News and opinions on disability
and inclusion

Making sense of our sector and the way forward

When I came into this job some four years ago, I was reasonably clear about what lay ahead for this organisation as well as the sector as a whole. Today I feel less sure and more unclear so I feel compelled to write something that might help me with this problem.

Recent conversations with a number of people in the disability sector have posed a number of questions about where this important sector is actually heading, what is Government’s real agenda and how could the sector possibly prepare for the future with so many confused and mixed messages?

This blog will probably ask more questions than provide answers, but hopefully it might stimulate some great dialogue.

What we know is that the Productivity Commission report on Better Social Services, which although only a draft report at this stage, raised some key opportunities and challenges for this organisation and our sector. What we do not know is how highly this report and the work of the Commission are valued by the Government. What we do know though is how important it is for all of us to stay connected to this process. The Commission looked at Individualised Funding, which is at the cornerstone of the Ministry of Health’s contribution to the changing disability sector. The Commission raises some key questions about Individualised Funding and whether it achieves all that some claim it does.

Recently a key piece of policy work on vocational services appears to have been put on hold and I have heard many (official and unofficial) explanations as to why this has occurred. I am as confused as anyone about this. Although this work appears to have been put on hold, I would be surprised if that means changes in the way vocational services are provided and funded will not take place. Therefore, all of us involved in vocational services need to look at the original proposals and extract the essence of what was being proposed. Although some of the details of the original proposals were problematic, we may need to position ourselves to meet the essence of the proposals.

Current developments and projects in the sector seem at one level connected but at another (especially on the ground) anything but connected. We are told that Enabling Good Lives is the cornerstone of the sector transformation but what does this mean? Does it mean the Enabling Good Lives principles or the current Enabling Good Lives pilots?

If it means the pilots, then which pilot? There are now two very different Enabling Good Lives pilots underway. Enabling Good Lives in Christchurch is entering its third and, perhaps, final year and has not been the overwhelming success that at times it is claimed to be. Despite the investment of $1 million dollars additional funding per year (In a sector crying out for better resourcing), we are now only seeing some of the potential which was promised two years ago – so is that too little too late?

Enabling Good Lives in Waikato has taken a year to get started and will work with a set number of individuals over the next two years. It has created a new entity called a “connector”. Is this just a change in name from “navigator” or is it something different? – Who knows. Although Enabling Good Lives Waikato has avoided some of the pitfalls of Enabling Good Lives Christchurch, it relies on the provision of extra leadership funding and the question still remains for me about whether it has addressed the fundamental challenges around choice and control.

Individualised funding is growing steadily and over 2000 people now access this opportunity. A couple of hundred people use Enhanced Individualised Funding (EIF) in the Bay of Plenty and it was signalled that EIF would go national. At the moment there appears to be some pull-back especially around how the money can be spent. The introduction of Enhanced Individualised Funding has been challenging and it has certainly raised expectations and put pressure of budgets. However, I am left wondering where this all heading.

Choice in Community Living has technically finished as a project but will continue in a “contained” form into 2016. It has been very successful (the quiet achiever). Unlike Enabling Good Lives providers like ours were very much a part of the delivery process – a point that has been overlooked by those wanting to push providers into some form of service delivery abyss. Choice in Community Living has clearly demonstrated that providers can work collaboratively together and provide supports for disabled people wishing to change their home setting, and that a direct relationship between disabled people / families and service providers can have positive outcomes aligned to the principles of choice and control. In other words, it shows that there is no one-way to secure great outcomes for disabled people.

Local Area Coordination continues in the Bay of Plenty for another year and two NASCs have Local Area Coordination pilots operating (Otago/Southland) and Hutt Valley. It is unclear at this stage what the intent and outcomes for these initiatives really are. It is also unclear whether other models e.g. our own Supported Lifestyles framework will be given a fair consideration when future decisions are made on funding. What I can say is our model has been evaluated three times over the last ten years and has a long body of evidence about success factors.

So, at some stage in the not too distant future, I believe that Government will decide whether it wishes to truly “transform” the disability sector or build on the effective elements currently present, or alternatively continue with the current ad hoc changes. The Government may decide to take some other approach entirely. There are some great pieces of work taking place in the sector led by disabled people, parent groups and dedicated community organisation, like ours. Let us celebrate this and build on these successes rather than feel the pressure to re-invent models and concepts that are not always as effective in reality as their “write-ups”.

