{"id":9867,"date":"2013-09-03T09:24:04","date_gmt":"2013-09-03T07:24:04","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=9867"},"modified":"2014-10-20T20:06:59","modified_gmt":"2014-10-20T18:06:59","slug":"posilat-deti-k-psychiatrum-muze-byt-i-modni-vec-domniva-se-lekar","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=9867","title":{"rendered":"Pos\u00edlat d\u011bti k psychiatr\u016fm m\u016f\u017ee b\u00fdt i m\u00f3dn\u00ed v\u011bc, domn\u00edv\u00e1 se l\u00e9ka\u0159"},"content":{"rendered":"

„Nedostatek d\u011btsk\u00fdch psychiatr\u016f se d\u00e1 vytvo\u0159it i um\u011ble,“ \u0159\u00edk\u00e1 v rozhovoru p\u0159ednosta Psychiatrick\u00e9 kliniky Fakultn\u00ed nemocnice v Plzni Ji\u0159\u00ed Beran. \u00a0Reaguje tak na slova ombudsmana Pavla Varva\u0159ovsk\u00e9ho, jen\u017e tvrd\u00ed, \u017ee\u00a0 nen\u00ed dostate\u010dn\u011b dostupn\u00e1 psychiatrick\u00e1 p\u00e9\u010de pro d\u011bti. <\/strong>
\n<\/p>\n

V \u010cesku nen\u00ed podle ombudsmana Pavla Varva\u0159ovsk\u00e9ho dostate\u010dn\u011b dostupn\u00e1 psychiatrick\u00e1 p\u00e9\u010de pro d\u011bti. V zemi by m\u011blo p\u016fsobit asi sto pedopsychiatr\u016f, p\u0159i\u010dem\u017e 30 jich podle ombudsmana sch\u00e1z\u00ed. Nedostatek psychiatr\u016f pr\u00fd zp\u016fsobuje, \u017ee jsou mal\u00ed pacienti zbyte\u010dn\u011b hospitalizov\u00e1ni. Kdy\u017e toti\u017e sch\u00e1z\u00ed ambulantn\u00ed pedopsychiatrick\u00e1 slu\u017eba, jsou d\u011bti v l\u00e9\u010debn\u00e1ch p\u0159\u00edli\u0161 dlouho.<\/p>\n

Kancel\u00e1\u0159 ombudsmana upozornila na p\u0159\u00edpad, kdy je v jedn\u00e9 z l\u00e9\u010deben um\u00edst\u011bn t\u0159in\u00e1ctilet\u00fd chlapec s poruchami autistick\u00e9ho spektra, ale bez ment\u00e1ln\u00edho posti\u017een\u00ed. Jeho matka zvl\u00e1d\u00e1 p\u00e9\u010di o n\u011bj o v\u00edkendech. P\u0159esto by nemusel b\u00fdt v l\u00e9\u010debn\u011b, kdyby m\u011bl k dispozici doma vhodnou p\u00e9\u010di.<\/p>\n

„Poji\u0161\u0165ovna m\u00e1 z\u00e1jem na tom, aby nem\u011bla tak velk\u00e9 v\u00fddaje. P\u0159\u00edpadn\u00fd nedostatek nejde na vrub zdravotnictv\u00ed. Je t\u0159eba \u0159\u00edci, \u017ee zdravotnictv\u00ed, a\u010dkoli se to nezd\u00e1, \u0159\u00edd\u00ed poji\u0161\u0165ovny,“ reagoval na ombudsmanova slova, p\u0159ednosta Psychiatrick\u00e9 kliniky Fakultn\u00ed nemocnice v Plzni, Ji\u0159\u00ed Beran.<\/p>\n

