The announcement about the future of the Disability Supports Services operated by the Nelson Marlborough DHB has left this disability advocate very confused. It is good news that the DHB will no longer be a disability services provider. DHBs are charged with looking after people’s health needs. Disabled New Zealanders use health services like anyone else. Supporting disabled people to live in the community, which is what disability support providers do, does not require a DHB.

The DHB said that they had two options with regard to their disability services. Not quite true.  The DHB made the decision in 2005 that they should not be a disability service providers and the Rutherford Initiative (the DHB line-by-line review of its spending) simply confirmed that. It seems that to make the decision more publicly palatable the DHB devised a consultation process around two options: option one – a Community Trust; option two – another organisation take over the service.

Why does the DHB think it has a role in deciding who should be the new service provider?  Why is the Ministry of Health apparently letting the DHB decide the shape of disability services in the Nelson region? That is the Ministry of Health’s job.

When an organisation decides they no longer want to provide disability services they advise the Ministry of Health, who check what services are already available in the region. If the Ministry decides that more disability service providers are needed, they run a tender process.  It would be wonderful if a whole range of providers could be encouraged to tender so disabled people in the Nelson region had real choice. A Community Trust could be formed to submit a proposal to the Ministry like other interested disability service organisations.  The Trust would be assessed, alongside other providers, as to whether it had the right skills to commence operating in the region.

Individuals would be able to choose from the range of Ministry-approved organisations, which would support them in the future. Appropriately, the decision would be made by the person requiring the disability supports. This is the well established process the Ministry of Health has used when institutions such as Braemar and Kimberley were closed.

Why is the Ministry of Health allowing the DHB to disregard people’s right to have choice and control over which organisation provides their supports? More transparency and honesty around the Rutherford Initiative is needed. If there are civic minded or interested people in Nelson who want to be in the business of disability service provision then they should be required to seek approval in the usual way.

Disabled people are not a commodity that can, at the stroke of a pen, be transferred from the DHB to a Trust they have designed, particularly a Trust that has no history or experience of disability service provision. It is abhorrent that disabled people are being seen as a bulk job lot simply to be ‘handed over’ to a new entity of the DHB’s design.

The DHB seems to be trying to make the services financially viable in readiness for hand over to the proposed Trust. Disability advocates are shocked that one of the things the DHB has endorsed is consolidating their four day service facilities into one. The DHB said they wanted to adopt a greater ‘person-centred’ focus.  Large numbers of people at a single day service does not sound person-centred to me.

Families and disabled people using DHB services may feel betrayed. When Braemar and Ngawhatu were closed, those that chose the DHB to be their provider thought they were going to receive a life-long service. The consultation showed that people wanted the DHB to continue providing services.  Of course they did as it would provide certainty for them. Disabled people must be individually supported so they have accurate information to help them make the most important decision of their lives – who is going to support them to be part of the Nelson community. People whose lives will be impacted by this decision have not been well supported to be part of the process so far.

ACC, the Ministry of Health and the Ministry of Social Development all currently fund people with disabilities who are being supported by the Nelson Marlborough DHB. IHC Advocacy urges these agencies to get involved. They must ensure that the interests and rights of disabled people are upheld. What is happening is contrary to the spirit and intent of the New Zealand Disability Strategy and the United Nations Convention on the Rights of Persons with Disabilities which New Zealand is a proud signatory of.

Anne Bell
IHC Advocate