Impairment-related Assessments should be about removing barriers

It is very easy to complain about how a system is not working but it is much harder to come up with new solutions to replace broken ones. It is also easy to talk about rights but much harder to ensure any system implement rights on an individual level, providing real benefit as oppose to simply political analysis. I believe in looking forward and having a go in coming up with my own ideas on how to do things better.

In this context, I have given a lot of consideration to how I would design an assessment system designed to enable people with impairments to have what they need when they need it. Such a system is always going to be complex because of the many factors involved. My focus would be on removing individual and specific barriers to outcome related activities, as opposed to either being label based or focusing on what someone generically can not do, like having a speech impairment.

This means going through a person’s daily living routine as well as a number of other activities including work and establishing what impairment related barriers they face. Some barriers, like not having a dropped curb at a specific place on their route to work etc, would result in a community solution, benefiting others as well as themselves. Other barriers may be overcome by the awareness of specific mainstream solutions, like online food delivery services.

Many barriers may be overcome by the use of assistive technology large and small from electric wheelchairs to bibs. The final solution to consider is personal care, including the use of personal assistants. The reality must be that because of the long term costs involved in providing personal care, the suitability of other solutions must be considered first because being value for money has to be a goal.

A final set of barriers to overcome is the extra costs of having an impairment in comparison to that of people without impairments in the same social setting. This would include extra washing, extra heating, extra hospital parking costs and so on. The key here must be reasonableness and fairness in comparison to others.

The catch to all this, if you wish to see it in that way, is that removing impairment related barriers is not about having a completely stress-free life. The government’s motivation to remove individual barriers has to be to expect people to contribute to society as much as they are reasonably able to do so. The barriers to opportunities should relate to the opportunities available to them if they did not have an impairment. This means that if someone wants support while they are on holiday, they need to be able to afford the normal costs of that holiday.

I believe meeting individual barriers is the way forward. It will enable an assessment to be transparent as the assessor needs to state how they propose an individual overcomes a specific barrier, even if it is not the solution the individual would have wanted, and many proposed solutions may not require funding from the government directly.

The barrier to this way of assessing people is likely to be the current attitude of those being assessed, especially if they are newly impaired. Their newly found impairment identity is likely to disrupt the process as they demand recognition of their negative feelings towards their impairment, being unable to easily think in terms of overcoming barriers. This would require a more sympathetic dialogue that enables people to realign how they feel about themselves. Without this, my assessment system will quickly become as toxic as the current one, or indeed any further one proposed by others.

My proposed assessment system will require deep changes in the dialogue between state and individual to succeed but if it was properly implemented, it would offer all people with impairments their best hope of full and meaningful inclusion within a good society.

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