Access: Disability as a wicked policy problem
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Sacha, in reply to
has resigned over the cuts to supports
That's the reason he is giving. However, he may instead have jumped before he ended up being held responsible for a huge stuff-up in another direction.
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Sacha, in reply to
he was not from the wealthy privileged elite group who dominate the British cabinet.
His wife has the wealth.
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But he's not a multi-millionaire old Etonian like most of them.
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Hilary Stace, in reply to
Also Scottish, Catholic and anti-Europe so those views might have had something to do with it too. Not an insider.
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Angela Hart, in reply to
that's one hell of a budget blow out, yes, it could be a reason for his quitting.
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Seems our Attorney General has reported an unjustifiable advantage for blind people while reviewing proposed social welfare law changes.
The report says clause 33 of the bill provides that a person is entitled to the Supported Living Payment (SLP) if the person has restricted work capacity or is totally blind. People with disabilities other than total blindness must prove both their disability and the impact it has on their capacity to work; people who are totally blind must prove only that they are totally blind in order to be entitled to the SLP.
Mr Finlayson says the rights of people with disabilities other than total blindness are impaired as they are not entitled to the same additional support, or automatic entitlement to the SLP, as those with total blindness.
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OMG, he doesn't mention a proposed fix, too much to expect he'd suggest putting all adult impaired who cannot work on the same footing as the vision impaired currently are. Much more likely that special provision for Vi will go. Election year next year, do try it, please.
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Angela Hart, in reply to
Mr Finlayson says the rights of people with disabilities other than total blindness are impaired as they are not entitled to the same additional support, or automatic entitlement to the SLP, as those with total blindness.
I wonder if the HRC sees it that way? Might be worth putting in a complaint, though I suppose the defence would be that the existing social welfare legislation overrides NZBORA.
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The reason for this anomaly whereby only blind people had non-means tested benefits is historical. I think (not entirely sure about the details) that is goes back to the first world war and Clutha McKenzie. He was the son of a cabinet minister and lost his sight at Gallipoli. Back in NZ he became an MP and built up the Blind Foundation and got pensions for blind people. So when the 1st Labour government came along and started providing disability benefits, the blind activists wanted to keep the advantage they already had, so while other benefits were means tested, theirs weren't. Although it was apparently only for blind men, not women. So a sighted woman could marry a blind man and get a full benefit, but not the other way around.
Someone will challenge this history/interpretation if it is not correct.
For some reason Finlayson has come across this now and is removing the blind privilege. There will be fight.
It would be better to remove the distinction between MoH and ACC funding and bring in a UBI which is topped up by need (and no means testing) eg for equipment, house modifications, vehicles, transport, educational support etc.
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topped up by need
I'm not entirely sure I have correctly understood what you are saying but it seems to me that you are rolling functions presently covered by MoH, ACC and MEd, into one all powerful agency.
This is dangerous territory.
There is no real needs assessment under MoH (it is unmet need that is looked at but not genuinely assessed, rather than actual need). I don't have experience with ACC, you may know whether they assess need or not and how.
Under MoH areas like house modification such as ramps are not funded in a reasonable way. For instance only one ramp will be funded, only one way in or out of the home. The Fire Brigade recommends at least two. How safe does your average wheelchair user feel in case of fire?
Similarly equipment under MoH, you only qualify for a wheelchair, for instance, if you are in full time work or study (and need one for mobility) or you cannot get around your home, even if it's by crawling.
There are many many ways to reduce costs and most of them are being applied to the detriment of the people with the needs. What's to prevent the same approach with your idea of needs topping up?I guess what I'm trying to say, badly, is that any approach can be set up to fail if the applied principle is cost reduction rather than doing the right thing by people. And having a needs based top up, while it sounds great, would only work if it was done honestly and fairly. This doesn't happen now, why would that change?
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Hilary Stace, in reply to
Sorry, I am conflating complex issues with disability support with the latest discussions about a Universal Basic Income. This UBI proposal would give everyone, even children, a guaranteed basic income every week. If you needed more eg for disability support, equipment, housing etc that would be provided on need (either in cash or services), not on financial means testing as happens currently in the Work and Income space.
Of course a lot of work would be required if this was to come in, but it would mean that you wouldn’t need to justify the need to have a benefit as you do now. The topping up would be done on much more trust basis than is currently done and there could be one simple system. So of course all the gate keeping and ring fencing of today would have to be addressed.
Just ideas at the moment, but some form of this UBI is likely to come in eventually and as disability activists we need to be prepared.
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Sacha, in reply to
It would be better to remove the distinction between MoH and ACC funding and bring in a UBI which is topped up by need
Yes please. Public actuarial-style funding across all disability supports, with core entitlement the same as every other citizen.
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Sacha, in reply to
rolling functions presently covered by MoH, ACC and MEd, into one all powerful agency.
Disability activists have been pushing for one agency for many years. I agree it would only be in our favour though if set up and run properly without cost-cutting as a prime directive - and with meaningful ongoing engagement with community.
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Angela Hart, in reply to
I agree that a single Ministry for Disability makes sense.
My concern when it comes to top ups based on need is that on the Ministry of Health side of things there is no needs assessment capability at the moment. Unless that capability exists within ACC, and that expertise was built on, we run the risk that the Ministry of Health, which is the logical agency to understand and have that capability, would be given that responsibility.
