Key Messages

• The social model of disability includes the concept of capacity-building, which recognises the rights of people with disabilities to develop and use their skills. The challenge for government and the disability sector now is to find the most effective ways of pursuing capacity-building.
• There are inconsistencies in eligibility for and the provision of government-funded services for people with disabilities. A proposal to develop a framework to address this has been prepared by the Office.
• People with disabilities are increasingly entering mainstream employment. This is highlighting tensions between providing people with disabilities with the same employment conditions and opportunities as other people, and recognising that they may require extra support and provision, including income support.
• Current inequities in support available to family members providing care for people with disabilities may be discriminatory under the Human Rights Act 1993. This issue requires urgent resolution.
• The implications for New Zealand of a proposed new United Nations convention on the rights of people with disabilities are being examined.

Philosophies of disability

The nature of provision for people with disabilities has varied over time, and this reflects changing philosophies of disability.

A brief historical overview of services and policies in New Zealand for people with disabilities is provided in Appendix 4.

The traditional approach to disability, often referred to as the medical model, locates disability within individuals.1 It tends to treat disability as an individual problem to be “cured” or at least contained. This means that provisions to compensate for or overcome the disability are targeted at the individual.

In contrast, the social model of disability places disability more within its social context. This approach has gained international endorsement. It is the approach currently applied in New Zealand and is actively promoted by people with disabilities. Its focus is on the relationship between people with impairments and their social and physical environment, and the removal of barriers to their independence.

The social model locates the key interventions within the realm of social policy and institutional practice, and implies that people with disabilities should be actively involved with decision-making about their own lives rather than being merely passive recipients of services. Effective representation in policy planning, evaluation and research is part of such involvement.

The two basic characteristics of the social model are its rights-based approach, which requires that people with disabilities receive the help that they need as an entitlement, and its orientation to community-based support, so that people with disabilities are recognised as participants in the community.

The New Zealand Disability Strategy incorporates both these characteris-tics, with its vision being a fully inclusive society so that people with disabilities can say that they live in "a society that highly values our lives and continually enhances our full participation".

As part of its rights-based approach, the social model includes the concept of capacity-building, recognising that people with disabilities are contributors to society as well as users of services, and have rights to develop and use skills to make an optimum contribution.

The New Zealand Disability Strategy includes the following objectives that promote capacity-building:

• Provide the best education for disabled people;
• Provide opportunities in employment and economic development for disabled people; and
• Foster leadership by disabled people.

The issue of capacity-building raises challenges for government and for the disability sector, in particular in relation to how best to pursue this goal, and the most effective mix of mainstreamed and special provision.

This year, the Office for Disability Issues’ first year of operation, we intend to work closely with the disability sector to develop joint strategies to address these challenges.

Issues of equity and coherence in service provision

The consultation with the disability sector in 2000, as part of the develop-ment of the New Zealand Disability Strategy, revealed widespread concerns about inequitable access to services for people with disabilities, and a lack of coherence in the services provided. A report prepared by the Ministry of Social Policy in August 2001 recorded overlaps, duplication, discontinuities and gaps in services, and identified a number of contributing factors, as follows:

• Different levels of provision available to people whose disability was acquired by injury through accident and to people whose disability had other causes. There are generally higher levels of assistance provided by ACC services than other government-funded services.
• Different definitions of "disability" operating between agencies as a basis for providing support. For example, the Ministry of Health definition differs from Work and Income, which has three different approaches to identifying disability for access to services.
• Provision of services from a single agency perspective, rather than from an inter-agency consideration of the services based on the needs of the client. For example, different systems of funding and different prioritisation systems operate for building modifications funded by different agencies.
• Difficulties with eligibility criteria, including: confusion over which agency should meet which needs; different criteria applying for different disabilities; rigid criteria that do not accommodate variability of need; and inconsistent application of assessment systems.
  Some examples are of these difficulties are:
  • regional variations in assessments for disability support services funded by Vote: Health;
  • children with hearing loss receiving assistance more readily than do children with vision impairment; and
  • people who have been part of a deinstitutionalisation plan being guaranteed appropriate services that are not guaranteed to people with similar disabilities who have always lived in the community.
• Inconsistent funding mechanisms and approaches to funding across agencies, with some services fully funded and some partially funded, and some budgets demand driven while others are capped.
• Problems with the location of providers, and with their effectiveness in providing culturally appropriate services and services responding to the different needs of men and women. These problems are particularly acute for rural areas, while Māori and Pacific peoples are likely to miss out on appropriate services in all regions.
• The alienation of some potential clients from the system, and patterns of transience that result in others being largely lost to services and support. Negative experience can lead to some po-tential clients withdrawing altogether, and people who are transient tend not to establish connections with any services or support.

The report concluded that the problems largely stemmed from the ad hoc and incremental development of the policies and services of government departments for the support of people with disabilities, and a related lack of policy leadership and co-ordination.

To address these problems, the Ministry of Social Development has identified needs for:

• Developing a framework to ensure that government-funded services and support for people with disabilities are provided in a coherent and equitable way. The framework would clarify the overall strategic direction for government-funded services and support for people with disabilities, and clarify responsibilities for ensuring this is main-tained.
• Improving data collection across government agencies on the use of services and support, as well as improving information for clients on the availability of and ways to access services and support.

We have prepared a proposal for the Office for Disability Issues to lead this programme of work. The proposal would require Cabinet agreement. If approved, the development of the framework would constitute a core part of our strategic policy programme.

