Health and Disability System review fundamentally fails disabled people4 min read
Like many people with disabilities or impairments, I spend a lot of my time hanging about in hospital waiting rooms. I’ve joked to my specialists on multiple occasions that I’m sending out ‘change of address cards’, and have my mail forwarded to them at the hospital. We are very lucky in Aotearoa New Zealand to have a public health system. Although there are some significant flaws in the public health system, I consider myself very lucky to live here.
When writing our submission on the Health and Disability System review last year, I was pleasantly surprised with how the review acknowledged the issues surrounding disability, and how often disability intersects with issues like ethnicity. I was genuinely hopeful that at last we were getting a disability overhaul that we so desperately needed. Then the final report came out.
The final report was about as far away from what we’d hoped for as you could get. Disabled Person Assembly put it well “A health review with disability tacked on”. CCS Disability Action Chief Executive David Matthews was similarly scathing, saying “Disability support is not a health service. With modern disability supports the focus should be on making sure disabled people and their whānau are fully included in their communities and have the same opportunities as other New Zealanders.”
Rather than tackling the some of the big issues that disabled people face in a health and disability support context, the report doubles down on the notion that ‘health and disability’ are one in the same. This harks back to some of the fundamental philosophical issues i.e. the Medical Model vs. the Social Model of Disability.
I personally sit in the middle of these models, as my disability is caused due to chronic health conditions that require a fair amount of medical intervention. I do defer to the expertise of my medical team, although for the most part it is still a shared decision-making process. There are certainly instances where one should rely on medical experts, if you’re sick or have a broken leg go to a doctor. However, in terms of system wide support, I firmly believe that disability support should be based on the Social Model and considered as separate from the health system.
The Social Model aims to empower disabled people and tackle the many barriers disabled people face in society. Disability is not necessarily caused by impairments but by the many roadblocks like inaccessibility and lack of inclusivity that get thrown into the daily mix. The NZ Disability Strategy is centred around the Social Model; and when talking disability support services, it is abundantly clear that disability should not be lumped in with the health system at the last minute. Yet that’s exactly what this report does.
The review recommends that disability support should fall under the umbrella of DHB responsibility, which in my opinion, is a terrible idea. By plonking disability support in the laps of DHBs, we take a giant step backwards by viewing disability as a purely a health issue. We lose the voices of disabled people and their whanau in favour of medicalised experts. It is also worth noting that there weren’t any disabled people or disability experts on the advisory panel. This review is a prime example of why disability representation is critical. By transitioning backwards to the DHBs, I’m very concerned that we run the risk of limited shared decision-making and not meeting the needs of disabled people. And I’m sure this won’t come as a shock to anyone with experience with DHB’s but, as a rule, the wait list times are horrendously long as it is. What on earth will it look like when they oversee disability support services?
I am very disappointed with the results of this review. They had a chance to make a significant difference and improve the state of disability support in New Zealand. Ideally, they would have recommended a separate authority to deliver and manage disability services. An authority that would have disability expertise and be led by and for disabled people. But we didn’t get that. We got a giant leap backwards, and I can only hope that the Government hears us and decides not to implement the recommendations.
