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4 Subject Areas
This section discusses recommendations under subject headings of education, employment, community care, health and poverty. They should be read in the context of the overarching themes covered in section 3. There are also important connections between the subject areas in this section. For example, access to education is important in opening up access to employment, inflexible community care provision can make it impossible to take up paid work, and so on.
4.1 Education
There needs to be recognition that barriers in education are not simply physical and that disability takes many forms. The extent, variety and implications of disabilities need to be understood and accommodated in the way education is designed, delivered and resourced.
a) Standards
There is considerable scope to extend the involvement of disabled children and young people in education, not just as pupils but to help define and identify good practice. As an Agency of the Scottish Executive, HM Inspectorate of Education ( HMIE) will be covered by the Disability Equality Duty. It would therefore be fitting for them to work with disabled children and young people to develop indicators of good practice. Other partners should be the DRC, disability organisations, local authorities, and perhaps relevant Scottish Executive officials. Careful planning would be required to take this forward.
HMIE should work in partnership with disabled people, including disabled children and young people, and disability organisations to develop indicators of good practice
Group 3
Further and higher education institutions should already have mechanisms for consulting with students, such as student consultation panels. These need to be fully inclusive to all equality groups. It is not a matter of setting up new and additional structures but ensuring the accessibility of existing structures (assuming they exist). Panels should also be clearly linked in to the Disability Equality Duty and the requirement to involve (not just consult) disabled people. The effective involvement of disabled students is one area where indicators of good practice should be developed and monitored.
Further and higher education institutions should involve disabled people through student consultation panels and that inspection bodies should monitor progress.
Group 3
b) Transition points
Disabled people may need support like personal assistance, note-takers, alternative and augmentative communication aids ( AAC), communication support workers, and equipment including specialised computer software such as Dragon (voice activation), Read and Write Gold for Dyslexia, or Screen Reader. Support and equipment needs may not vary significantly between educational settings or between education and employment. However, provision to meet support and equipment needs is often specific to a setting. This can mean that when the disabled person moves from one to another it is necessary to make new applications to different providers. When a person is combining part-time education with part-time employment at the same time it can become even more complicated. This can have detrimental consequences for social mobility.
In addition to the amended DDA, recent legislation made provision for planning transitions and supporting children and young people during transitional periods. The Education (Additional Support for Learning) (Scotland) Act 2004 requires education authorities to plan well in advance when a child or young person with additional learning support need is preparing to leave school. An education authority is required to start preparing for the pupil's transition from school education earlier than 12 months before transition is expected to take place. Involving the pupil in transition planning is not a one-off event. They should be involved at every stage of the process. However, it is important to ensure the reality matches the legislative intention and that transition from school is made as smooth as possible.
All disabled people should receive appropriate and adequate support and equipment throughout school, further and higher education and at all points of transition such as the transition from school to post school.
Group 3
Although children tend to have their needs assessed and met more efficiently and effectively than many adults through the 'education route' in some areas the support and provision of augmentative and alternative communication aids ( AAC) can end abruptly when the child reaches adulthood and is no longer receiving statutory education.
Further and higher education institutions and Careers Scotland have potentially very helpful roles to play in getting across to employers positive messages about the capacity of disabled people to make good employees. Developing close links with a range of partners, including community groups, employers and enterprise networks helps create effective learning opportunities and progression routes for learners from a range of backgrounds. Young disabled people have the potential to make excellent employees and every opportunity needs to be taken to get this message across to employers.
In developing links with business, further and higher education Institutions and Careers Scotland should take on board the need to promote disabled people as employees.
Group 1
c) Employment in education
Consistent with previous recommendations, disability equality training should feature in initial teacher training and professional development thereafter. However, to promote positive messages about disabled people's capacity and to 'embed' disability awareness into the educational sector, it is necessary to get away from thinking of disability access issues purely in terms of service use. Disabled people do not just have potential to learn but also to teach. To acquire a disability does not have to mean the end of a career in teaching. To increase diversity within the teaching profession helps to provide positive role models and better reflects student diversity.
