National Disability Insurance Scheme

This essay will discuss the theoretical perspectives of anti-oppressive and structural social work, focusing on forms of inequality in society, the social model of health, and its significance to disability, and the human rights model regarding the Convention of the Rights of Persons with Disabilities (CRPD). Included will be an overview of the National Disability Insurance Scheme (NDIS).

It is important to define anti-oppressive social work as ‘a dominant theory of critical social work practice’ (Healy 2005, p. 178 cited in Dalrymple & Burke 1995). Critical social work is used to describe a range of perspectives that make use of critical theories. Therefore, the use of anti-oppressive social work, is employing a critical social work approach, through humanistic and social justice principles, and further focussing on the ‘lived experiences’ and values of oppressed people (Dalrymple & Burke 2006). Structural social work can be defined primarily as social workers and clients maintaining a level balance of power interaction. Mullaly (1997, p. 105 cited in Dalrymple & Burke 2006) states, ‘the structural approach views various forms of oppression as intersecting with each other at numerous points, creating a total system of oppression’. So, anti-oppressive social work considers the social justice and values of all those who are oppressed and fights for change, while the perception of power, oppression and inequality will determine an individual’s personal and structural associations (Dalrymple & Burke 2000 cited in Dalrymple & Burke 2006). This oppression causes marginalisation among people in society not due to disability, but rather from ableism, when individuals hold an expectation of ability, though stigmatise or discriminate against those who do not achieve what they regard as normal (Wachsler 2007 cited in Morley et al. 2014). Therefore, an individualistic approach, viewed as conventional social work, will consider this aspect as a deficit of the individual, disregarding the structural context, allowing biomedical discourses to balance neoliberal policies, producing social predicaments of individual accountability. To amend this an alteration of the structural context regarding ‘social institutions, laws, policies and practice’ would require equal distribution of goods and services inclusive of marginalised groups (Mullaly 2010 cited in Morley et al. 2014). So, the social model, rather than the biomedical model, would propose that disability would be of little concern if society was receptive to acknowledging differences (Morley et al. 2014).

The disempowerment and marginalisation of disabled groups shape the historical framework for comprehending the present models for disability treatment and care. These highlight the degree to which the social environment is disabling for an individual with a physical or mental impairment. For instance, if the environment is designed for persons in wheelchairs, then the disabling effects of mobility restrictions would be insignificant. The bearing of cerebral palsy on an individual’s ability to live a contented life is negotiating social factors, such as ‘availability of support, opportunities for carer respite, accessible education and work opportunities’ (Habibis 2014). Therefore, while the medical model focusses on the individual with the disability, whether physical or mental impairments, (Finkelstein 1980, 1996; Oliver 1986, 1996 cited in LoBianco & Sheppard-Jones 2007), the social model instead examines the environment of the individual with the disability. However, the social model suggests that until societal barriers to disability are removed, there will continue to be limitations to disabled individuals gaining full community participation (Hurst 2003 cited in LoBianco & Sheppard-Jones 2007).

The social model could construct disability as being socially oppressed, which in turn has political implications, whereby ‘disability as a social construct, not the attribute of the individual; instead it is created by the social environment and requires social change’ (Mitra 2006 cited in Bingham et al. 2013, p. 615). Therefore, the social model suggests the importance of understanding the structures, policies and practices of society to enable the comprehension of the exclusion of disabled individuals from society (Barnes & Mercer 2005 cited in Bingham et al. 2013). Which determines that the social model requires ‘political action’ to improve environmental factors, whereas it is determined that the medical model would require ‘treatment’ to improve the individual (Hughes & Patterson 1997; World Health Organisation (WHO) 2002 cited in Bingham et al. 2013). As a result, societal provisions may be more ‘just, unprejudiced, and ethically preferable’ than the existing situation for persons with impairments (Blustein 2012 cited in Haegele & Hodge 2016). Although, one critique of the social model is the failure to recognise impairment as an obvious characteristic of an individual which is a vital feature of their lived experience (Palmer & Harley 2012 cited in Haegele & Hodge 2016). As clarified by Palmer & Harley (2012 cited in Haegele & Hodge 2016), disconnecting impairment and disability, the model does not quite describe the lived experience of persons with disabilities. Instead, critics have stated a more complete and inclusive disability model or social theory is required (Haegele & Hodge 2016). The second critique of the social model is the lack of understanding of the differences between individuals with disabilities. It is indicated that the social model overlooks the ‘intersectionality’ of varied modes of oppressed states (Fitzgerald 2006 cited in Haegele & Hodge 2016). Therefore, this critique would state the social model is unable to comprehend the experiences of a person with a disability separate of further qualities, for instance, ‘gender, race, or sexual orientation’ (Haegele & Hodge 2016). The final critique of the social model is regarding the social creationist outlook. This theory indicates that aspects of ‘sexism, racism and dis-ableism are genuine and are socially generated by a racist, sexist, and dis-ableist society’ (Oliver & Barnes 2012 cited in Haegele & Hodge 2016). This perspective contrasts with other perspectives, such as social construction, as it considers these aspects in relation to ‘institutionalised discrimination’, instead of the combined observations of individuals who constitute a population (Haegele & Hodge 2016). The social model of disability is situated within the framework of human rights, which reasons that differing physical or mental abilities and functions do not validate different treatments (Habibis 2014).