Interestingly, we see a number of organisations starting their own “transformation” processes – some by simply changing the rhetoric about what they do, others by rebranding and others through taking a more intentional approach. It is clear that there is a growing “competitive” element in the sector which Government appears to have no problem with (they see this as linked to greater efficiencies) but it is causing some tensions. The viability and number of smaller organisations is clearly being questioned and I wonder if there was a clear warning to all community organisations with the recent demise of Relationships Aotearoa.

So what does this all mean? More confusion? More work? More challenge? Well probably all of this and a whole lot more. What it means for me is that although there does not appear to be a clear Government plan, there is a clear intent to bring about change to our sector along with the wider community sector as a whole. This Government seems set on stepping back from direct service provision, but it has not quite figured out the right way for this to happen. The overall strategy appears to involve streamlining contracts and government processes as well as focusing on outcomes and demonstrating value for money. While we can see the ideology, what is missing is the vision (what this will look like) and the detail of the process (how it will happen). This “gap” is challenging but cannot hold any of us back from action.

What do I think the sector should do? We simply need to work more collaboratively and focus on transforming current practices and services – easier said than done. How could this happen? By all of us focusing on:

  • Delivering high quality, outcome based services to disabled people and their families in a way which is determined by them – person-directed not just person-centred.
  • Developing effective and new community development processes to help remove barriers to participation for disabled people and families – it is no good giving people more choice and control if the community they live in is not inclusive.
  • Continuing to support disabled people to have their voices heard on key issues impacting on their lives.
  • Investing in new and creative specific service development initiatives developed in partnership with disabled people, which will add to the choice available to them.
  • Showing our willingness to ask and answer the tough questions about what we do, how we do it and what needs to change.

There could and will be more things to do – let me know your thoughts.

David Matthews
Chief Executive

11 Responses to “Making sense of our sector and the way forward”

  1. AllanHall says:

    Govt. engage the private sector because it is cheaper than public sector and have better links into the community than public sector . Individualised funding has been talked about for many years- and thus choice for the disabled person.But unless Govt increase funding other private providers will go the way of Relationship AotearoaDavids five points are O.K.What is the role of L.A.C.s in all this.

    • Those are great points Allen. Funding is often the forgotten piece of the puzzle. It is difficult to get quality supports on the cheap, no matter how good your principles are. Individualised Funding has indeed been round a long time. It is an important part of giving people more choice and control, but is not a silver bullet as people are increasingly realising.

      Local Area Coordination has been a bit forgotten about, but it still exists in the Bay of Plenty and there are now two NASC-based pilots. It is difficult to see where LACs fit in.

      Also we have to approve comments for the blog because of spam. I noticed you posted several times before I could approve the comments. I deleted the last two of your comments because it looked like they were mostly a repeat of your first comment.

  2. Jade Farrar says:

    I think EGL represents the govenment’s commitment too DSS reform in coproduction with sector leaders with lived experience.

    Quite rightly the demonstrations are looking at different issues across a wide variety of impairments and experiences of citizenship.

    David appears to not understand the word “demonstration”, no promises are being made EXCEPT to enable better self directed lives.

    This is the beginning of a new era, somethings will work, other things will not remain much longer.

    For individuals and families finally, we are heading into a buyers market (services AND community experiences tailored to how we want to live and to get us what we want out of life; the normal human experience. time for fresh new and exciting!

    The last 80 years in the sector have been a real hoot I’m sure, but personally I would give anything a go at this point

    • Those are very fair and good points, Jade. I hope it is the beginning of a new era.

      To give a bit of context, there was a Select Committee report on disability supports in 2008. This report found major issues with supports. In response, the Government did make a commitment to reform supports. This initially took the form of the Ministry of Health’s New Model (Elements of the New Model still exist, including Local Area Coordination). The Ministry of Health also continued to roll out Individualised Funding.

      Separately, the Ministry of Social Development commissioned the Enabling Good Lives report (Originally just a review of vocational services), which led to the Christchurch demonstration and now the Waikato demonstration.