Disabled people should be encouraged to take up careers in the educational sector and retention of disabled employees should be encouraged.
Group 3
When X was a child, her parents were told there was no point in her taking exams because she would never get a job. Forty years later, she is a lecturer working in education throughout Scotland.
She went to a special school from the age of 6 to 14, which she describes as "a wholly negative experience". She says: "I was labelled 'delicate' and Educationally Sub-Normal, because I had spent a year in an isolation hospital and couldn't read. We drew a lot of pictures and went on a lot of outings but academically - forget it. A whole tranche of kids were written off. There was a culture of low expectations."
Fortunately her mother was a dinner lady at a mainstream secondary school and mentioned her daughter to the head teacher, who after "a lot of hard work and pulling of strings" managed to get her transferred to his school. After much catching up, X sat GCSEs and A levels but then drifted into a series of dead-end jobs. She didn't return to full-time education until 1994 "as an escape route from a job I hated". X went to college in Perth and Dundee, obtaining qualifications in graphic design and publications, and has lectured ever since, originally in design. She now works in the fields of higher, further, adult and community education, specialising in the inclusion of disabled students.
DRC Scotland
Y has worked as a university lecturer in computing since 1979. Over the years his sight has deteriorated to the point where he only has slight peripheral vision and he is now registered blind with a guide dog. The university has been very supportive, making adjustments to allow him to stay in his job including letting him bring his guide dog to work and getting special software for his computer (with help from Access to Work). He mentors a junior lecturer who helps out with tasks like marking so he can concentrate on front-line work.
DRC Scotland
4.2 Employment
a) Raising awareness
The employment rate of disabled people in Scotland currently stands at just 45 per cent, compared to 82 per cent for non-disabled people. Although the DDA gives disabled people rights to challenge discrimination by employers and obliges employers to make reasonable adjustments, much remains to be done to change the negative attitudes of many employers towards disability.
There is no good reason why disabled people should be cast as a drain on the economy and many good reasons why employers should employ disabled people. For example, disabled employees can help businesses diversify, identify new markets and attract disabled customers (disabled people in Britain are estimated to have an annual spending power of £80bn). Many disabled people require no or few adjustments, and support is available from the Access to Work scheme. Many companies already benefit from the skills and capabilities of disabled people. Over half a million disabled people are contributing to the profitability of small businesses. And retaining a member of staff who becomes disabled generally costs less than recruiting a replacement.
The Disability Equality Duty requires the promotion of positive attitudes towards disabled people. It covers public sector employers, and those from other sectors contracted to carry out public functions. However, positive messages need to be promoted to all employers. Again, as per the Disability Equality Duty, disabled people should be involved from the outset in developing those messages, which may need to be tailored to different types and sizes of employer. One way to reach employers can be through intermediaries - people or organisations with whom they can be expected to come into contact, such as recruitment agencies, solicitors, accountants and others.
The Scottish Executive, the Enterprise Networks and Disability Rights Commission should work together, in the context of the disability equality duty, to develop and promote a positive message to all employers and intermediaries about disability.
Group 1
"We have two people with learning difficulties who started three months ago, with a support worker. They learn all the duties required in a retail environment and work across all departments until we see where they are best suited. They are on the payroll and treated the same as all other employees if there is a disciplinary issue or problem. They have settled in really well. One boy in particular has come on in leaps and bounds. His confidence has grown so much we have increased his hours and transferred to him to a different department where there is a vacancy."
Human Resources Manager, Morrisons, Bellshill
Examples of workplace initiatives for people with communication support needs:
- A communication aid was developed to enable an individual to work in his local pub. Similarly recipes and instructions on the use of kitchen machinery have been adapted to increase employment opportunities for adults with learning disability interested in catering.
- Speech and Language Therapists have been working with local employment services in Edinburgh and Argyll and Clyde to provide training to job coaches and other workers who support people both starting new jobs and returning to work.
