Health and Disability System Review Report a Huge Disappointment – time to stop treating disability as a health issue
The Health and Disability System Review Report is actually a “health system” review that pays lip service to the disability sector and continues the marginalisation of disabled people, says New Zealand Disability Support Network CEO Dr Garth Bennie.
“The Simpson Report completely ignores the issue that matters most to the disability sector – that disability is not a health issue. The recommendation to devolve disability support to DHBs has the potential to simply further entrench disability in the health system,” says Dr Bennie.
“The cursory attention paid to disability-related matters in the Simpson Report is a reflection of how the current system already operates to marginalise disability. “It dismisses the significant contributions of disabled people, families and service providers who have been collectively working for changes that are far more transformational than what it offers up.
“The single chapter of the Simpson Report devoted to disability reveals a very superficial understanding of the Enabling Good Lives Principles which have informed over a decade of effort to demonstrate new ways of governing, designing and delivering support.
“The work of the disability sector is taking us in the opposite direction from the proposed shift to DHBs. Our view is that ultimately, disability support needs to escape from the health system altogether, rather than fragmented even further within the DHBs.
Just as we are concerned about a proposed Maori Health Authority being restricted to an advisory role, we have similar concerns about any disability focused structure in the proposed new system not being fully empowered to commission and fund disability support services.
“We need far bolder moves from government that recognises disability is not primarily about healthcare, but about social support, ending discrimination and creating opportunities. Many in the sector are calling for a separate entity that can focus on disability policy and support. NZDSN believes this should occur in the context of much broader reforms that end the fragmentation across Health, MSD, and ACC that discriminate based on the cause of disability. This should include a dramatic re-think about how we better integrate social and income support, how its funded and how commissioning works.
If government does not take the opportunity or have the appetite for such reform and is determined to pursue the proposed changes outlined in the Simpson report, there is considerable work to do – and NZDSN welcomes the opportunity to contribute. This includes how the Enabling Good Lives Principles will directly inform the way services are commissioned and how governance arrangements will involve disabled people and families.
“Proposals to abandon the work of the past decade and simply offload disability support on to the DHBs is not acceptable. It is important that we take the opportunity to continue the direction of travel that is being informed by an already agreed set of principles, so that disability support does not become further entrenched in the health system as the proposed changes unfold,” says Dr Bennie.
“The Simpson Report does offer some broader recommendations that we would support. These include:
· the proposal to set in law annual increments to the health budget to cover cost pressures which would give providers a far more predictable future and avoid funding cuts by stealth – which have plagued disability funding for many years.
· Employing more disabled people in the health and disability system, particularly in leadership roles, is something providers and the system as a whole should be accelerating – whatever the structure of the system might be in the future.
· Improved and more equitable access to core health services for disabled people is long overdue.
NZDSN looks forward to the opportunity to contribute to the enormous amount of work that will be needed to ensure that new and already demonstrated ways of designing, governing and delivering disability support are safeguarded in any implementation of the proposed changes.