      I consider that promises to significantly reform disability supports to give people more choice and control were made by the Government. The Select Committee in the 2008 report said that if significant change had not happened within six years, responsibility for disability supports should move to a new independent Disability Commission. It is now seven years since the 2008 report.

      To read more go here:
      http://www.odi.govt.nz/what-we-do/improving-disability-supports/#September2008SocialServicesSelectCommitteereportinquiryintothequalityofcareandserviceprovisionfordisabledpeople4

  3. John Taylor says:

    Thank you for this reflection David. I agree with much of what you say. In particular I agree that many in government have the belief that individualised funding is the ‘magic bullet’ to change the issues in the sector. Clearly it is one very important element for some people in creating true choice and control, but the experience of some others is that it forces them into fulltime administration of their lives.
    Like you and Jade, I think we need to move to a place where disabled people and families have real control (governance) over what they do, where they do it and how they do it, the same as any other citizen of NZ. That is what the principles of EGL point towards. The demonstrations are more about government figuring out how they can get their systems to support the same: something that the CHCH demonstration has shown is a lot harder than any of us imagined!

    • Those are good points John, I will pass them on to David. Me and Pete Wilson have a blog planned for next week about Individualised Funding. We remain really supportive of Individualised Funding as a way for people to have more choice and control over their lives, but, as you say, it is not a magic bullet. There are also risks around it, especially around funding cuts. Activists and researchers in the United Kingdom are increasingly becoming more aware of the risks and there is significant debate about personalisation in support services over there.

  4. sorry I find HB CCS disappointed in lack of help for services for my adult son with range of disabilities now he’s a adult. As we have had CCS involved from birth till leaving Lower Hutt which were outstanding help. Why do different regions not have enough staff to cover adult services? As family with IF funding why do we miss out on services to send us whats happening in Hawkes Bay by email would be quicker.

    • Sorry to hear that Ginny. We are a diverse and partially decentralised organisation. Each region can provide different supports. That said, we are trying to become more consistent because it is frustrating for people moving between regions. Do you want me to get someone from HB CCS to contact you?

  5. Roger Loveless says:

    Really like your link to policy work on vocational services and inclusion. All too often issues are over simplified and some groups fall through the cracks. At least it seems there is now more recognition of the complexities.

    • Thanks Roger, there is always a risk of people getting left behind during even well-intentioned policy changes. It is a risk we need to be vigilant about, especially with an aging population. One concept I like from economics is the idea that there is no such thing as a free lunch. If the government is spending less money, people somewhere are paying more (Not necessarily in money, they could be paying in time too).

  6. Greetings David,

    Very interesting read, and I’m not surprised that you are asking “what is Government’s real agenda and how could the sector possibly prepare for the future with so many confused and mixed messages?”

    I am surprised that it has taken you four years to ask…or has it reached the stage that you realize things have got so unstable for disabled people that it would be unconscionable not to go public?

    My (physically impaired) partner and I have long since realized that the Ministry of Health: Disability Support Services appears to take note of what ‘the voices of disabled people’ are saying, then produces yet another happy clappy brochure advertising their latest seemingly ‘fit for purpose’ scheme to ‘meet our needs’. But the reality is so often far removed from the hype…

    Take Choice In Community Living for example…according to MOH:DSS for the disabled person…

    “It is about increasing their status as a tenant or home owner and separating this from their support arrangements.”
    Sounds great…but why, in the fallout from the Public Health and Disability amendment Act(2) did our local NASC seem to think CICL was right for us? My partner owns his own home, and has had myself as his only carer for 16 years. For almost the entirety of those 16 years there was no contracted provider available in our area willing or able to supply a suitable carer…even when we needed one. So you might grasp that being able to be paid as his carer would have been great for both of us. Not to be…but…why the hell did our NASC seem to think that CILC was going to somehow fix our most immediate problem of ever dwindling cash resources? So cash strapped that we cannot afford to keep living in our home.

    “But, but” the NASC will say…”we gave them a choice!”

    A pitiful joke, and rather insulting.

    I have read at least 100 documents from either MOH or Cabinet on all aspects of disability…and I swear…if the words “flexible”, “putting the person in the centre” or “choice” appear, I automatically switch off…there is only so much garbage the brain can accommodate.

    So…welcome to our world David…now what?

Leave a Reply