3.Getting it Right for Disabled People
Kia tika mo te hunga hauā

Disabled persons have the inherent right to respect for their human dignity. Disabled persons, whatever the origin, nature and seriousness of their handicaps and disabilities, have the same fundamental rights as their fellow citizens of the same ages, which implies first and foremost the right to enjoy a decent life, as normal and full as possible.
Article 3, United Nations Declaration on the Rights of Disabled Persons

3.1 Introduction /
Timatatanga

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Human Rights in New Zealand Today / Ngā Tika Tangata O Te Motu identified the pervasive barriers that prevent disabled people from fully participating in society as a key human rights issue. Disabled people may also experience multiple disadvantage in terms of their ethnicity, age, gender or sexual orientation. In spite of significant progress in developing a high-level framework and strategy and the increasingly effective voice of disabled communities, in their daily lives disabled people remain among the most disadvantaged citizens in New Zealand .

Disabled people may have physical, sensory, neurological, psychiatric, intellectual or other impairments . An aging population means that increasing numbers of people in New Zealand have impairments. The outcomes and priorities for action in this section address issues affecting older people who experience disability as well as disabled people generally.

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Knowledge of the experience of disabled people is limited and this affects policy design and delivery and everyday practice in schools, homes, workplaces and public places.

3.2 Protection and fulfillment of rights /
Te tiaki me te tutukitanga pai o ngā tika

Outcome: The rights of disabled people are respected, protected and fulfilled.

The status report identified the invisibility of disabled people as a key barrier to the realisation of rights. New Zealand is participating in the development of an international Disability Convention, which aims to ensure visibility and status for disabled people. Within New Zealand , the Human Rights Act 1993 provides protection against discrimination, although many consider that it provides a lower level of rights for disabled people compared with others.

While the New Zealand Disability Strategy provides an excellent framework, in order to make a difference in people’s everyday lives, there is an urgent need to make progress in implementing it. The collection and use of data also needs to be improved so that this progress can be assessed.

Priorities for action:

• Take a leadership role in the development of a comprehensive international human rights disability convention
• Support the continued participation of disabled people and their organisations, including Indigenous disabled people, in the development of this convention
• Review the Human Rights Act 1993 exceptions relating to disability
• Strengthen accountability for the implementation of the New Zealand Disability Strategy by developing and achieving specific targets
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• Improve direct involvement of disabled people in the monitoring and evaluation of the New Zealand Disability Strategy implementation
• Improve the collection and use of disaggregated data in relation to disabled people.

3.3 Participation in decision making /
Te urunga ki ngā whakataunga

Outcome: Every disabled person in New Zealand is able to express their views and have their views taken into account on matters that affect them.

Participation in making decisions is both a right in itself and also a means to better protect and promote other rights. Disabled people’s participation is a key element of this section of the Action Plan. Strengthening advocacy by and for disabled people is an important way of increasing participation and monitoring and addressing the full range of human rights. Disabled people and their organisations are co-operating with agencies such as the Health and Disability Commissioner and the Office of Disability Issues to begin making improvements in this area.

Priorities for action:

• Strengthen advocacy by and for disabled people by providing the necessary knowledge, skills, support and resources to enable more disabled people to become advocates and self-advocates
• Include in contracts with residential service providers a requirement to:
• have at least two residents or resident-selected advocates on their governing body;
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• provide governance training; and
• report on resident satisfaction with this process of representation.

3.4 Safety /
Te Marutau

Human Rights in New Zealand Today / Ngā Tika Tangata O Te Motu reported concerns about the safety and autonomy of disabled people, particularly in situations where assistance is needed with daily activities. Priorities for action to improve the safety of disabled children and young people are included in the children and young people section of this Action Plan. Priorities for action to address safety issues for disabled people more generally are included in the civil and political rights section. Proposed research on the families of disabled people (see the special feature on families in the children and young people section) will address safety within the family, amongst other issues. The safety of disabled people would also be strengthened by implementation of the actions to increase participation in decision making, set out above.

3.5 Disabled people in compulsory treatment and places of detention /
Te hunga hauā i roto i ngā whare matua oranga, me ngā waahi mauhere

Outcome: Where disabled people are lawfully detained, they are safe and their human rights are respected.

Human Rights in New Zealand Today / Ngā Tika Tangata O Te Motu identified significant gaps in data about disabled people who are detained. The lack of reliable data prevents accurate assessment of the adequacy of current levels of service provision. A small number of prisoners requiring urgent treatment for mental illness remain in prison while they wait for an available bed in a forensic mental health facility.

The status report noted the benefits of the new Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003, which provides a separate legal framework for the detention of people with an intellectual disability. However, some concerns were raised about the impact of the new legislation, and careful monitoring of its implementation was recommended.

Priorities for action:

• Collect and publish data on disabled people in prison
• Monitor the implementation of the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 and the provision of appropriate rehabilitation programmes
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• Improve the provision of mental health services for people in prison, including by increasing the number of secure forensic beds in the community that are available to prisoners in need of specialised forensic treatment.

3.6 Mental health services /
Rātonga oranga hinengaro

Outcome: Where people use mental health services, they are safe and their human rights are respected.

Human Rights in New Zealand Today / Ngā Tika Tangata O Te Motu identified two critical human rights issues in mental health clinical practice:

• The inappropriate use of seclusion and
• The tension between compulsory treatment and the rights to refuse treatment, to make an informed choice and to give informed consent.

