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DISABILITY :CHALLENGES VS RESPONSES
( By Ali Baquer; Anjali Sharma )

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a-Welfare State : New Dimensions

General Principles :

After India achieved political independence in 1947, the new government of the country accepted, in good faith, the philosophy of a welfare state from the British, India’s former rulers. In the United Kingdom, and in several other countries of the industrialised world recovering from the havoc created by World War II, the disabled soldiers had to be rehabilitated and accorded dignified means of livelihood. Other categories of groups in need of benefits from the government were added to the long queues of the wounded, the women widowed and children orphaned by the war. The services provided by the welfare state were, consequently, meant to be totally financed by taxation and, at the same time, were intended to be offered free of cost to all citizens who needed them.

Given the social, economic and political situation in India and numerous human problems resulting from the Partition of the country and each demanding urgent attention, the types, quality, quantity and level of service were, of necessity, determined by the availability of resources. The voluntary services, most of them inherited from the British Raj, were invited to complement the efforts of the already overstretched services of the new government. Largely because of the serious and widespread problems the country was facing at the time, and partly because of the style of functioning, the survival of the voluntary organisations depended on the approval of the government bureaucracy and the pleasure of political elite, a legacy which has continued to this day. This practice must be demolished without further delay.

The Indian Adaptations :


The implementation of a wel-fare state model in India, from the outset, was unfortunately overburdened with contradictions and frustrations. It was designed for failure and it is not surprising that its achievements always have been rather modest. Successive governments in Delhi, and generations of policymakers and political leaders, learned to live with the limited success of government programmes in the field of education, health, welfare and other services, which normally characterise a welfare state and reach out to the needy, the deprived and the disadvantaged. Systematic attempts have been made by national and international experts, with the active support of high-level government officials, to explain the shortcomings in the delivery of welfare state services by redefining social problems and matching available resources to them, rather than to find practical ways of resolving them. The ‘population explosion’ has been a God-sent gift to justify each failure.

Innovations need Support :


In most countries bold, imaginative and innovative programmes of social action are frequently generated and sustained outside the rigid, cautious and conservative machinery of the government. In India, however, social interventions by non-governmental agencies are strictly controlled through an undeniable politics of funding of innovative projects. Those unable or unwilling to tow the official policies and practices end up paying a high price.

During ‘official’ analysis of real life situations, the expectations of consumers get deliberately narrowed and lowered to justify the inefficient use of insufficient services. Gradually, the monopoly of statutory services has been found to be ineffective even by those in favour of a welfare state model and they recommend greater use of voluntary services to help the welfare state get a white-wash and make it appear as "more responsive to the needs of the consumers".

New Welfare State :


The concept of a benevolent, all-embracing and all-providing welfare state, however, has undergone substantial change not only in India; but also in the most advanced countries where resources are not desperately scarce and population is not multiplying at an alarming rate outstripping all programmes aimed at expediting social change. The old style, post-World War II, universalistic welfare state–providing services to all and funded directly and solely by the government–started to disintegrate.

In addition to resource starvation facing the complex arrangement of services provided by the welfare state, the consumers, influenced and inspired by important events taking place in several countries as well as the sustained efforts of various UN agencies, became more aware of their rights. Frustrated by the indignity of being denied services which they thought were their right, they started to demand a more efficient and more just delivery of services. They were supported by activists and social thinkers in their criticism of the performance of the welfare state services particularly in areas of education, health, employment, housing and welfare.

Governments in various countries, unable to maintain an acceptable standard of services, began to dismantle the myth that a welfare state was created as perfect, flawless and the ultimate answer to the needs of all people in an effort to promote social justice, human dignity and equality. They pointed out that the welfare state, because of its insistence on provision of a wide range of services either free of cost or on heavily subsidised rates, discourages individual growth and personal enterprise and encourages dependency culture, passivity and indolence. In most of the countries, supporting a network of welfare state services, poverty became a characteristic of sizeable sections of the population.

Within five decades of the conception and inception of the welfare state, its boundaries have got blurred and its advocates have lost their bite. From the ideology of the state being the only provider of welfare related services, policies began to shift emphasis in favour of pluralism and of competition with other providers of services. The welfare state began to drift towards the values of market and started to promote commercial concepts of cost-effectiveness and of other tangible and quantifiable outcomes of social interventions. In addition, the welfare state was caught between the dramatic rise in the expectations of consumers and rapid decline in levels of resources. Costly, but at the same time visibly effective, technology in the service of mankind made the dilemma appear more serious than it perhaps was.

The Market Culture :


Commercial culture is nearly always harmful to humanitarian programmes. Most economic theories have damaging social consequences but in most countries market forces have been challenging the very foundations of the welfare state and its values of social morality and social justice. Statutory services, uneasy and uncertain about their purpose and their incapacity to survive without constant supply of additional resources and crippled with the obesity of their bureaucratic organisation, have started to enter into partnership both with voluntary and private sectors, particularly in the areas of education, health and housing at least for those citizens willing to give up their right to free services.

Balancing of Service Sectors :


The underfunding of welfare state services, the lack of preparedness of the voluntary sector and its parasitic dependence on the government for funds and for its approval, the enormous difficulties experienced by the informal family sector in continuing their traditional role to look after the needy in community, have together created a situation for the private enterprise to offer its services only for profit. As all these factors compete with each other to find a balanced relationship, the practice of blaming the needy as responsible for their conditions of poverty, deprivation and plight continues. Even deserving consumers of services are regarded as factors destroying welfare services and impeding economic growth of their respective countries. In order to correct the situation, some even suggest strong punitive methods against the ‘delinquents’.