– Co \u0159\u00edk\u00e1te vyj\u00e1d\u0159en\u00ed ombudsmana?<\/strong><\/p>\n

D\u011btsk\u00fdch psychiatr\u016f nejsp\u00ed\u0161e nen\u00ed dost, ale ot\u00e1zkou je, co je to dost. Jsou na to n\u011bjak\u00e9 tabulky? A pokud jsou, jsou sm\u011brodatn\u00e9? Jedno je ale jist\u00e9. D\u011btsk\u00fdch psychiatrick\u00fdch l\u00e9\u010deben a odd\u011blen\u00ed pro d\u011btskou a dorostovou psychiatrii b\u00fdvalo v\u00edce. P\u0159es nesouhlas d\u011btsk\u00fdch a dorostov\u00fdch psychiatr\u016f byla n\u011bkter\u00e1 odd\u011blen\u00ed po roce 1990 zru\u0161ena.<\/p>\n

– Tak\u017ee je d\u011btsk\u00fdch psychiatr\u016f nedostatek?<\/strong><\/p>\n

P\u0159ed dvaceti, t\u0159iceti lety d\u011btsk\u00fdch psychiatr\u016f nebylo v\u00edce a n\u011bjak\u00fdm zp\u016fsobem to zvl\u00e1dali. On se d\u00e1 toti\u017e nedostatek vytvo\u0159it i um\u011ble. Popust\u00edm uzdu fantazii. Kdy\u017e by d\u011bt\u0161t\u00ed l\u00e9ka\u0159i pos\u00edlali o n\u011bco m\u00e1lo v\u00edc d\u011btsk\u00fdch probl\u00e9mov\u00fdch pacient\u016f k psychiatr\u016fm, tak v tom okam\u017eiku vznikne ohromn\u011b dlouh\u00e1 \u010dekac\u00ed doba. M\u016f\u017eeme si p\u0159edstavit ur\u010dit\u00fd \u0159et\u011bzec. \u017de t\u0159eba u\u010ditel ve \u0161kole m\u00e1 probl\u00e9m s n\u011bjak\u00fdm d\u00edt\u011btem, tak ho nenapadne nic lep\u0161\u00edho, ne\u017e \u017ee d\u00edt\u011b p\u016fjde k psychiatrovi. Rodi\u010d d\u00edt\u011bte po\u017e\u00e1d\u00e1 pediatra, ten mu doporu\u010den\u00ed nap\u00ed\u0161e raz dva. Jen\u017ee u psychiatra se sejde takov\u00fdch \u017e\u00e1dost\u00ed v\u00edc a okam\u017eit\u011b st\u00e1vaj\u00edc\u00ed po\u010det psychiatr\u016f nesta\u010d\u00ed. Cht\u011bl jsem t\u00edm uk\u00e1zat, jak je to t\u011b\u017eko stanoviteln\u00e9. Po\u010det zlomen\u00fdch nohou je naprosto jasn\u00e1 v\u011bc, ale v psychiatrii je to hor\u0161\u00ed.<\/p>\n

– Chcete t\u00edm \u0159\u00edci, \u017ee spousta p\u0159\u00edpad\u016f by se dala \u0159e\u0161it na jin\u00e9 \u00farovni ne\u017e u psychiatr\u016f?<\/strong><\/p>\n

Je to jen moje fantazie, jak se m\u016f\u017ee snadno st\u00e1t, \u017ee po\u010det odborn\u00edk\u016f je mal\u00fd. Kdy\u017e vezmu v \u00favahu, \u017ee t\u0159eba p\u0159ed t\u0159iceti lety bylo d\u011btsk\u00fdch psychiatr\u016f je\u0161t\u011b m\u00e9n\u011b a n\u011bjak to sta\u010dilo. Proto\u017ee tehdy nebylo zvykem se na n\u011b obracet.<\/p>\n

– Tak\u017ee po\u017eadovan\u00fd po\u010det psychiatr\u016f m\u016f\u017ee b\u00fdt nafouknut\u00e9 \u010d\u00edslo, proto\u017ee rodi\u010de, u\u010ditel\u00e9 \u010di d\u011btsk\u00e9 poradny si s probl\u00e9mov\u00fdmi d\u011btmi neum\u00ed poradit na sv\u00e9 \u00farovni a pos\u00edlaj\u00ed d\u011bti k psychiatr\u016fm?<\/strong><\/p>\n

