Professor Brian Howe, “one of Australia’s leading thinkers on social policy,” contributed a guest column to this month’s staff news at Melbourne University:
During the past 25 years disability policy has increasingly been anchored in a human rights philosophy, which has been encouraged by the United Nations and progressively taken up in Australia by successive federal, state and territory governments. Such a philosophy encapsulates the basic principle that people with a disability should have the same basic rights and opportunities as other members of society.
In March 2007, Australia was among the first of around 80 nations to sign the United Nations Convention (treaty) on the Rights of Persons with Disabilities. The stated purpose of the convention is to ‘promote, protect and ensure the full and equal enjoyment of human rights and fundamental freedoms, for all persons with disability, and to promote respect for their inherent dignity’ (UN 2007). The creation of such conventions has been a bottom-up process in which delegates from government, the disability sector and the Human Rights and Equal Opportunity Commission (HREOC) have been involved, suggesting that there is broad support for such a developmental approach.
The universal character of conventions such as this one suggests that they are not only about winning active support from governments, they look also for support from business, trade unions and civil society to ensure that people with disabilities are not denied “the same rights and opportunities as other members of society”. Unfortunately the language of human rights represents at best aspirational policy and is often a long way from what happens in the real world.
Especially disadvantaged are the 700,000 Australians of workforce age who suffer severe or profound core activity limitations requiring regular assistance in getting organised for the daily round. Often suffering from serious physical or mental impairment or psychiatric disorders they place enormous pressure on their carers and their families.
The inadequacy of the funding base forces the severe rationing of services, effectively damaging the quality of life for the severely disabled. As Australian disability advocate Mary Lou Carter says, “the disability system in this country is entirely crisis driven” for the most relying on caring families to sustain care as the resources available are rationed to care for the most needy.
The policy takes little or no account of the aging of the population, an important driver of increased numbers so people with disabilities or the pressure point driven by ageing carers worrying about the future of their disabled dependents.
Australian social policy which has for the most part been developed incrementally usually tries to avoid facing up to fundamental inequalities, which are presently placing enormous and damaging pressure on families.
During the 1970s there were proposals considered by the Whitlam government and presented to parliament to create national and universal no fault insurance scheme to cover sickness and injury such as then existed in New Zealand and continued to operate until the present. The approach then advocated by Mr Justice Woodhouse would ultimately influence work place and motor vehicle accident schemes, but the lack of a comprehensive scheme has meant that people with very similar disabilities will be treated very differently if they compulsorily insured (as they are at work and in motor vehicle accidents) than if they have an accident at home.
Accident and worker’s insurance is not based on fault, reflects previous earnings, covers medical and occupational rehabilitation and may facilitate a graduated return to work.
For those most severely disabled as a result of accidents where there is no insurance policy the pathways may not be neither as generous nor as comprehensive. Income replacement is the lowest in the OECD, rehabilitation may be cursory, hospital stay may be limited and reliance on family support may come early and be life long.
One system is designed to maximise the chances of resuming normal life. The other is more accepting of long term dependency ultimately increasing overall costs for taxpayers.
It is for this reason it is so important to establish national disability insurance as has operated in New Zealand for the past forty years. With national occupational superannuation we are effectively ensuring that all Australians will have a decent level of income as they age. Everyone has some level of risk of incurring a serious illness or injury that will set limits to our capacity to participate in normal community life.
A National Disability Insurance scheme might help to mitigate that risk and share with families much more equally in the long term costs of caring for a severely disabled member. The existing medical insurance scheme could provide an equitable means of raising funds through an increased levy enabling the more equitable funding for the long term needs of those with more serious levels of disability.
It is good that Australia has signed the convention on the rights of people with disabilities. This commitment would have about it much greater credence if it was followed through with a national Disability Insurance Scheme as was proposed and supported by last year’s summit. This would help make the disabled equal citizens.
[Australia ratified the treaty in July 2008. HREOC has been renamed the Australian Human Rights Commission.]