26 February 1992
on independent living: rehabilitation policies for the disabled
(Rapporteurs: Mr FOSCHI, Italy, Christian Democrat
Mr SCHWIMMER, Austria, ÖVP)
The First European Conference of Ministers responsible for the Rehabilitation of the Disabled took place in Paris from 7 to 8 November 1991. It gave strong endorsement to the Council of Europe's programme. This report, in an earlier version, was the Assembly's contribution to the conference. It calls for the governments of all member states to take part in the Council of Europe's programme, for the Social Charter to be amended so as to include stronger rights and safeguards and more up-to-date concepts with regard to policy; and for greater public awareness of the need to help disabled people express their full potential as members of society. The Final Declaration of the Ministerial Conference is attached.
I. DRAFT RECOMMENDATION
1. The International Year for Disabled Persons was proclaimed in 1981 and prompted the Council of Europe Parliamentary Assembly to adopt Recommendation 925 (1981). 1993 will mark the end of the Decade for the Disabled and should provide an opportunity to take stock of progress and to consider what remains to be done, particularly as it will be necessary in 1993, with the completion of the single market and freedom of movement for persons, to create a European social area from which people with disabilities are not excluded. Disabled people should, on the contrary, be able to help devise solutions for everyone, on an equal footing with others.
2. To men and women with a disability, being independent means being able to live like ordinary men and women; it does not mean being passive recipients of assistance, but it means having a wide choice of opportunities and being responsible for one's own life.
3. A disability is a restriction caused by physical, psychological, sensory, social, cultural, legal or other obstacles that prevent disabled people from becoming integrated and taking part in family life and the community on the same footing as everyone else. Society has a duty to adapt its standards to the specific needs of disabled people in order to ensure that they can lead independent lives.
4. Yet how many people are there of whom we say that we accept the fact that they are different, but in respect of whom society still makes very little effort to allow them to make their presence felt? We do not know how many such people there are, nor what their needs are, nor, in particular, what their wishes are. There is no information or evaluation system whereby it is possible, on the basis of reliable statistics and reviewable indicators, to obtain information and make forecasts that are comparable from one European country to another.
5. The Council of Europe has done very valuable work in this field, but unfortunately its work has often been restricted to a small number of member states; the Assembly itself knows very little about the experts' proposals and has not, to date, had an opportunity to forward its own conclusions to national parliaments because of the limitations of the communications system at the Council of Europe.
6. The time has come for the Assembly to call on the governments and the agencies concerned in its member states:
i. to ensure that the interests and needs of disabled people are taken into account; to provide for the co-ordination by local authorities and associations of the various measures taken to this end; and to ensure their coherence, comprehensiveness and effectiveness by setting up if necessary a central unit for concerted policy decision-making, placed under the authority of a minister: the object being to ensure proper co-ordination and effectiveness, not to bring services and initiatives under the direct authority of the state;
ii. to strive for and encourage genuine active participation by disabled people in family life, the community and society, and in the organisation of their own lives; to guarantee recognition and effective exercise of all their civil, political, social, economic and cultural rights; and to ensure in any event the proper representation of their interests and needs;
iii. in order to give people with disabilities opportunities to be as fully involved as possible in society and working life and to be as independent as possible, to give priority to:
a. preventive measures, both genetic and medical, in the light of new scientific discoveries but also of bioethical hazards and restrictions; special attention should be paid to infant mental health and neuro-psychiatry centres because of the crucial effects of any action taken at an age when children are developing;
b. education and integration at school;
c. reinforcing home services and assistance to families, with special attention being paid to severely disabled people and dependent elderly people;
d. providing placement and vocational guidance and training services and passing legislation allowing disabled people to obtain ordinary employment in keeping with the complex developments in the labour market or, in the most serious cases, employment in co-operatives and sheltered workshops;
e. setting up a network of local and regional rehabilitation and social back-up services, to be run as far as possible by family and voluntary associations;
f. guaranteeing ease of access to buildings and overcoming visual, auditory and psychological obstacles to communication;
g. adopting the necessary fiscal and supportive measures for families and associations;
h. defining European standards for the training of specialised medical and technical personnel, care being taken to avoid confusion between responsibilities and above all to establish that medical diagnosis and treatment be entrusted only to doctors with special training in the field of rehabilitation;
i. supporting every effort aimed:
- at helping and standing by and improving awareness of the problems of disabled people,
- at backing charity initiatives,
- at surmounting obstacles, especially those of a psychological character, between disabled people and their families and the rest of society;
j. amending the Social Charter of the Council of Europe to include the rights and safeguards needed to ensure that a comprehensive rehabilitation policy is fully and coherently applied, as proposed in Assembly Recommendation 1168 (1991).
