Government departments develop policies.  These policies determine what services need to be provided and the type of support that is required from those services.  In order to do this in a way that will promote an inclusive society, government agencies need to be aware of and responsive to disability needs and issues, and to have good information.  They then look at how those services will be funded, ways to contract or directly provide them, and specify the delivery and reporting requirements.

Objective 6: Foster an Aware and Responsive Public Service

This objective was the key focus for implementation of the New Zealand Disability Strategy by the 37 government departments in the 2002-03 year.  This was very important, as for most departments their 2002-03 plan was their first attempt to understand the New Zealand Disability Strategy and work towards achieving its vision.

There has been a high level of commitment by departments to the implementation of this objective.  The work of the Department of Conservation and the Ministry of Housing has been particularly noteworthy.  The Department of Conservation reported that it had taken the New Zealand Disability Strategy and shown how the objectives and vision were linked to the strategic objectives and statement of intent of the Department of Conservation.  The Ministry of Housing worked with the Housing Corporation of New Zealand to ensure the aims of the New Zealand Disability Strategy were included in accountability documents, and the Housing Corporation of New Zealand 'Statement of Intent 2002-05 includes a disability section.

Actions

6.1 Develop mechanisms to ensure that all government policy and legislation are consistent with the objectives of the New Zealand Disability Strategy

All policy papers presented to the Government's Social Development Committee are required to include a disability perspectives.  In line with this requirement, the Office for Disability Issues was consulted and/or provided comment on a wide range of Cabinet and policy papers in 2002-03.  This work fell into three broad levels of involvement, ranging from comprehensive involvement with policy development as part of interdepartmental working parties, to involvement in an overview capacity at the scoping stage of work then providing comment on draft versions of policy papers, to providing comment on work at the final stages of Cabinet papers. 

A key strategy the Office for Disability Issues has developed is to focus on building the capacity of other government departments to provide their own disability perspective.  In order to do this the Office has developed a policy framework as a resource for government agencies to use when including a 'disability perspective' in their policy work.  The framework was developed within the Office, peer review feedback was received and incorporated, and it was then sent for wider consultation to 34 individuals in 22 government agencies.  This was done with the intention to not only improve the product, but also raise awareness across departments of the need to include a disability perspective and of the framework resource to assist them.  A paper copy of the final draft was provided to all 37 government departments in June 2003, with the framework being prepared for web publication in 2003-04.

The Department of the Prime Minister and Cabinet had previously developed Cabinet Guidelines to ensure, at a high level, that policy proposals have a disability perspective.  This Department provides an overview of much of the policy work of other departments through the work of the Policy Advisors' Group, which has a co-ordinating role in strategic policy development.  In 2002-03 the Department of the Prime Minister and Cabinet's Policy Advisors' Group met to review the disability perspective in current policy work it was overseeing.  It concluded that it could do more to monitor how the guidelines were being implemented in policy work, and identified specific objectives of the New Zealand Disability Strategy for focus in the 2003-04 year.  

6.2 Adapt public sector training to ensure that service development and service delivery are consistent with the New Zealand Disability Strategy

All 37 departments reported that they had altered their induction training to include the New Zealand Disability Strategy.  Many reported that they had developed new training material about the Strategy, and the need to have a disability perspective in work at all levels.  The guide for policy makers developed by the Office for Disability Issues provides an additional resource.

Many departments also noted that they are now offering disability awareness training for staff.  This was not limited to those departments with a focus on disability service delivery, although it was particularly evident in the social service departments.  Some departments were specific about how this disability awareness training was developed and delivered, and the level of involvement of disabled people in this training.  This is something the Office for Disability Issues will be asking for in future New Zealand Disability Strategy implementation progress reporting.