Royal College of Speech and Language Therapists
b) Standards
Measures of success for the employment of disabled people are of critical importance. They might include 'soft indicators' of progress on the way to employment, such as confidence levels and numbers of hours worked, as well as 'hard indicators' like numbers entering employment or occupying senior managerial roles. There may be indicators concerning the retention of staff who become disabled, and variables such as geography and sector (there will be different issues for different types and sizes of employer). In effect, success measures are needed at all stages of the 'employment cycle', into work, sustaining work once entered, work progression, and work retention if a person acquires a new impairment or an existing impairment worsens.
Careful thought needs to be given to how potentially very wide-ranging indicators can be transformed into practically useful tools to drive change and improvement. Consideration also needs to be given to who might use them. Although the Disability Equality Duty provides a vehicle for introducing them into public sector bodies and their contractors, difficulties remain regarding how private sector companies more widely can be persuaded to implement them. One possibility may be the promotion of Corporate Social Responsibility reporting, where annual reports include information not just on finances but on social and environmental impact.
To develop appropriate indicators is likely to require joint working between a number of partners.
Disability organisations should work with the Enterprise Networks to identify measures of success for employment of disabled people.
Group 1
One way of motivating employers is by rewarding and publicising good practice. This should also help to build confidence by demonstrating to other employers what can be achieved and how. For example, SUSE is looking to co-ordinate national 'Diversity Awards'. Scottish Enterprise holds annual business awards for excellence in business practice. Disabled people should be involved in setting criteria for awards in recognition of good practice on disability and in the selection of award winners.
The Enterprise Networks should consider establishing and maintaining a business award on disability.
Group 1
Epilepsy Scotland - Employer of the Year Winner: Harry Gow Bakery, Inverness
"Although people are more aware of epilepsy today it is still a condition which a lot of people shy away from. Twelve years (1991) ago when Mr Gow first employed me to do administration and payroll duties it was very difficult to get a job if the company you had the interview with realised you had epilepsy. If it was mentioned on application forms then interviews were never forthcoming so I did not mention it on application forms. Mr Gow did not try to get me off the premises when I told him I had epilepsy at my interview.
When I started at Harry Gow Bakery I only took a seizure during the night. Then my fits became more frequent and happened while I was at work. Sometimes I would blank out while I was speaking to people on the phone or I would wander round the office. Over the years the company has been very supportive: I have undergone two brain tumour operations and I recently needed an epilepsy assessment which involved a 6 weeks residential stay at a specialist unit. Yet I never worried I would lose my job. My colleagues are all very good about my epilepsy. In fact, the company has employed two other people with epilepsy since I joined. Mr Gow has also gone over and above existing safety regulations and spent additional money to ensure the machinery in the factory is more user-friendly for employees with epilepsy."
c) Information services
Both disabled people and employers need access to high quality information if they are to have the confidence to try out employment or to employ a disabled person for the first time. For example, disabled people might need information about their rights or the impact of earnings on benefits. Employers might need information on how to make reasonable adjustments, vocational rehabilitation, where to get disability equality training or how to make employee training and task instructions accessible to people with communication support needs. Both may need information about support that might be available, such as Access to Work or specialist advice and support services. However, it is not always at all obvious where to go for information and advice.
The Scottish Executive should investigate the effectiveness of regional resources for signposting disabled people and employers to information, advice and advocacy on disability.
Group 1
Macform is a small family-run construction business in Wishaw specialising in Church renovations. They had recruited a profoundly deaf joiner to work with them. They then recruited a second deaf person as a joiner's labourer so they could work together. Both are native BSL users.
Having two Deaf staff raised particular communication and health and safety issues on building sites. There is often no hard wiring for alarm systems and within the construction industry the alarm is often people shouting at others, e.g. if they drop something from scaffolding.
The Company Secretary contacted RNID Employment, Training and Skills Service for advice on how to support their staff. Advice was give on Access to Work for funding to purchase equipment and communication support. They have since purchased a radio paging device that allows the site manager to send a signal to a pager so that the deaf staff have warning of fire alarms or if they are needed by the site manager. The site manager also ensures safety by not allowing the Deaf staff to work near scaffolding should anything fall and they do not hear the 'warning shout'. They also have a mobile phone that head office can text them on when they are needed at other sites. Interpreters are provided for team meetings to make them fully inclusive and all staff have had deaf awareness training.
