kindergartens. On the other hand, all children at an appropriate age in the HMSCC, Vidin,
are going to children's establishments in the town. One child is going to full-day
kindergarten, eighteen children are enrolled in united children's establishments and six
children are going to a school for children with special needs. The main reason is the lack
of infrastructure for children with disabilities in most of the nurseries, kindergartens and
schools in the community.
Medical care
Healthcare for the children at the homes for medical – social care is provided in
accordance with the "Paediatrics" Medical Standard. In 2013 the NPM team did not find
any omissions in the provision of healthcare for the children at HMSCC.
The diagnostic, treatment and rehabilitation activities in these institutions are carried out
in all child wards of the homes under review. When surgery, invasive diagnostics are
needed and when deemed necessary by the intensive treatment doctor children are taken
to a children's ward suitable for the purpose in another medical establishment. In most
cases upon the admission of the child the parents sign an informed consent form.
The activities of all wards at the HMSCC are carried out by a team with manager – head of
block and head nurse. The team servicing a group of children is managed by a doctor and
comprises: nanny, nurse, supervisor / pedagogy specialist, rehabilitator and psychologist.
The specialised medical staff is only on duty during the day as there is shortage of
paediatrics. The following commissions are formed based on orders issued by the
principals of the homes: medical board, medical control committee, health care council,
committee checking the fitness of the pharmaceuticals.
Administrative capacity and management
This year the trend continues for most of the multidisciplinary teams of the HMSCC to not
pass qualification and additional training courses to work with children in the age group 0
- 3, as well as to work with children with disabilities (more than 50% of the children
placed in these homes have medium and heavy disabilities).
An alarming example is the staffing policy of the Ministry of Health during the
competitions for the position "Director of a Home for Medical Social Care for Children “.
On 1 August 2013 Coalition "Childhood 2025" – a union of 16 leading civil organisations
and networks representing more than 150 NGO and individuals from all over the country,
working on issues related to the deinstitutionalisation of children with disabilities and
children placed in homes for medical – social care for children has contacted the
Ombudsman of the Republic of Bulgaria in the capacity as National Preventive
Mechanism. According to the signal, following competition for a director of the Home for
Medical - Social Care for Children "St. Ivan Rilski" in Sofia, the previous director was
appointed. This person was previously fired from the home due to findings related to
poor organisation, lack of control and adequate care for the children at the home. As a
result of the competition Dr,. Dzhurelova, director of the home until 2011, was appointed
director of the Home for Medical – Sofia Care for Children "St. Ivan Rilski" in Sofia. During
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