6.3 Ensure that all government agencies treat disabled people with dignity and respect

All departments reported on this action, most noting the disability awareness training for staff.  For departments with a disability service delivery focus this was often enhanced by a number of other actions to remove or reduce barriers, including making information available in a variety of formats.  Some examples of these are:

• the Department of Labour developed a set of principles for working with disabled people, included these in its management policy framework, and communicated them to staff
• the Department for Courts (now part of the Ministry of Justice) reviewed targets set in its Equal Employment Opportunity to 2010 project, ensuring disability measures were provided
• the New Zealand Customs Service and the Ministry of Agriculture and Forestry met and agreed on close collaboration on their border control policies and operation to ensure consistency of approach for disabled travellers
• the Ministry of Social Development's Work and Income used a wide consultation process to review its current Service Charter, which addresses the needs of all people who interact with Work and Income, including disabled people

6.4 Improve the quality of information available, including where to go for more information, the services available and how to access them; and

6.5 Make all information and communication methods offered to the general public available in formats appropriate to the different needs of disabled people.

All departments reported activity on these actions.  All departments are working to ensure that their websites are consistent with the e-government guidelines developed by the State Services Commission, and many reported that their websites now meet the accessibility standards.  Many departments reported on work being undertaken to review printed material, with further work scheduled for the 2003-04 year to provide this material in a variety of formats.

6.6 Ensure the locations and buildings of all government agencies and public services are accessible

All departments had undertaken significant work on this action.  Many had completed accessibility surveys, and noted that work will occur to implement the recommendations of those surveys in the 2003-04 year.  The Ministry of Social Development provided a particularly good example of this in the reported outcomes of work on its Project Accessible.  This has resulted in:

• its accessibility guide for buildings and furniture being reviewed and rewritten
• a programme for all desks for staff and clients to be wheelchair accessible and height adjustable being implemented by June 2004
• hearing loops installed on request at all offices with a high number of hearing-impaired clients
• changes to the National Office floor plans, including the development of a fully accessible conference facility floor with hearing loops.

6.7 Work with territorial authorities to develop ways they can support the New Zealand Disability Strategy

No specific activity to implement this action was reported by government agencies for the 2002-03 year.

Objective 10: Collect and Use Relevant Information about Disabled People and Disability Issues

The goal of objective 10 is to improve the quality of relevant disability information that is collected, analysed and used to inform decision making.  Statistics New Zealand and the Ministry of Research, Science and Technology are key government agencies in the implementation of this objective.  The Ministry of Health has also undertaken a number of initiatives in this area.

Actions

10.1 Ensure that guidelines for research funding take into account the need for research on disability issues, include disabled people in the development and monitoring of the disability research agenda, and enable disabled people to put forward their own experiences in the context of the research

The Ministry of Research, Science and Technology includes the work of the Health Research Council, which has nine Research Portfolios that cover the full spectrum of national health research priorities.  The strategies for these Portfolios are set through an extensive consultation process with health stakeholders, government and non-government organisations, researchers and consumers.  The Health Research Council also seeks specific input from Expert Panels for each of the five priority population groups: Māori; Pacific peoples; children and youth; older adults; and people with disability.  The Expert Panel for disabled people is chaired by the Deputy Director General, Disability Issues, Ministry of Health and membership includes prominent disability researchers and consumers. 

Research is prioritised for funding by the Health Research Council if it includes disabled people as investigators and/or participants, or provides a training position.  It is also prioritised for funding if it is likely to provide knowledge that enables people with disability to participate more in society and have greater control over their lives, or provides more information about their specific issues and needs.  The Health Research Council also uses relevance to the New Zealand Disability Strategy as a criterion for prioritising research in the assessment process for the annual funding round.  In the 2002-03 funding round, only one proposal relevant to the New Zealand Disability Strategy was submitted.  This proposal was subsequently withdrawn because it gained funding from other sources. 

The Health Research Council funded a workshop on disability and rehabilitation in Christchurch in March 2003, in an attempt to ascertain the barriers to research in these areas.  It also wished to identify ways in which the Health Research Council could act to build capacity and increase the investment in research of relevance.  The Council is currently considering the recommendation that the assessment process should be changed to allow special consideration of proposals classified as disability research, and planning specific capacity-building initiatives for the disability research workforce.