7. The Assembly recommends moreover that the Committee of Ministers:
i. seek to associate the governments of all member states, and if possible of all European states, in the activities of the Council of Europe for the benefit of people with disabilities, whether physical, psychological or sensorial in origin, and to encourage the holding of periodical conferences of European specialised Ministers;
ii. promote the use of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) having regard to the work of the Council of Europe within the frame of its Partial Agreement;
iii. invite the government of each member state to describe what steps have been taken to implement Resolution AP (84) 3, as revised, on a coherent policy for the rehabilitation of disabled people;
iv. to provide for the setting-up of a European information and evaluation system for obtaining reliable statistics, calculated with regularly updated indicators, in order to provide information and forecasts that are comparable from one European country to another.
II. EXPLANATORY MEMORANDUM
by Mr Foschi
1. The United Nations proclaimed 1981 International Year for Disabled Persons. The Council of Europe Parliamentary Assembly made a contribution through its Recommendation 925 (1981). It was hoped, inter alia, that henceforth all the member states would take part in its work, thus transcending the restricted framework of the "Partial Agreement", which was the system of co-operation at the time. In 1991 these wishes were met when, for the first time, a conference attended by the appropriate ministers from all member states of the Council of Europe was held in Paris on 7 and 8 November. Representatives from Albania, Bulgaria, Canada, Estonia, the Holy See, Latvia, Poland and Romania were invited as observers. The declaration adopted by the Ministers at the close of the conference is appended to this report.
2. 1993 will mark the end of the United Nations Decade for the Disabled (1). This will coincide with the establishment of the "single European market" and freedom of movement in Europe. It will thus be an opportunity to take stock both of past action and of the measures needed to meet new demands.
The work of the Council of Europe
3. Back in 1960, the Council of Europe began European co-operation in this field with the "Partial Agreement" activities previously carried out under the Treaty of Brussels and later by the WEU (1950-60). For more than thirty years the Committee on the Rehabilitation and Resettlement of the Disabled (CD-P-RR) has conducted an important experiment, in several phases, which member countries have drawn upon when enacting new laws.
Initially the studies carried out and resolutions adopted related to special categories of disabled people (sufferers of tuberculosis, poliomyelitis, people with heart complaints, epileptics, chronically injured, the deaf, etc., (see P-SG (83) 5) and some specific aspects of the question such as education etc.
4. Later on the committee set itself the goal of tackling rehabilitation as an on-going process concerning all aspects of social life and not only the medical side, and for all categories of handicapped persons.
The many legal texts resulting from this effort have enabled the Committee of Experts to work out a full programme for a coherent policy on the rehabilitation of the disabled, adopted in the form of a resolution of the Committee of Ministers of the Council of Europe in 1984 (Resolution AP (84) 3). This is now the official document and is made available to all European countries, along with some non-European countries, to help work out an overall policy for protecting the rights of the disabled. Other large-scale studies (2) have been carried out. Attention should be drawn, in particular, to a report for which the committee is responsible and which serves as an essential tool: the report on European legislation on rehabilitation and employment of the disabled (published 1990) in 16 Council of Europe member states.
The role of the Parliamentary Assembly
5. It comes as some surprise that, despite the extent of the Council of Europe's work on rehabilitation, this has never been the subject of a special examination by the Parliamentary Assembly.
This is further proof of the need to bring an end, long overdue, to the absurd inability the different sectors of the Council of Europe have in communicating with one another. It is worth underlining the role which the Parliamentary Assembly might play since its members are representatives of national parliaments required to vote on the national legislative proposals. They could therefore accept or reject the guidelines put forward by experts for European co-operation in one of the most interesting, if one of the most complicated, areas of health and social policies. It is only recently, following the Social, Health and Family Affairs Committee's initiative, that fruitful dialogue has begun with the Partial Agreement Secretariat.