Ne\u0159\u00edk\u00e1m v\u0161echny, ale mo\u017en\u00e1 v\u00edce. Nav\u00edc ne\u0159\u00edk\u00e1m, \u017ee to neum\u011bj\u00ed, ale je to velmi obt\u00ed\u017en\u00e9, nevd\u011b\u010dn\u00e9. A kdy\u017e se do pov\u011bdomosti dostalo, \u017ee takov\u00fdto obor existuje, tak se tam d\u011bti pos\u00edlaj\u00ed. D\u00edt\u011b t\u0159eba hezky nekrou\u017e\u00ed p\u00edsmenka, \u0161patn\u011b \u010dte, tak n\u011bkdy putuje k psychiatrovi.<\/p>\n

– Psychiat\u0159i potvrzuj\u00ed, \u017ee \u010dekac\u00ed doby jsou hodn\u011b dlouh\u00e9, t\u0159eba dva, t\u0159i m\u011bs\u00edce.<\/strong><\/p>\n

J\u00e1 netvrd\u00edm, \u017ee \u010dekac\u00ed doby nejsou. Ot\u00e1zkou ale je, \u010d\u00edm je to d\u00e1no.<\/p>\n

– Vy byste ne\u010dinil \u017e\u00e1dn\u00e1 opat\u0159en\u00ed t\u0159eba na l\u00e9ka\u0159sk\u00fdch fakult\u00e1ch?<\/strong><\/p>\n

Psychiatrem se \u010dlov\u011bk nestane absolvov\u00e1n\u00edm l\u00e9ka\u0159sk\u00e9 fakulty, ta d\u00e1 z\u00e1kladn\u00ed l\u00e9ka\u0159sk\u00e9 vzd\u011bl\u00e1n\u00ed a pak se mus\u00ed l\u00e9ka\u0159 v\u011bnovat specializa\u010dn\u00ed p\u0159\u00edprav\u011b, aby se z n\u011bj psychiatr stal.<\/p>\n

– Tomu rozum\u00edm, ale podle psychiatr\u016f poji\u0161\u0165ovny necht\u011bj\u00ed, aby se nov\u00e9 praxe otev\u00edraly.<\/strong><\/p>\n

Poji\u0161\u0165ovna m\u00e1 z\u00e1jem na tom, aby nem\u011bla tak velk\u00e9 v\u00fddaje. Samoz\u0159ejm\u011b, \u017ee nebude nikde prohla\u0161ovat, \u017ee bude propl\u00e1cet v\u00edce v\u00fdkon\u016f d\u011btsk\u00fdm psychiatr\u016fm bez jak\u00e9hokoli omezen\u00ed. Kdyby poji\u0161\u0165ovna \u0159ekla chirurg\u016fm, \u017ee jim proplat\u00ed jen polovinu v\u00fdkon\u016f, tak polovina chirurg\u016f odejde a nebudou. Tot\u00e9\u017e se t\u00fdk\u00e1 i jin\u00fdch obor\u016f. Kdo reguluje a rozhoduje o zdravotnictv\u00ed, je poji\u0161\u0165ovna. A ta m\u00e1 z\u00e1jem, aby v\u0161echny pen\u00edze, kter\u00e9 vybere, nerozdala nebo dokonce \u0161la do dluhu. Tak mus\u00ed br\u00e1nit v\u00fddaje. Tak\u017ee poji\u0161\u0165ovna \u0159ekne, budeme platit tolik a tolik v\u00fdkon\u016f, ty ud\u011blaj\u00ed t\u0159eba dva nebo t\u0159i l\u00e9ka\u0159i a dal\u0161\u00ed by museli cht\u00edt \u00fahradu v hotovosti, kdyby cht\u011bli fungovat.<\/p>\n

– Jak by se to dalo za\u0159\u00eddit, aby bylo do syst\u00e9mu pu\u0161t\u011bno v\u00edce pen\u011bz?<\/strong><\/p>\n