In addition to research on disability the Health Research Council invests in research focusing on better understanding, treating and preventing impairments such as sensory loss, including fundamental biomedical research on vision and hearing.  The Health Research Council does not classify this as 'disability research' and therefore has not provided any details of this research in this report on progress in implementing the New Zealand Disability Strategy.

10.2 Collect relevant and useful information about disability through all relevant surveys to inform the research programme

In 2002-03 the New Zealand Health Survey began to be implemented, with the questionnaire designed, the contractor hired, and fieldwork begun.  The Ministry of Health reports that this survey will identify people with functional limitations, and that the proposed children's and other age-group-specific health surveys (eg of older people) will also identify this group of people.  Interviewing will be completed in October 2003, with preliminary results available in December 2003.  Further analyses will be released progressively throughout 2004.  When data is available from the relevant surveys, Public Health Intelligence will include information on disabled people in any resulting publications.

The Ministry of Health began a survey of the health of people over the age of 65 in the West Coast area, and planned for a health survey of Deaf New Zealanders, with data collection expected to start in late 2003.

10.3 Use disability research, and analyse disability data, including that from the 1996 and 2001 Disability Surveys, to contribute to policy work, service development and monitoring

There have been a number of separate pieces of work in 2002-03 to implement this action and its objective. 

In 2001 Statistics New Zealand ran the Household Disability Survey and the Disability Survey of Residential Facilities for the second time. Statistics New Zealand is chairing an analytical committee which aims to develop and oversee a process to ensure that useful analysis from both the 1996 and the 2001 Disability Surveys is undertaken.  The committee has been established to make the best use of the investment in the Surveys through cross-sectoral collaboration, and to avoid duplication and inadequate or irrelevant analysis.  The agencies and organisations that are members of the analytical committee are the Ministry of Health, the Ministry of Social Development, the Department of Labour, Te Puni Kokiri, the Ministry of Pacific Island Affairs, the Ministry of Women's Affairs, the State Services Commission, ACC, Disabled Persons Assembly, NZCCS, the Royal New Zealand Foundation of the Blind, IHC, Schizophrenia Fellowship Inc, and Alzheimer's Society New Zealand.

The major outcome of this Statistics New Zealand committee's deliberations was agreement by agencies to pool resources for the production of an inter-sectoral report on disability. The Ministry of Health is co-ordinating the production of the analytical report, which is due for publication in late 2003.  Statistics New Zealand has assisted with the extraction of data for the report and has provided technical advice and comment on the report.

The report will include chapters on Māori and Pacific peoples with disabilities, as the 2001 Household Disability Survey included over-samples of Māori and Pacific peoples that improved the reliability of estimates for these ethnic groups.  As a result, more detailed analysis of Māori and Pacific peoples with disabilities will be possible. 

In addition to contributing to the production of the inter-sectoral report, Statistics New Zealand has continued to promote the data from the 1996 and 2001 Disability Surveys through presentation of papers on the surveys at appropriate forums, including the New Zealand Sociological Association Conference and the Social Policy Evaluation and Research Conference.  Information from the 2001 Disability Survey has been published as 'Snapshots' on the Statistics New Zealand website www.stats.govt.nz.  These snapshots have been a source of information for further reporting by the media.  Statistics New Zealand is currently considering recent suggestions from the disability community about ways to improve the readability of material published on the Web and in paper-based questionnaires.

At the end of June 2003 Statistics New Zealand was in the process of considering submissions on the content of the 2006 Census of Population and Dwellings.  There was no decision on whether questions on disability will continue to be included, or whether there will be a post-censal survey on disability.  A final decision on content is expected to be released in October 2003.  In order to further inform this decision a workshop of stakeholders from the disability sector was held at the end of July.  This workshop explored the information needs of the sector and how these might be best met.

