A Response to Disability in 1986 and Beyond: A Report of the Royal College of Physicians

The article attempts a radical critique of the recent report published by the Royal College of Physicians, which established that there are serious shortcomings in the services provided for people with disabilities. The author disputes that the development of more medical services in medical environments would be in the interests of disabled people. He proposes instead a partnership between the medical profession and autonomous structures democratically created by people with disabilities. This would lead to the development of responsive and non-intrusive services that enable people to live independently in the community.     

Disability and Self-help: A Case Study of the Spinal Injuries Association

This paper provides an 'insider' view and suggests that organised self-help has a role to play in improving the quality of the lives of disabled people. Through a discussion of the work of the Spinal Injuries Associations, it shows the kinds of services that can be provided, controlled and run by disabled people themselves. Finally, it considers the implications of the self-help approach for the work of professionals and suggests that such an approach should be seen as complementary to medical and administrative approaches.     

Disabled People,Health Professionals and the Social Model of Disability: Can there be a research relationship?

The social model of disability is proposed as an alternative to models that have viewed disability as an individual, rather than a socio-political issue. The use of this model to guide both research theory and practice is proposed in order to equalise research power relationships, and involve and empower disabled people. Health professionals have traditionally reinforced the medical model of disability in both research and practice, and this has been seen as contributing to the oppression and marginalisation of disabled people. If the social model is to achieve wider dissemination, it would appear important to develop a dialogue between disabled people and health professionals. However, because of negative perceptions it can be difficult for health professionals to find an appropriate position in relation to disabled people, research and the social model of disability. While not denying the past, it appears essential to look at ways in which disabled people and health professionals can work together to overcome the oppression and marginalisation that has been linked to the provision of health services.     

Government Policies and Disabled People in American Indian Communities

Although services and resources for disabled people in the United States have improved greatly as a result of legislation and advocacy efforts, many of the disabled in American Indian communities have yet to benefit from these advances. Inaccessibility to services is often complicated by problems and debates over which agency, state or federal, is responsible or has jurisdiction to provide the services. Meanwhile, Indian communities struggle to accomplish what they can with limited resources.     

Application of the International classification of functioning,disability and health in Taiwan: victory of the medical model

Since July 2012, eligibility for disability benefits and services in Taiwan has been assessed based on the International Classification of Functioning, Disability and Health. This study examines disabled people’s experiences of this new assessment system: does it incorporate the social model or a multidimensional understanding of disability and assess the needs of disabled people adequately? In-depth interviews were employed with 24 disabled persons to answer these questions from the perspective of disabled people. The findings show that the new assessment model is still medicalised: social roles and social participation are not considered, the assessment process is dominated by professionals, users’ perspectives are not included and only those who are assessed to have a high level of disability are satisfied with the new system while many others would prefer the old assessment system. These findings have relevance for the analysis of needs assessments of disabled people in different countries.     

Counting Us Out: A Discussion of the OPCS Disability Surveys

This paper provides a summary of the main findings of the first two OPCS reports on disability and a critique of the methodology employed. Whilst the first report highlights the systematic underestimation of the prevalence of disability which was enshrined in previous government research, it should by no means be interpreted as providing the 'true' figure. Such a project is an impossible one, since 'disability' is a social construct, and definitions dependent upon the interests, intentions and presuppositions of those with the power to define. As far as the severity scales are concerned, a wholly spurious 'objectivity' is identified. The second report, on financial circumstances, does implicitly provide official recognition that disability causes poverty. Because of the research methods employed, however, it fails even to approach an adequate quantification of the financial disadvantages experienced by disabled people. A critical understanding of the deficiencies of the OPCS surveys, in terms both of overall approach and of method, can provide a salutary example of how not to research issues of disability.     