When asked, the Company Secretary said that for a few minor adjustments they were able to retain two excellent workers, who are valued by the company.
RNID
Jobcentre Plus has the potential to play a major role in providing disabled people with financial assessments and employment information (although it should be noted that the 'New Deal for Welfare' Green Paper proposed a bigger role for private and voluntary sector organisations). All Jobcentre Plus staff should be trained in disability issues, not as a one-off, but as a continuous programme to ensure consistency and to develop the organisation's capacity to provide for ever increasing diversity of need.
Disability organisations have anecdotal evidence that disabled people's experience of Jobcentre Plus is not always positive. Further work could usefully be undertaken to strengthen the support provided by Jobcentre Plus. Involving disabled people would help to show how support could be improved to meet their needs better.
There is much that Jobcentre Plus could do actively to promote the Access to Work scheme, both to disabled people and to employers, as awareness of it tends to be low. It is also important to ensure consistency north and south of the border in policy and delivery on employment support services, particularly Access to Work.
The work being done by Jobcentre Plus providing financial assessments and employment information to disabled people should be developed and strengthened.
Group 1
4.3 Community care
a) Choice and control
Community care, as the main means through which day-to-day support is delivered to disabled people, has a pivotal role to play in promoting independent living - or compounding disempowerment. If delivered inflexibly it can remove choice and control from disabled people, not just about who provides what support, when and how, but ultimately about how disabled people live their lives. To have choice and control over care and support services therefore has wider positive ramifications.
The Disability Equality Duty means that disabled people should be involved (not just consulted) in the development of strategy and priorities, decisions about how services overall are designed, and implementation policies.
In order to ensure effective delivery of the public sector disability equality duty, disabled people should be engaged both proactively and effectively in the design and implementation of care and support services.
Group 4
It is imperative that wherever possible disabled people should be full partners in decisions about their own care and support package. To facilitate this, independent advocacy should be available to those who need it, communication support needs must be met and disabled people must have access to the information necessary to play a proactive role. However, it is important not to set the benchmark for involvement too high and end up excluding people who cannot act as full partners from having any say. The intention is, though, that the disabled person should have as much responsibility as possible for decision-making.
The disabled person should be a full partner in the decision-making processes of her/his care management. An independent and trained advocacy service should be available if required by the disabled person in order to facilitate this process.
Group 4
b) Research
In view of the fundamental importance of independent living and the key role care and support services can play in making it a reality, comprehensive research is required to make sure that it is having the desired outcomes.
Research on care and support services for disabled people should be reviewed and, where gaps are identified further, research should be commissioned, including participatory action research if appropriate.
Group 4
4.4 Health
a) Disentangling disability from ill-health
It is important to understand the sometimes complex relationship between disability and ill-health. According to the social model, disability is the consequence of social barriers. People who have impairments may experience ill-health and benefit from measures promoting good health - just like anyone else. Disability should therefore not be confused or conflated with ill-health. However, a person with chronic illness may also experience disabling social barriers. Some forms of impairment can have an adverse effect on stamina or can cause pain which limits activities, irrespective of illness or social adjustments - although adjustments can reduce the negative social impact of such limitations.
Equipment provided by the NHS can be necessary for individuals to overcome social barriers.
Although there have been extensive improvements to the built environment, this is of little use to people who cannot get out of their own homes. Following a petition to the Scottish Parliament, the Minister for Health and Community Care made a one-off award of £1.9m for the year 2005-06 to wheelchair services which helped reduce waiting lists. In addition the Minister commissioned an independent review of NHS Wheelchair Services in Scotland, which was to report to a steering group of stakeholders. Recommendations were made to the Minister by 31st March 2006 although the outcome is not yet known.
Scottish Disability Equality Forum
There has been some discussion about whether free prescriptions should be introduced, as has occurred in Wales. A particularly strong case can be made that people with chronic illness should receive free prescriptions. They are likely to be at risk of poverty due to restricted access to earned income. The additional cost of essential prescriptions can be a significant burden. The list of exemptions for chronic conditions has not been updated for years. A consultation exercise on prescription charging has recently ended.