The Mental Health Research and Development Strategy is funded by the Ministry of Health and administered by the Health Research Council.  It is overseen by a steering committee, including people who bring Māori, Pacific peoples' and consumer perspectives.

As part of this research strategy a case mix study is being carried out.  This is a large-scale project that aims to develop the first version of a national case mix classification for specialist mental health services in New Zealand.  With this information, funders and service providers will be able to benchmark services and to work towards establishing best practice to improve delivery to consumers with different needs.  The study will help inform the understanding of 'who received what services from whom at what cost' and support funders and services to improve delivery to consumers with different needs.  The project commenced in January 2002, with the data collected over a six-month period between February 2002 and July 2002.  Data was analysed and preliminary findings were released on 1 June 2003.  The final report is due for release in September 2003.  The desired outcome is a first, albeit rough, case mix classification for mental health services in New Zealand.  

The Ministry of Health carried out a pilot study in 1999-2000 for a National Mental Health Epidemiology Study, and work continued in 2002-03 on: the design of the questionnaire for this survey; the design of the sample and interview questions to ensure that results would provide accurate information on Māori and Pacific peoples; the development of an electronic database for real-time recording of responses; and preparation for the field test.  This epidemiology study is a survey to measure the prevalence of mental illness within New Zealand.  It will also help to describe how mental health problems and substance abuse limit people's activities and patterns of mental health service use (and barriers to service users) and identify risk factors for mental health and substance use problems.  There will be over-samples of Māori and Pacific populations, enabling nationwide epidemiology for these population groups for the first time.  The study has now received Ethics Committee approval, and has been prepared for the full pilot in August 2003.  The next steps will be to complete the field test before going into the full survey from November 2003.  Full results are expected by 2006.  

10.4 Undertake research focusing on disability issues for Māori and Pacific peoples

In addition to the work detailed under action 10.3, there have been a number of separate pieces of work in 2002-03 to implement this action on research for Māori and Pacific peoples. 

The Ministry of Health, the Health Research Council and ACC are working together on a three-year project that aims to provide information about the use and experience of Māori when accessing health and disability services (see action 11.3).

In a separate ongoing project, the Ministry of Health, with representatives from Te Ropo Rangahau Hauora a Eru Pomare, District Health Boards, the primary health care sector and ACC, is leading a project on ethnicity data collection which will involve changes across the whole of the health and disability sector.  This project aims to ensure accurate, consistent ethnicity information is gathered by the health and disability sector, and involves standardising the collection, recording and use of ethnicity data.  In 2002-03 a standard was agreed for the collection of ethnicity data. This standard has been designed into the Ethnicity Data Protocol for the people who will be collecting, recording and using ethnicity data.  The next phase of this project will be the development of training and educational materials to implement the Ethnicity Data Protocol to ensure that data collectors have the skills to collect ethnicity data according to the protocols.

10.5 Make disability research information available to disabled people in culturally appropriate and accessible formats; and

10.6 Adopt ethical and procedural standards for disability research projects; and

10.7 Appoint disabled people as members of ethics committees

No specific activity to implement these actions was reported by government agencies for the 2002-03 year.

Objective 7: Create Long-Term Support Systems Centred on the Individual

Implementation of this objective is particularly important, as it affects all of the objectives that relate to service provision.  How services are contracted, funded and delivered can and does create barriers to access by disabled people.  This objective is about ensuring that this is done in a way that is focused on the individual requiring support, and not only addresses immediate needs but looks to meeting needs in the long term.

The key departments involved in leading work on the implementation of this objective are the Ministries of Health and Social Development.  Other government agencies involved are Te Puni Kokiri; Housing New Zealand; the Ministry of Education; the Department of Child, Youth and Family Services; the Ministry of Pacific Island Affairs and ACC.