6. The 1984 programme and the Committee of Ministers' resolution should now be discussed in the Parliamentary Assembly, taking stock of the last forty years and comparing all the different European experiences, examining trends and changes made to national legislation. It might then be possible to propose to the Committee of Ministers a set of recommendations and initiatives designed to overcome old prejudices which still remain and the effects of piecemeal legislation and to combat the serious risk of a possible backward step on the grounds of superficial calculations regarding the economic costs of a rehabilitation policy, whose shortcomings are the cause of even heavier costs both in human and social as well as economic terms.
7. This analysis was conducted by our committee as a contribution to the Paris Conference of Ministers responsible for Rehabilitation, to some extent following the guidelines included in the proposal for a recommendation put by a number of parliamentarians on 5 May 1988 (Doc. 5894).
Disability, rehabilitation and independent living: The future of the Social Charter
8. A report on the work carried out by the Council of Europe over the last forty years should include a brief analysis of changes in recent years in Western society with regard to the disabled.
For scientific as well as historic reasons, the first disabled people to be dealt with were war victims and working accident victims. More recently society has also been dealing with the elderly or those born with a disability.
The ever-increasing awareness of human rights, applicable to each individual, and the consequent affirmation of equality between all as enshrined in the European Convention and the Social Charter (3), have given rise to a new philosophy regarding rehabilitation which has quickly revolutionised the original concept founded only on medical care and recovery of functions.
9. In order to reaffirm and update this philosophy, we suggested in our report on the future of the Social Charter (Doc. 6499 and Addendum), leading to Assembly Recommendation 1168, an amendment to paragraph 15 of Part I, to the effect that "every disabled person has the right to rehabilitation with a view to maximum self-reliance and the realisation of his or her social and economic rights, whatever the origin of his or her disability". Similarly, we suggested a new paragraph 4 in Article 11 (Part II) concerning the establishment and development of rehabilitation programmes for disabled people. In Article 15 we specified that the people concerned were those with physical, social, psychological and/or sensory disabilities and added that the Contracting Parties undertook to assist disabled people with career development and social integration through measures to reduce barriers to communication and circulation (3). It is hoped that all these proposals will rapidly be given a follow-up by the authorities concerned, in particular after the Council of Europe Ministerial Conference on the European Social Charter (Turin, 21-22 October 1991), in the final resolution of which it is stressed that "... it would be timely to up-date and adapt the substantive contents of the Charter in order to take account, in particular, of the fundamental social changes which have occurred since the text was adopted".
10. The notion of rehabilitation is now seen as a continuous, overall process beginning with prevention, progressing to medical treatment and finally social integration. According to this new approach rehabilitation is a learning process including all measures which might prevent or reduce to a bare minimum the physical, psychological, sensory, social and economic consequences of illnesses leading to congenital or acquired disabilities or those brought on by accident.
11. This entails methodically implementing the necessary actions in order to achieve these objectives until the subject is reintegrated into family, school, work and general social life.
If these objectives are to be achieved, certain rights must be respected and methods applied.
a. encouraging the subject's active participation in the rehabilitation process at each phase, starting with information about the possibilities of integration;
b. moving away from institutionalisation, which results in the chronic and passive dependence of the disabled person, to an open system founded on the greatest possible independence through the full recognition of the right to "be different";
c. adapting social, health care, working environment, educational and general services to the needs of the disabled and giving them a say in them;
d. creating an information system on the special needs of the disabled and the means available to integrate them;
e. preventing any risk of aggravation;
f. developing team work, with specially trained staff;
g. co-ordinating activities at individual, national, regional or local level, making sure that each phase follows on smoothly and that all resources are used rationally.
12. Changes in concepts and methods of rehabilitation have led to a great deal of confusion and doubt in the terminology used across Europe. Certain key words are often mistakenly used as synonyms, leading to flawed legislative standards. Therefore it is necessary to clarify the exact meaning of three basic terms which lie at the heart of the matter. The Council of Europe's Committee of Experts has helped to define them. In the light of recent changes in terminology, it has become necessary to revise the glossary of "equivalent" terms in the various languages.
An impairment is any loss or abnormality of psychological, physiological or anatomical structure or function. It is characterised by losses or abnormalities that may be temporary or permanent and that include the existence or occurrence of an anomaly, defect or loss in a limb, organ, tissue or other structure of the body, including the systems of mental function.
A disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. It is characterised by excesses or deficiencies of customarily expected activity performance and behaviour.
A handicap is a disadvantage for a given individual resulting from an impairment or a disability that limits or prevents the fulfilment of a role that is normal, depending on age, sex and social and cultural factors.
In fact, a handicap is the more or less inevitable consequence, socially and environmentally, of impairments and disabilities owing to the absence of suitable action of prevention, rehabilitation, medically and socially.
13. Obviously these three terms are not synonymous nor are they linked necessarily by a cause-and-effect relationship. They are different points in a whole process which may be avoided, for example, by taking preventive action suited to preventing the impairment in the first place, or medical action and rehabilitation measures liable to limit the impairment. But, above all, the third condition, handicap, may be avoided or reduced if rehabilitation services and society at large were organised in such a way as to offer a proper integration process, meeting the special needs of sufferers: for example, eliminating barriers in construction or by dealing with communication and psycho-social difficulties. As such, a handicap is more a lack of care from authorities than the objective result of illness or injury; it actually allows the shortcomings of society to be gauged.
14. Based on the traditional three-dimensional concept outlined earlier, in 1989 the Committee of Experts of the Council of Europe made a laudable proposal to use the WHO's international classification for studying the consequences of illness (4).
The ICIDH is the logical follow-on from the ICD (International Classification of Diseases), allowing the problems related to the handicapped to be continuously studied, as well as problems regarding rehabilitation or the compiling regional, national and international statistics needed for planning such work.
The Council of Europe has applied the International Classification paying particular attention to certain practical points such as: assessment of rehabilitation programmes; classification of statistics; application in mental health areas; assessment of professional abilities; and a radical overhaul of handicap classification.
15. This memorandum, albeit brief, must not overlook the important work being carried out on mental health matters by the Committee of Experts for the Application of the WHO ICIDH. A special report has been published in 1991. It is aimed at encouraging European psychiatrists to use the ICIDH in the complex area of mental illness. By measuring psychological impairments and social disabilities, the effects of therapy may be assessed, patients treated in different health structures may be taken into consideration, the exercise of social services both individually and collectively may be closely examined, the treatment required by the chronically ill may be determined and the links between illness, damage to the nervous system or other systems, the resulting impairment of cognitive and psychological faculties and involvement in family life and the community and the exercise of social functions may be studied.
16. The ICIDH (5) is not well known, used, translated or applied in every European country. It is only applied in France, Germany, the Netherlands and Spain. Accordingly, all member countries of the Council of Europe should be recommended to translate it, distribute it and co-ordinate their trials on it.
A European information system
17. A computer-assisted study on European legislation on handicaps (publ. 1990), provides a broadsheet analysis of the contents and developments in national legislation in 16 member countries of the Council of Europe. This document is the best if not the only means of comparison available at the moment; distortions in the directions followed by different European countries have transpired together with the fragmentary nature of existing policies and a degree of incoherence in the contents of the programme adopted by the Committee of Ministers in 1984. However, this document also reveals the huge wealth of experience and progress made in legislation in this field.
Unfortunately, information sources are often lacking and it is not always possible to follow general policy developments in this area, as in others.
18. Finally, it may be worthwhile highlighting the pressing need for a better system of information than the current statistical system. This is patchy, and a new system could be more radical, linking together the various aspects of medical, assistance, and social matters, inter alia. Among other things, this might lead to the adoption of new classification criteria since the traditional categories are outdated. This might take into account the ICIDH, on one hand, and, on the other, European projects which should lead to the harmonisation of legislation and free movement, at least in the twelve EEC countries. Therefore we should reject corporatist views and condemn hot-air discussions.
Living longer and leading a healthier life
19. The first strategic objective is an information system. The second - linked to the WHO's 38 targets - is to improve people's lifestyles, raising the quality of life. This entails offering preventive services, together with rehabilitation, and integration at school, in training, at work and in society at large.
Special attention must be paid to the living conditions of the handicapped person especially in adulthood or for adults who become handicapped; these cases should be given priority for home care services for dependents and a housing programme.
The third strategic objective is to enhance healthy living, as it were, by structuring physiotherapy and rehabilitation, together with a network of home services, protected and semi-residential housing for the mentally ill.
