is governed by the following texts: * Code de l'Action Sociale et des Familles (CASF) (Social and Family Action Code), Code Civil (Civil Code) and Code de Justice Pénale des mineurs (Juvenile Criminal Justice Code): these define the grounds and nature of administrative and judicial interventions; * Code de la Santé Publique (CSP) (Public Health Code): defines compulsory examinations according to the child's age, and the procedures to be followed. The texts have been reformed in recent years by : * Law n°2007-293 of March 5, 2007 reforming child protection ; * Law n°2016-297 of March 14, 2016 on child protection; * Law n°2022-140 of February 7, 2022, known as the "Taquet" law, on child protection. In the Defender of Rights' framework decision on child protection (Reference 3), it is stated that "due to their history and particular vulnerability, children in child protection care have specific health needs. Numerous studies have demonstrated the deteriorated state of health of these children, the lack of information on risk factors, family history, the need for psychological care, etc.". These findings have led to the launch, in addition to legal reforms, of innovative national experiments falling within the scope of Article 51 of the French Social Security Financing Act: "Pégase" and "Santé Protégée", two programs designed to coordinate the care of children in the care of the Children's social welfare. As stated in its strategic plan (Référence 4), "the ILDYS Foundation's action is part of a public service mission in conjunction with the Finistère Child and Family Department. In the child protection sector, the aim is to respond as closely as possible to the needs of each child, and to guarantee his or her safety through support for parenthood and parental substitution."