Actions

7.1 Ensure that overarching processes, eligibility criteria and allocation of resources are nationally consistent, but that individual needs are treated flexibly; and

7.2 Ensure that government agencies, publicly funded services and publicly accountable bodies co-operate to ensure that the disabled person is at the centre of service delivery; and

7.3 Investigate the development of an holistic approach to assessment and service provision that applies across agencies and funding sources; and

7.5 Encourage equity of funding and service provision for people with similar needs, regardless of the cause of their impairment

The Office for Disability Issues is leading a large piece of strategic work to implement these four actions, aimed at creating long-term support systems centred on the individual.  Cabinet approval was gained in June 2003 for the Office for Disability Issues, in close association with an officials' group and in consultation with the wider disability sector, to:

• propose guidelines on how to apply the New Zealand Disability Strategy in relation to government-funded supports
• propose mechanisms to ensure policy and service development is coherent with the Disability Strategy
• scope the work required for a policy review of inequities between ACC and other Government-funded supports

In addition to this strategic work led by the Office for Disability Issues, the Minister for Disability Issues has established an inter-sectoral project for organisations to trial innovative ways of improving inter-sectoral collaboration in needs assessment and service co-ordination for disabled people aged under 65.  The Ministry of Health is leading this project in partnership with the Office for Disability Issues, Te Puni Kokiri, Housing New Zealand, the Ministry of Education, Department of Child Youth and Family Services, the Ministry of Pacific Island Affairs, ACC and the Ministry of Social Development.  This inter-sectoral collaboration project aims to improve:

• outcomes for people with all disabilities across all aspects of life
• collaborative arrangements within and between organisations with an interest in needs assessment and service co-ordination
• effectiveness of needs assessment and service co-ordination for different groups, including Māori and Pacific peoples
• transitioning between services, including for young school leavers

Separate focus groups were held in January 2003 with disabled people and providers/carers discussing options for inter-sectoral needs assessment and service co-ordination trials.  Up to three trials will be established around the country and are expected to run until mid-2005.  The trials are expected to adhere closely to the vision and objectives of the New Zealand Disability Strategy, and may build on existing service arrangements or propose entirely new arrangements.  After the trials have been evaluated, advice and recommendations will be developed for the Government on the future direction of the inter-sectoral work.

7.4 Develop and maintain effective rehabilitation services

The Ministry of Health has led a review of 40 providers (including eight Māori and two Pacific providers) to identify sector capability and capacity.  A report detailing results of this review is to be produced in 2003-04. 

7.6 Identify unmet need and develop affordable solutions to fill these gaps; and

7.7 Improve timeliness of service provision

No specific activity to implement these actions was reported by government agencies for the 2002-03 year.

7.8 Develop a highly skilled workforce to support disabled people

This is an area of growing focus, particularly by the Ministry of Health.

In September 2002 the Ministry of Health published the 'Mental Health Workforce Development Framework''.  In October 2002 the Health Workforce Advisory Committee published a discussion document 'The New Zealand Health Workforce – Framing Future Directions'.  One of its six chapters was entitled 'Building the Health and Support Workforce for People Who Experience Disability'.  This was followed by wide consultation, including a summit meeting in March 2003 which led to a number of recommendations to the Government about the development of the disability support workforce.  These publications are available from the Ministry of Health website www.moh.govt.nz.

The Ministry of Health's Clinical Training Agency, in collaboration with the Disability Services Directorate, undertook an analysis of the disability workforce in 2002-03.  Their report, 'Disability Workforce Analysis Report', was published in February 2003.  The focus of the project was predominantly on training needs and was described as 'a first step towards developing an understanding of the issues, and a basis from which further much needed work can proceed'.  This publication is available from www.moh.govt.nz/cta.  

7.9 Ensure that disability services do not perpetuate the myth that disabled people are ill, while recognising that disabled people do need access to health services without discrimination

The Ministry of Research, Science and Technology has reported that the Health Research Council has adopted the social model of disability as a basis for identifying and prioritising disability research, in line with the New Zealand Disability Strategy.