Employment issues

In September 2001, the Minister for Disability Issues released the document Pathways to Inclusion, setting out a new direction for vocational services for people with disabilities. Its focus is on strategies to ensure that people with disabilities have opportunities to gain real skills and real jobs, with the same rights and conditions as other workers. It also includes a commitment to improving the quality of vocational services that help people participate in the community in other ways.

One of the key strategies included in Pathways to Inclusion is the repeal of the Disabled Persons Employment Promotion Act 1960 (DPEP Act). The DPEP Act exempts employers of people with disabilities in sheltered workshops from meeting employment conditions applying elsewhere. Its repeal will entitle people employed in sheltered and segregated settings to the same as any other employed persons, including rights to pay-ment at least at minimum wage rates (unless employees are granted an under rate workers permit 2 ) and to holidays under the Holidays Act 1981. The repeal was programmed for action in 2003.

The proposed repeal has received a high level of support from people with disabilities, but has implications for providers of vocational services, as well as potential implications for other employers. For this reason, the changes will be phased in over five years. During this time, providers will be supported to develop new employment relationships and community participation programmes.

A programme of further work to implement Pathways to Inclusion is currently under way, including:

• a review of the use of the Disability Allowance to pay for access to vocational services (led by the Ministry of Social Development);
• policy development relating to financial security for people in sheltered employment (led by the Ministry of Social Development);
• policy development relating to the availability of employment sub-sidies for employment in sheltered or segregated settings (led by the Department of Labour);
• the establishment of a new system for issuing Under Rate Workers’ Permits (led by the Department of Labour); and
• a review of tax exemption options for people in sheltered employ-ment (led by the Inland Revenue Department).

These workstreams recognise the need to resolve emerging tensions between requirements to ensure that people with disabilities have the same employment conditions and opportunities as other people, and recognition that they may require extra support and provision, including income support. While other agencies are responsible for these workstreams, the Office for Disability Issues will maintain an overview of this work.

Caregiver issues

The disability sector has expressed increasing concern that family caregivers of people with disabilities do not receive the same caregiver entitlements from government as other caregivers. Their ineligibility for payment was highlighted in August 2001, with the decision on the Hill case by the Complaints Review Tribunal of the Human Rights Commission. In its decision, the Tribunal acknowledged the right of family members to apply to be paid caregivers of one or more of their family who have disabilities.

At the time of the Tribunal’s decision, the policy of not paying family members was covered under the Government exemption from compliance with the Human Rights Act. With the removal of the exemption as from 31 December 2001, the ineligibility of family caregivers for caregiver entitlements has become potentially discriminatory on grounds of family status, requiring “good public policy reasons” for its continuance.

The Ministry of Social Development is currently reviewing the issues and questions relating to the payment of caregivers of people with disabilities, and in particular to the payment of family members who are providing care. Further work will be required, involving consultation with government agencies, provider groups, consumer groups and family advocate groups, to develop options for government decisions on this issue.

The international policy context

The United Nations General Assembly has adopted a resolution to establish an ad hoc committee “to consider options for a new convention on the human rights of people with disabilities”. A convention is a legally binding treaty that involves ongoing reporting processes. The proposed convention reflects the international disability movement’s disappointment with the ineffectiveness of the non-binding UN Standard Rules for the Equalisation of Opportunities for People with Disabilities (adopted in 1993). It also reflects the growing international significance of the human rights perspective on disability.

There is a high level of support for the proposed convention within the New Zealand disability sector, as it is viewed as an essential counterpart, at the global level, to the New Zealand Disability Strategy. The New Zealand Human Rights Commission has also signalled its close interest in the convention. There is potential for New Zealand to take a leading role in work on the new convention, as our domestic legislation and policy relating to disability is considered advanced by other countries. At the present time, the Ministry of Foreign Affairs and Trade is monitoring developments on the convention, in liaison with the Ministry of Health and the Ministry of Social Development.

We are currently undertaking work to explore the implications of the proposed convention for New Zealand, and developing proposals for New Zealand’s response to the UN ad hoc committee meeting on the convention, including the involvement of people with disabilities and relevant non-government organisations.

Other key issues

Further issues that are likely to shape future work programmes for policies and related services for people with disabilities are:

• Increased rates of disability, including dependent disability. The Ministry of Social Policy’s3 Social Report 2001 estimated the rate of dependent disability4 as 11% of the population. Since the incidence of disability requiring support is associated with increasing age, the rate is likely to increase with the ageing of the population over the next 50 years, creating a need for more services.
• Continued endorsement of the human rights-based approach to supporting people with disabilities and of its associated community-based approach to services and support. This is likely to result in mainstream services across government coming under increasing pressure to be more responsive to people with disabilities.
• Increasing recognition of the diversity of needs of people with disabilities, including recognition that needs will differ among population subgroups – including women, Māori, and Pacific peoples – and between individuals. This is likely to increase demand for more customised services.

Endnotes

1. The discussion of these definitions is taken from the Health Funding Authority and Ministry of Health report Disability in New Zealand: Overview of the 1996/97 Surveys.
2. Under the Minimum Wages Act 1983.
3. Now Ministry of Social Development.
4. The proportion of the population who acknowledge one or more functional limitations and require assistance, either intermittently or on a daily basis, to live independently.

For further information contact the Office for Disability Issues.