Improvement in mental health service infrastructure and clinical practice are key to minimising the use of seclusion and addressing issues of competency and capacity. The priorities for action emphasise infrastructure, practice guidelines, collaboration and greater accountability and transparency in monitoring practice.

Priorities for action:

• Ensure early implementation of the Mental Health Commission’s Blueprint for Mental Health Services which will develop mental health service infrastructure
• Ensure that any practice that involves confinement, isolation and reduction of sensory input is acknowledged as seclusion in guideline documents
• Initiate a collaborative project to clarify human rights issues around the use of seclusion
• Require District Health Boards (DHBs) to report the extent of the use of seclusion in service profiles
• Investigate the concept of capacity as an additional criterion for use in compulsory interventions
• Strengthen the formal recognition of advance directives to enable people to make decisions about their treatment before becoming unwell
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• Investigate the effectiveness of legal protections for service users under the Mental Health (Compulsory Assessment and Treatment) Act 1992 and the length of Community Treatment Orders.

3.7 Elimination of poverty /
Te whakakāhore i ngā tikanga rawakore

Outcome: Every disabled person in New Zealand has an adequate standard of living.

Human Rights in New Zealand Today / Ngā Tika Tangata O Te Motu identified disability-related expenses and barriers to and in employment as key contributors to the significant disadvantage experienced by disabled people in terms of living standards. Policies and practices to improve these standards need to take into account the extent and nature of the additional costs of disability to individuals and their families, but up-to-date information is not available.

Disabled people face major barriers in accessing and retaining work, gaining promotion, and achieving an adequate income. These barriers could be addressed by strengthening the international and national legislative framework, and improving attitudes towards disabled people at all levels. Continued public sector leadership and achievement of the existing equal employment opportunities targets is also required.

Priorities for action:

• Undertake research to identify the cost of disability to disabled people, their families and the disability community
• Develop and implement a campaign to overcome negative attitudes against disabled people seeking employment and in employment
• Minimise segregated employment for disabled people and remove exemptions from the minimum wage
• Achieve disability-related EEO objectives in public service departments and ministries and improve accountability for results
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• Ratify ILO Convention 159 on Vocational Rehabilitation and Employment (Disabled Persons).

3.8 Access to and provision of quality services /
Te whakarato tonu me te wātea ki ngā tikanga kairangi

Outcome: Every disabled person in New Zealand has access to quality services.

Human Rights in New Zealand Today / Ngā Tika Tangata O Te Motu concluded that disabled people lack authentic involvement in decision-making and policy development in relation to health, education, and other types of services. Disabled people face barriers to services and information, and to many places, including buildings and transport. While the Building Act 2004 includes an access standard for built environments, there is a need to review this on a more regular basis.

Government agencies are focusing on a more co-ordinated approach to service development. For example, the Ministry of Health and the Departments of Corrections and of Child, Youth and Family Services are co-operating across sectors to deliver more client-centred services. A review of support services as a whole is now needed to inform future developments.

Local authorities have a significant role in ensuring the accessibility of services. The Auckland City Council and the Manukau City Council have recently launched programmes to ensure the improved accessibility of their cities.

The Mental Health Commission has reported that access to child and youth mental health services and funding for community support services for people with experience of mental illness do not meet the guidelines set out in Blueprint for Mental Health Services: How Things Need to Be.

Priorities for action:

• Conduct a review of systems for providing support to disabled people (including home-based support, equipment, housing/vehicle modifications, rehabilitation, disability information and advisory services) with a focus on improving personal autonomy, flexibility, accessibility, equity, consistency, co-ordination and accountability to disabled people
• Ensure implementation of the Blueprint for Mental Health Services guidelines for child and youth mental health services
• Encourage the development of community-based services provided by people with experience of mental illness for people with experience of mental illness
• Improve disabled people’s access to information and communications technology
• Review NZ Standard 4121:2001 (access standard in the built environment) every 5-10 years to reflect developments in best practice in building accessibility
• Make public transport more accessible to disabled people by implementing recommendations of the Human Rights Commission Inquiry into Accessible Public Land Transport.

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(Further priorities for action for education, health and housing services are outlined in the sections on children and young people, and on economic, social and cultural rights.)

3.9 Bioethics /
Tikanga rangahau rongoa koiora

Outcome: There is effective participation of disabled people in all bioethical debates and decision-making bodies.

There is concern among disabled people in New Zealand about the possible implications of rapid advances in biotechnological knowledge. These include concerns that developments in biotechnology (such as genetic screening) can be used as a means to discriminate or to devalue the lives of disabled people. There is no evidence in the New Zealand Disability Strategy progress reports of appointment of disabled people to ethics committees, and disabled people’s perspectives are lacking in ethical and bioethical debates.

Priorities for action:

• Ensure effective representation of disabled people on national bodies such as the Bioethics Council, the Advisory Committee on Assisted Reproductive Procedures and Human Reproductive Research, National Ethics Committee on Assisted Human Reproduction, and ethics committees at research centres and universities
• Examine the human rights implications for disabled people of biotechnology/genetic technologies
• Train researchers, bioethicists, members of ethics committees, legal and medical professionals, and health and disability service providers in a human rights approach to bioethical issues , and in particular on the equal value and human rights of all children, young people and adults regardless of their level of impairment
• Review legislative protection against discrimination on the basis of genetic information (including collection and use of genetic information in areas such as employment and insurance).

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