In the region of one in five Australians is affected by a disability. However, many are impacted by barriers in respect of work, study, sport, transport and everyday activities. The Disability Discrimination Act 1992 protects individuals throughout Australia from unjust treatment in many areas of public life. The Act renders disability discrimination as unlawful and upholds ‘equal rights, equal opportunity and equal access for people with disabilities. The Commission is also responsible for promoting the United Nations Convention on the Rights of Persons with Disabilities, which was endorsed by Australia in 2008. Any individual experiencing direct or indirect discrimination can lodge a complaint with the Commission. It is essential for the Australian Human Rights Commission (AHRC) to work collaboratively with individuals and organisations around Australia to be aware of their rights and meet their legal obligations (AHRC). The United Nations Convention on the Rights of Persons with Disabilities (CRPD) commenced in 2008.

The CRPD constructed a dynamic new disability rights theory that empowers disability organisations and produces a new theory for disability academics. Before this convention, individuals with disabilities were protected by a variety of general human rights conventions. Although, regardless of obtaining nominal protection under these general human rights conventions, individuals with disabilities have frequently had many of their human rights denied. Therefore, the CRPD goes beyond simply repeating rights, it constructed a new rights discourse, empowered civil society and causes human rights to be accessible to any individual with a disability than at any other time in history (Harpur 2011). Globally, individuals are often excluded from society, and in some regions must fight for their right to live. Impairments can often be regarded by laws and culture as being inherently negative, rather than purely an aspect of social diversity (Campbell 2001, 2009; Harpur 2009b cited in Harpur 2011). It is stated that the CRPD has advanced public policy beyond the governing medical and social disability models, rather, it has built upon the social disability model and presented a new disability rights theory (Harpur 2011). The concept of the social model has been supported by the CRPD, whereby the introduction of CRPD clarifies the way in which the convention builds upon a non-radical comprehension of the social model, ‘recognising that disability is an evolving concept and that disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others’ (Finkelstein 1980; Oliver 1994 cited in Harpur 2011). Two of the Australian Community Workers Association (ACWA) Code of Ethics principles states that all ‘human beings, irrespective of race, religion, gender, age, sexual and gender diversity, or other individual differences has a right to maximise his or her potential providing it does not infringe on the rights of others’. It also states ‘social inclusion is a human right where every individual has an active role to play in society and has the expectation of full social, educational and economic participation. An inclusive society is based on the fundamental values of equity, equality, social justice, and human rights and freedoms, as well as on the principles of tolerance and embracing diversity’.

In 2012, the Federal Labour Government announced the introduction of a National Disability Insurance Scheme (NDIS), whereby the purpose of the scheme is to amend the current approach to care and lessen the stigma and social isolation experienced by people with disabilities. With the implementation of this scheme, the current funding will be increased twofold, and there will be three tiers of support. The first is the provision of disability insurance to all Australians, guaranteeing access to required services if ever they experience disability. The second delivers information and referral services to people affected by disability. The third tier provides individualised packages of high-quality care and support to all Australians with substantial and continuing disability. Disability advocates have welcomed the scheme, not least due to the insurance model supplying universal care that differentiates it from paternalistic charity-based schemes, however, critics claim that the concentration on individual packages of care does not correspond with the social model of disability and replicates liberal/market principles rather than human rights perspectives (Fawcett & Plath 2012).

An essential aspect of work in the future, is to reflect on ways of working towards a socially just society, where people can access the resources and services they require, resources are delivered equitably, as opposed to equally, human rights are upheld, and everyone can participate significantly in self-determination (Morley et al. 2014). In all practice, it is imperative to reflect on the Code of Ethics relevant to your practice and agency and reflect and be aware of personal values and beliefs.

Reference List

Australian Community Workers Association (ACWA), Practical Ethics Series, viewed 26 April 2018.

Australian Human Rights Commission (AHRC), viewed 28 April 2018, https://www.humanrights.gov.au/our-work/disability-rights/about-disability-rights

Bingham C, Clarke L, Michielsens E & Van De Meer M 2013, Towards a Social Model Approach?: British and Dutch disability policies in the health sector compared, Personnel Review, Vol. 42, No. 5, pp. 613-637, https://doi.org/10.1108/PR-08-2011-0120.

Dalrymple, B & Burke, B 2006, Anti-Oppressive Practice: Social Care and the Law, 2nd edn., Open University Press, Buckingham.

Fawcett B & Plath D 2012, A National Disability Insurance Scheme: What social work has to offer, The British Journal of Social Work, Vol. 44, No. 3, pp. 747-762, https://doi.org/10.1093/bjsw/bcs141

Habibis D 2014, The Illness Experience: Lay perspectives, disability and chronic illness, in Germov J 2014, Second Opinion, An Introduction to Health Sociology, 5th edn., pp. 1-530, Oxford University Press, South Melbourne, Victoria, Australia.

Haegele JA & Hodge S 2016, Disability Discourse: Overview and Critiques of the Medical and Social Models, Quest, Vol. 68, No. 2, pp. 193-206, DOI: 10.1080/00336297.2016.1143849.

Harpur P 2011, Embracing the new Disability Rights Paradigm: The importance of the Convention on the Rights of Persons with Disabilities, Disability & Society, Vol. 27, No. 1, pp. 1-14.

LoBianco A.F & Sheppard-Jones K 2007, Perceptions of Disability as related to Medical and Social Factors, Journal of Applied Social Psychology, Vol. 37, No. 1, pp. 1-13, Blackwell Publishing.

Morley C, Macfarlane S & Ablett P 2014, Engaging with Social Work: A critical introduction, pp. 1-335, Cambridge University Press, Port Melbourne, Victoria, Australia