The reality is that the Ministry's contracted agencies, the NASCs (Needs Assessment and Service Co-ordination Agencies) do not assess need. They look at unmet need, but even that is not assessed in terms of, for instance, support hours required to meet the need. Rather they go back to the office after an assessment interview, enter data into Socrates and are told what supports they can offer, which generally bear little relationship to the unmet need and rarely enable it to be met.
The Ministry appears quite happy with the way the NASCs operate, even though most of them do not generate any numbers to show how big or small people's needs are. This is scandalous because these are NEEDS ASSESSMENT agencies, but that is what we have to live with.
Any new system would have to discard the old ways of working and the old attitudes, along with all the people who could not/would not adapt positively to the changes. A brave new world- I hope I live to see it!I personally don't think that the Ministry of Health should have any jurisdiction over disability supports because it can't help but operate from a medical model and see people as needing fixing. People who can't be fixed are a nuisance and they take resources away from the more deserving people who can be fixed.
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Sacha, in reply to
If the establishment of a Disability Ministry was guided strongly by disabled people and allies, you'd staff or contract any needs assessment function from scratch with clear kaupapa, service standards and training, not transfer or retain existing incompetents. Naturally the industry would resist that, so it will take persistent determined advocacy and political leadership.
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Hilary Stace, in reply to
Over the years there have been significant changes in disability support. There were the pensions under the first Labour government. In the early 70s ACC for disablement by accident and then in 1975 the Disabled Person's Community Welfare Act provided some specific supports for the non ACC group. In the early 1990s there was the major restructuring putting disability support into Health from Social Welfare and bringing in the ring fenced NASC system. Surely 23 years later we are overdue for another total review of the system to bring in one simple and fair person centred disability support system for all?
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Angela Hart, in reply to
Surely 23 years later we are overdue for another total review of the system to bring in one simple and fair person centred disability support system for all?
Yes
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Sacha, in reply to
yes
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Something like this but obviously with much more design and oversight input from disabled people needing the services
http://www.radionz.co.nz/news/political/300878/new-plan-for-children-in-care-unveiled -
Hilary Stace, in reply to
Suspicious about this. Nice idea but it also proposes more contracting out, more fragmentation and using cheaper professionals via NGOs instead of a strong centralised unionised, professional workforce.
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Angela Hart, in reply to
yes, I noticed the emphasis on NGOs. They are also a way of taking accountability away from Government.
I really don't understand what is wrong with employing your own people, other than ideology around small government. It allows proper training, accountability, professionalism, auditing, and is surely the simplest way to produce an effective, reliable and responsive service.However it does require bureaucrats to function in a non political manner. It may be difficult to do that now. Again, the MoH is a good example, its contractors the NASCs, for instance, are not checked or audited in any meaningful way other than financial. The quality of the tasks they perform is not usually reviewed. And the public can do nothing about it, they are monopolies and the only avenue of complaint about their services is to the NASCs themselves. The MoH declines responsibility for its contractors.
Any new outfit would need to have better quality control systems in place.
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MSD revisiting how to pay disabled employees in sheltered workshops, to meet our UN Convention obligations.
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Rosemary McDonald, in reply to
not transfer or retain existing incompetents.
....got into a random discussion with a random person( who knows another random person) about a MOH:DSS contracted provider that serves a rather large region here in jolly old Godzone.
Three names came up...employees who have exhibited such mind blowing incompetence (and on more than one occasion sheer bloody nastiness) over the past two decades that the lives of some disabled people and their families have been made absolutely and intolerably miserable.
Yet two are still employed in their role... and get this...one has ascended to the stratosphere of the upper echelon.
Bet my last dollar that they will secure new high level roles in your new MOD.
On the other hand...and on a much more positive note (who said I can't be cheery?)
We had reason to engage with another provider recently.
Two decades ago this provider was operating out of an unappealing low market storefront in and industrial area. They did good work. Excellent, in fact. Top blokes...I'll call them Bill and Ted...were true gents with hearts of gold and high skill levels.
About 8 years ago they were forced to join in the larger, modernised, corporatised parent company in the HUGE new purpose built facility....Bill and Ted had bigger premises and administrative support....so you'd think the already good would be better...right?
Nah...rapidly went to shit...and we can't have been the only clients who had issues..because...
Bill's retired...but Ted is back doing what he and Bill were doing twenty years ago from another unappealing store front in an industrial area. And again doing good work in a fashion that makes the process easier for us (although they still have to wriggle through the bureaucratic hoops they are making every effort not to pass that onto to us).
So...lets here it for the giant leap backwards...
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Rosemary McDonald, in reply to
Suspicious about this. Nice idea but it also proposes more contracting out, more fragmentation and using cheaper professionals via NGOs instead of a strong centralised unionised, professional workforce.
Our Leader spent time in Motueka yesterday...
He said the current Child Youth and Family review could have a "very direct impact on the way that people here work for instance".
But any change would not be around nationalisation of community services, Key said.
Rather it would look at the possibility of rationalising the number of providers in communities.
"Every individual support group is really well meaning and what they are doing is legitimate, but in the end the Government pays the bill and the question is the cost of delivery to us," Key said
The last bit bears repeating...
but in the end the Government pays the bill and the question is the cost of delivery to us
Oh, dear.
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Angela Hart, in reply to
rationalising the number of providers in communities.
That is, contract a monopoly service, underfund it and contractually gag it.
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