The changing landscape of public service delivery systems for disabled people in China: a Shanghai case study

This article will consider the current development of an emerging contract culture for the delivery of social services and its impact on disabled people in China. The discussion is based on an original qualitative study in Shanghai. The past 30 years have seen dramatic changes in China, which in parts have led to improvements in the lives of disabled people. The China Disabled Persons’ Federation (CDPF) became a key player in delivering these changes with the government. However, the CDPF is being criticized by disabled people for being too bureaucratic and not being effective enough in its delivery of services. One of its responses is to work with newly emerging not-for-profit organizations (NPOs) of and for disabled people. The CDPF has now begun to contract the delivery of some services to such NPOs. It is hoped that this may improve their effectiveness but the development of a contract culture in the delivery of services for disabled people may also be seen to pose a threat.     

Telephone therapy: call for help.

1. Many disabled people are unable to take advantage of community resources because they cannot leave their homes, but the telephone can provide a link to psychotherapeutic services. 2. In both telephone and office therapy, the therapist orients members to the group, suggests an arena in which goals might be established, encourages verbalizations, sharing of concerns, strategies for solving problems, and assesses the psychodynamics of the therapeutic situation. 3. Psychotherapy via telephone can provide significant benefits to people who formerly were barred from services. Telephone therapy requires the therapist's commitment to the challenge of mastering a new technique and to altering fee structures to allow those on fixed incomes to be served.     

International guidelines and the inclusion of disabled people. The Ugandan story

Uganda has made much progress towards including disabled people in its mainstream development, particularly in the political agenda. The exact process by which this has been achieved and the relationship between this and international guidelines and legislation are not known. This study undertakes to examine this from two specific perspectives: (1) How do international documents relevant to disabled people relate to national legislation in Uganda? (2) What can this comparison, together with the perceptions of stakeholders, tell us about how the legislation and services could improve? International legislation and Ugandan legislation is reviewed and compared. Data from 5 semi‐structured key informant interviews and 6 focus group discussions involving a total of 38 people are collected and analysed. The themes arising from the data are related to the documents, legislation, policies and other relevant literature. The results examine the barriers to service provision; the role of change; the importance of representation; policy and legislation issues; and the effects of devolution. Five specific findings relate to how legislation and services can improve: more resources to increase access for disabled people; strong leadership and collaboration between Disabled People’s Organisations (DPOs) funding bodies and governments; awareness raising and training; representation from all impairment groups; and raising the profile of disabled people through further legislation.     

Integrating people with disabilities: their right – our responsibility

A full understanding of disability recognizes that it has a powerful human rights dimension and is often associated with social exclusion, and increased exposure and vulnerability to poverty. Disability is a human rights issue. The World Bank (1999) report points out that one in five of the world’s poorest are disabled, for whom access to basic rights is a daily struggle. Though arising from physical or intellectual impairment, disability has social implications as well as health ones. In most countries, government services for disabled people are still small‐scale rehabilitation projects separated from the rest of the community. People with disabilities are amongst the poorest of the poor. Barriers built by disability and poverty can only be removed by the concerted and integrated effort of the government, NGOs, corporates, movie mughals and educational institutions. It is the duty of the rest of society to acknowledge the rights of the poor and the disabled. This can no longer be treated as philanthropy but is a responsibility.     

‘Unjust,inhumane and highly inaccurate’: the impact of changes to disability benefits and services – social media as a tool in research and activism

This article details research carried out as part of an MA in Social Research at the University of Leeds (UK). The research was concerned with two key issues: documenting the impact of recent cuts in benefits and services on disabled people; and the role of disabled people’s organisations in responding to this impact. It also explored the use of social media in recruiting research participants. Working with Hammersmith and Fulham Action on Disability, the experiences of 95 disabled people were gathered using focus groups and an online questionnaire distributed via social media. The use of social media to gather participants is something I felt was particularly interesting in relation to disabled people, especially in light of social media’s role in current disability rights campaigns, and a method I feel should be explored further.     

Disabled People, Service Users, User Involvement and Representation

The issue of representation and representativeness has become central in debates about user involvement, disabled people and users of social care services. This article examines the emphasis of service agencies on the 'unrepresentativeness' of disabled people and service users; looks at how this is experienced by the latter and considers why the issue has gained such importance. It examines the different meanings attached to representation by recipients and providers of services. As well as looking at how the issue of representativeness is used to devalue, exclude and disempower disabled people and service users, the article explores its relation with the competing participatory and representative models and practices of democracy employed by disabled people and service providers.     