The Scottish Executive should give consideration to free prescriptions for people with chronic illness.
Group 4
A survey carried out by Capability Scotland in 2005 found that only 70% of disabled people or people with a medical condition or long-term illness who participated currently receive free prescriptions. Three-quarters (75%) of people on less than £100 per week get free prescriptions and 20% on between £100 and £200 per week currently do not receive them.
Capability Scotland
b) Disability and healthy working lives
Disabled people, as much as anyone else, have an interest in healthy work environments. It is therefore important that measures to promote healthy working lives are fully accessible to disabled employees and employers. While underlining the important fact that ill-health and disability can be completely unconnected, making adjustments to work places may be appropriate to both workers with a health condition and those with a disability.
In consultation with disabled people, the Scottish Centre for Healthy Working Lives should review its work to examine where it can play a role with regard to disability.
Group 1
c) Access to health services
Given the way health services tend to be structured, disabled people can find themselves narrowly defined by their impairment as if it is only in relation to this that they will need to access health services. Clearly this is far from the truth. Disabled people may need family planning services, cancer-screening services, inoculations before travelling - any general or specialist health-care service. All health services therefore need to be accessible to all disabled people, whatever their impairment.
The Disability Rights Commission has been working with the Scottish Executive Health Department and NHSScotland on the 'Fair for All' project. This aims "to encourage health practitioners and managers to strive for best practice that goes beyond compliance with the law and promotes the rights, independence, choice and inclusion of disabled people as health service users and members of the community" (for more information see http://www.drc.org.uk/fair4all/).
The 'Fair for All' project should continue to ensure that its work on the access needs of disabled people in relation to the NHS includes communication support needs of all types.
Group 3
4.5 Poverty
Although the Scottish Executive does not have powers when it comes to social security or employment policy, and both these are of critical importance to tackling poverty, there is still much it can do. As discussed, it can open up access to education and to employment, and thereby to earned income. It can also take action to reduce extra costs incurred by disabled people. For example, extra costs can arise because public transport isn't accessible, or because social barriers result in some disabled people spending a disproportionate amount of time at home, incurring additional heating costs. Sometimes disabled people require special diets, or a health-condition necessitates additional heating or frequent prescriptions.
The cost of bus travel in Scotland was removed in April 2006 for people over 60. However, disabled people who cannot access public transport must still pay the cost of community transport. Although this can be an excellent service, the charge discriminates against people with disabilities and adds to the overall cost of being disabled.
Scottish Disability Equality Forum
In the wake of rapid rises to fuel costs, there is a particularly strong case for extending current fuel poverty programmes to include disabled people. The Scottish Executive runs a Central Heating programme and 'Warm Deal'. The first provides central heating systems and insulation measures in the private sector where the householder or partner is 60 or over and there is no system or one that is irreparably broken. Applicants over 80 can receive upgrades and replacement of partial or inefficient systems. The Warm Deal provides grant up to £500 for a package of insulation measures to all households in receipt of a range of benefits - including some, but not all, disability benefits. A smaller grant of £125 is available to pensioner households not on benefit.
The new programmes for 2006-08 were announced on 14th March 2006. Only pensioners are eligible for central heating - and they can now have upgrades and repairs done to inefficient or partial systems if they receive the guarantee element of Pension Credit.
The Scottish Executive should consider how best the fuel poverty schemes can cover disabled people, including families with disabled children.
Group 4
Research conducted by Capability Scotland in October 2005 (publication pending) shows that fuel poverty has not improved for disabled people since 2001. Research conducted then found that over 40% of participants were fuel poor - the same as in 2005. The research also found that 4% have no central heating, 12% have partial or full central heating that does not work properly and 40% of participants have a heating system that is over 10 years old.
A recent report estimated that a disabled person with high to medium needs requires £23.40 per week to meet fuel costs (Disabled People's Costs of Living - More than You Would Think; Smith, Middleton et al; JRF 2004).
Capability Scotland
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