To si rozhodne poji\u0161\u0165ovna sama, kolik na tuto p\u00e9\u010di m\u016f\u017ee vydat. Kdyby tady byla ochota poji\u0161\u0165ovny propl\u00e1cet v\u011bt\u0161\u00ed po\u010det v\u00fdkon\u016f, tak by se na\u0161li i tac\u00ed, kte\u0159\u00ed by st\u00e1li o specializaci v d\u011btsk\u00e9 psychiatrii, kte\u0159\u00ed by si cht\u011bli otev\u0159\u00edt svoji vlastn\u00ed ambulanci. Ale pokud maj\u00ed pov\u011bdomost, \u017ee poji\u0161\u0165ovny dal\u0161\u00ed ambulanci pro d\u011btskou dorostovou psychiatrii neotev\u0159ou, tak se do atestace nikdo nehrne.<\/p>\n

– A zvy\u0161uje se podle v\u00e1s po\u010det nemocn\u00fdch d\u011bt\u00ed?<\/strong><\/p>\n

To, \u017ee se o n\u011b\u010dem mluv\u00ed, nemus\u00ed je\u0161t\u011b znamenat, \u017ee je p\u0159\u00edpad\u016f v\u00edc nebo \u017ee je to najednou velk\u00fdm probl\u00e9mem. M\u016f\u017ee to b\u00fdt i m\u00f3dn\u00ed o tom mluvit. Ned\u00e1vno se ho\u0159ekovalo nad t\u00edm, jak jsou du\u0161evn\u011b nemocn\u00ed zav\u00edr\u00e1ni v l\u00e9\u010debn\u00e1ch do klec\u00ed, tak v\u0161ichni prohla\u0161ovali, jak\u00e1 je to hr\u016fza, te\u010f u\u017e to vy\u0161lo z m\u00f3dy a je tu zase jin\u00e9 t\u00e9ma. Chci t\u00edm \u0159\u00edci, \u017ee je to \u010dasto tenden\u010dn\u00ed.<\/p>\n

– Jak to vypad\u00e1 u v\u00e1s na klinice, jak\u00e9 jsou \u010dekac\u00ed doby, kdy\u017e se na v\u00e1s obr\u00e1t\u00ed d\u011bt\u0161t\u00ed pacienti a rodi\u010de?<\/strong><\/p>\n

Mus\u00edme rozli\u0161ovat v\u00fdkony pl\u00e1novan\u00e9 a akutn\u00ed, kdy je akutn\u011b nemocn\u00fd na voln\u00e9 l\u016f\u017eko p\u0159ijat\u00fd hned. \u010cekac\u00ed doba na pl\u00e1novan\u00e9 vy\u0161et\u0159en\u00ed nebo pl\u00e1novanou hospitalizaci je dlouh\u00e1. Pak se mus\u00ed \u010dekat ur\u010dit\u011b m\u011bs\u00edc i d\u00e9le, t\u0159eba i dva m\u011bs\u00edce, ale i zde se p\u0159ihl\u00ed\u017e\u00ed k nal\u00e9havosti stavu.<\/p>\n

– To, \u017ee nem\u016f\u017eete p\u0159ijmout akutn\u00ed p\u0159\u00edpad, se st\u00e1t nem\u016f\u017ee?<\/strong><\/p>\n

Urgentn\u00ed p\u0159\u00edpady jsou sporadick\u00e9. Nen\u00ed to tak, \u017ee bychom denn\u011b museli p\u0159ij\u00edmat des\u00edtky takov\u00fdch d\u011bt\u00ed. Tak\u017ee hospitalizace je v\u011bt\u0161inou na z\u00e1klad\u011b objedn\u00e1n\u00ed.<\/p>\n

—<\/p>\n

Mlad\u00e1 fronta DNES<\/p>\n

Jitka \u0160r\u00e1mkov\u00e1<\/p>\n","protected":false},"excerpt":{"rendered":"

„Nedostatek d\u011btsk\u00fdch psychiatr\u016f se d\u00e1 vytvo\u0159it i um\u011ble,“ \u0159\u00edk\u00e1 v rozhovoru p\u0159ednosta Psychiatrick\u00e9 kliniky Fakultn\u00ed nemocnice v Plzni Ji\u0159\u00ed Beran. \u00a0Reaguje tak na slova ombudsmana […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":2220,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-9867","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/9867","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9867"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/9867\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/2220"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9867"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9867"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9867"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}