As an inevitable consequence of all such trends, a different welfare state is emerging which seems to be largely concerned with commercial interests. Alternative arrangements to statutory services are increasing. The government, despite a visible reduction in its scope as the sole custodian of welfare state, is still responsible for offering a large volume of a number of welfare services. The private sector is forging ahead in gaining ground in an increasing number of areas including education, health, housing and employment with profit making as the only guiding principle and is, at the same time, offering to those ready to pay, a much better quality of service and a larger choice than is given by other forms of available services. But, like statutory and voluntary sectors, the private sector also suffers from a number of shortcomings.

New Role for Voluntary Sector :


In such a situation the voluntary sector, fragmented and varied and ill-organised as it is, must assume a new responsibility to protect the quality of care particularly for those who need the services the most. It must accept the responsibility of maintaining highest standards of service delivery by employing efficient management practices, training programmes for staff selected for their dedication and by providing education of and awareness for the consumers as much about their rights as the constraints facing society. It must keep a watch on the demoralised and feeble system of statutory services, on the one hand, and marketisation of humanitarian programmes, on the other.

There is little doubt that for many years to come, despite its high administrative costs, rising expectations of a growing number of consumers from it and its several shortcomings, a welfare state would not be totally abandoned, either in theory or in practice.

A new, and perhaps more robust, concept of the welfare state appears to be emerging in India as a direct consequence of the realisation that there exist gaps between the needs of the members of a civilised society and the service provision it can manage; between the expectations of the consumers in the context of their growing awareness of their rights to services as well as what modern technology can deliver and the half-hearted, ill-planned, whimsical and frequently wasteful provision of services; between resources available from the taxation paid by a shrinking workforce and the increasing subgroups of population needing services. These gaps need to be narrowed, if not altogether eliminated.

The End of the Monopoly of Service Provision :


There seems to be an inevitable conclusion that governments supporting the welfare state model must decide in favour of giving up their monopoly of service provision and look for a multiplicity of service providers so that comprehensive coverage, efficiency of delivery, sensitivity to local variations, cost-effectiveness and innovation can be encouraged. Those providing care, such as families, on an informal basis must be given substantial assistance to help them carry their burden.

Apart from the support given by families, relations and friends, there are at least three major ways of providing services: statutory, voluntary and private. These three sectors, between themselves, are competent and capable of guaranteeing moral, legal, financial and administrative responsibility for the outcome; prompt responsiveness to situations demanding help; well-meaning innovation and experimentation; respect and understanding of consumers’ needs; arranging a range of services allowing choice, healthy competitiveness in economic and professional terms, efficiency and efficacy. Coordination between the three services would facilitate skilful matching of resources with needs. The strategies of financing each of the three sectors would also multiply and prevent duplication of funding.

The relationship between these three sectors at planning, financing, implementing, monitoring and evaluating stages can be entrusted to a single agency. One of the main tasks of this coordinating agency would be to recommend expansion of the entire range of services at the same pace as the expansion of the country’s economy. Such a range of collective effort should ensure the basic essentials required by all segments of the population.

Voluntarism to become a Movement :


This new scenario offers a challenging role to the voluntary movement and it has all the potential to grow into a healthy, pragmatic and meaningful partnership with both the statutory and private sectors. The voluntary sector would need to equip itself better by providing appropriate training and career prospects to their staff and by removing uncertainties from their work situations on the basis of stable and long-term financial support.

Judging from the experience of education, health and transport, it is obvious that privatisation has already made deep inroads in the welfare state service provision. Although based entirely on the profit motive, the private sector looks determined and well equipped to continue to grow and offer statutory and voluntary sectors a healthy challenge. In view of the international demand for the implementation of human rights, demographic changes with serious implications for the quantity and quality of caring services, and a gradual shift of groups and subgroups from dependence on welfare services to independence, it is rational to establish a clear balance between statutory, voluntary and private sectors.

Disability as an Area of Prime Concern :


It is interesting that the birth of the welfare state, nearly half a century ago, had been prompted by the conditions of people with disabilities and impairments. Once again similar, but much more clear and potent considerations seem to guide the examination of the concept of the welfare state. On the basis of careful scanning of literature, research outcomes, legislation and experience of people with disability and of the organisations working with and for them in India and in several other countries, it is recommended that, to start with, the voluntary sector should be entrusted with overall responsibility for providing all services in the field of disability. With experience and passage of time the responsibility of the voluntary sector should include all other service areas traditionally covered by the welfare state.

A change in the legal, administrative, organisational and financial arrangements would be necessary to accommodate redefined needs of consumers and providers of services; for the inclusion of new groups of AIDS sufferers, drug users, victims of communal/religious ethnic violence; growing awareness of rights and benefits from advancements in medical, health, pharmaceutical, technological and other inventions aimed at improving the quality of life.

The great reservoir of voluntary effort should eventually release the government from its burden, on the one hand, and encourage private enterprise to complement existing and planned services, on the other. In addition to providing essential services sensitive to local needs and in line with national policies and international guidelines, the voluntary sector would become an enabler and facilitator of comprehensive service delivery.

The Provider and the Facilitator :


The voluntary sector would coordinate services offered by all providers, including families and communities; keep in constant touch with the needs and expectations of consumers; maintain highest possible standards of service provision through up-to-date training and re-orientation facilities for workers at all levels. Such exercise would shape expectations and perceptions of providers of services in the government, voluntary and private sectors and indeed of consumers and their families.

After establishing planning, monitoring and evaluation procedures for relevant, effective, efficient and comprehensive service provision in the field of disability, and in generating meaningful partnership with statutory and private sectors, the voluntary effort would tackle other issues and, thus, would gradually transform welfare state into a dynamic system capable of adjusting to the new realities of the 21st century.

 
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