- the social position of people with disabilities, and often their families, is not good;
- the disability service system is not good enough;
- an integrated approach is needed, which must also pay attention to a stable funding base.
Wednesday, October 7, 2009
NDIS and Shut Out miss the elephant in the room
On important counts I agree with the NDIS proposal as I do with much of the Shut Out Report.
We agree that:
We appear to disagree about the causes of the malfunctioning service system. It is not just about under-funding and therefore crisis management. Primarily it is about values, beliefs and fears, service orientation and competence. There are strong tensions between wanting money for the strengthening of service technologies (such as “early intervention”, “case management”, “advantages of competition in the marketplace”) and meeting (even understanding) of the real and fundamental needs of people with disabilities. And in that tension people with disabilities are crushed by the weight of the upper tectonic plate of managerialism (yeah, a bit strong, I know, but that's what it can feel like when it happens to you).
We disagree that more money will transform the existing disability service system into providing service that will meet real needs. More than money is needed.
Besides NDIS, the Shut Out report contains a number of strategies, including complaint mechanisms, advocacy, leadership training, capacity building, jobs in public service, and so on. All worthwhile if done well.
Curiously there is no mention of quality improvement, or transformation of services. But why not? “Disability services” share first place (56% of respondents) in Shut Out's ranking of identified barriers to experiencing a good life, with “Social inclusion and community participation.“ That is not counting barriers presented by “Disability services—workforce issues “ (21%) and ”Families and carers “ (30%). If we take into account that only half of all submissions came from individuals and the rest from the service system itself, that shines the light strongly on a glaring priority for attention.
In arguing that much of the disability services system is a ripe candidate for overhaul I seem to invite no contest from NDIS proponents and government who agree the system is not functioning well enough. Does anybody know then why there are no proposals for doing so? Perhaps the NDIS feasibility study will reveal a strategy.
I hope they don't!
What? After what you've just said? Yes, changing our existing services system must be done with great care. it takes time and should not be devised by a small group of predominantly financial and commercial competition experts, or service providers. In fact with the principles of care Joan Tronto talks about, I suggest. Doing something like that could equally well end in disaster. And who will pay - again?
I think it's possible though. A service system that works towards modeling in its structures and operation those values that work well towards living a good life. Change from the inside out. Isn't that what always works best? It would be so rewarding working like that. It can be attempted. Given a fully participatory approach, drawing on the values that underlie fundamental human wellbeing. Given an understanding of an ongoing need for strong safeguards whatever advances we make. For this process of change itself that would include, somehow, giving it a degree of independence of such efforts so that they transcend periods of government.
Ok, that's my two cents worth for today.
Posted by Erik at 5:39 PM