Do self‐assessment and self‐directed support undermine traditional social work with disabled people?

In recent years, self‐assessment and self‐directed support have become mainstream options within disability services. The Disabled People’s Movement has advocated the need for such change for a long time but this has been persistently resisted by many social workers. In this article, it will be argued that both self‐assessment and self‐directed support undermine traditional social work and that social workers need to begin to work alongside disabled people, rather than ‘for’ disabled people, in order to achieve substantial system change.     

'Service user': regressive or liberatory terminology?

The term 'service users' has come to be increasingly used both in the UK and beyond to describe people on the receiving end of health, welfare and social care policies and services, including disabled people. This use of language is contentious. It has come in for criticism as presenting people in passive, consumerist terms. However, many disabled people, and others, use the term of themselves. This article seeks to develop discussion about this terminology and suggests that as well as being used by state and service system in regressive and pejorative ways, it may also serve as a unifying concept which has helped groups to act with solidarity and to challenge and seek to improve their status in society. In this way, it may parallel the terms 'disabled' and 'disability' as used within social approaches to disability.     

The crisis of local authority funding and its implications for independent living for disabled people in the United Kingdom

The recent financial collapse of Northamptonshire County Council sets a worrying precedent for local authorities in the United Kingdom, and in particular for disabled people who depend on services provided by local authorities, such as Direct Payments for personal assistance, for their daily living needs. While the Northamptonshire situation has been blamed on financial incompetence, we argue that it has deeper roots in austerity policies implemented by Conservative-led governments since 2010 on a national level. We also argue that the placement of responsibility for funding personal assistance services in the hands of local authorities creates a deeply unjust ‘postcode lottery’ for disabled people, and we call for a national right to all services necessary for independent living, regardless of cost.     

Choice: what,when and why? Exploring the importance of choice to disabled people

Extending choice and control over public services is central to current policies in England. Such policies have immense potential for independence and well‐being. However, it is still not clear how disabled people conceptualise choices, what choices are important, for which groups of people, in what areas of life and why. This paper presents findings from the first phase of a longitudinal qualitative study of choice and control over the life‐course. Semi‐structured interviews were carried out with 111 participants including disabled young people with progressive conditions; their parents; adults and older people with fluctuating support needs and those experiencing sudden deterioration in health. The findings suggest that while most people across all study groups wanted to be able to make choices in all areas of their lives, there are significant differences in the importance they attach to specific choices. The findings have implications for service reforms and identify some policy and practice issues that need to be addressed.     

The Dearing Report and Students with Disabilities and Learning Difficulties

The movement to promote improved levels of participation from groups under-represented in higher education which occurred between 1980 and 1990 neglected disabled people. The position has been addressed by the national higher education funding councils since 1992 and progress has been made. Therefore, it was surprising to find that, whilst certain social groups were highlighted, nothing was said about disabled people in the terms of reference of Sir Ron Dearing's National Committee of Inquiry. This paper describes attempts made to inform and influence the Committee. Next, it considers the Report itself. First, the recommendations for future policy which are directed specifically towards disabled people are discussed; secondly, the potential implications for disabled people of the general recommendations are explored; and thirdly, the supplementary report on students with disabilities is reviewed. The conclusion provides a brief overview of developments since the Report's publication.     

The social model of disability: thirty years on

This year marks exactly 30 years since I published a book introducing the social model of disability onto an unsuspecting world and yet, despite the impact this model has had, all we now seem to do is talk about it. While all this chatter did not matter too much when the economy was booming, now it no longer booms it is proving disastrous for many disabled people whose benefits and services are being severely cut back or removed altogether. In the article I restate my view of what the social model was and what I see as its potential for improving the lives of disabled people. Finally I focus on the unfortunate criticisms of it and the disastrous implications these have had for disabled people.