The fourth strategic objective relates to vital amenities such as basic socio-medical centres, grading new job types and making the most of charity.
20. With regard to rehabilitation specialists, European standards must be drawn up for the specialisation of doctors so that, once they have specialised in medical rehabilitation, they can undergo further training in the various fields concerned (for example, physiotherapy, neurology, psychiatry, cardiology, urology, etc.). The same approach should apply to qualifications for non-medical technical staff, care being taken to avoid confusing skills relating to medical procedures with those relating to the implementation of technical and activity programmes, which are the responsibility of specialist social workers. To this end, special pre-university schools should be set up.
21. These objectives must be assessed according to a set of indicators allowing comparisons to be made between European countries. Here, too, there is a need to adopt, firstly, a classification system and a computer system for making significant data-readings.
* * * *
22. Action in this area urgently needs a boost. No other socio-political subject currently involves the whole range of social matters. There is an individual and indivisible link between the absolute right to health, education, work, leisure, participation in society, satisfaction of needs, security, social services, at home and in the family, human progress, freedom from fear, intolerance, hatred or pity. At present there are approximately 500 million physically, psychologically or sensorially handicapped people throughout the world. They may represent up to 30% of the population given under-estimates, very often based on quite different criteria and dealing with extremely different societies in the North and South.
23. It is a fact that the number and proportion of handicapped persons are increasing because of lower natality and infant mortality rates and the increase in life expectancy. There is also now a larger share of very old people. Another cause is the efficiency of therapies which extend the life of individuals affected by an impairment, an increase in invalidity due to accidents, road accidents, accidents at home or the workplace. Finally, a proper prevention programme is lacking.
Coupled with this is a corresponding increase in serious and very serious illness, in adults and handicapped old people, the large numbers of dependent elderly people and those with multiple handicaps.
24. We must now go beyond the piecemeal approach and give priority to:
a. preventive measures, both genetic and medical, in the light of new scientific discoveries and of bioethical hazards and restrictions. Special attention should be paid to infant mental health and neuro-psychiatry centres because of the crucial impact of any action taken at an age when children are developing;
b. education and integration at school;
c. reinforcing home services and assistance to families, with special attention being paid to seriously disabled people and dependent elderly people;
d. providing placement and vocational guidance and training services and passing legislation allowing disabled people to take up ordinary employment in keeping with the complex developments in the labour market or, in more serious cases, to be employed in co-operatives or sheltered workshops;
e. setting up a network of local and regional rehabilitation and social support services;
f. guaranteeing ease of access into buildings and overcoming visual, auditory and psychological obstacles to communication;
g. adopting the necessary taxation and family assistance measures;
h. defining European standards for the training of specialised medical and technical personnel, care being taken to avoid confusion between responsibilities;
i. supporting every effort aimed at helping and standing by the handicapped, helping such efforts to become widespread and backing charity initiatives; eliminating all barriers, especially psychological ones, put up between the handicapped and their families and the rest of society;
j. amending the Council of Europe Social Charter to include the rights and safeguards needed to ensure that a comprehensive rehabilitation policy is fully and coherently applied.
(1) Cf. adoption of the World Action Programme by the General Assembly on 3 December 1982 (United Nations Resolution 37/52).
(2) Examples are:
- the report on systems of information on people with an impairment, disability or handicap;
- the report on sheltered workshops (1981);
- the report on training medical staff for rehabilitation (1984);
- the report on special measures to be taken for promoting the social integration of the mentally handicapped;
- the report on the assessment of a handicap with a view to professional rehabilitation (1987);
- the report on the use of international classifications of impairments, disabilities and handicaps (ICIDH) in re-education and rehabilitation (1990);
- the technical report on the use of international classifications (ICIDH) in surveys and statistics (1990);
- the report on European legislation on rehabilitation and employment of the disabled (published);
- the glossary of basic terms used in rehabilitation.
(3) Article 15 of the Charter also recognises the right of disabled people to vocational training and occupational and social rehabilitation.
The suggested amendments are as follows:
Part I, paragraph 15:
15. Every disabled person has the right to rehabilitation with a view to maximum self-reliance and the realisation of his or her social and economic rights, whatever the origin and nature of his or her disability.
Article 11, new paragraph 4:
4. to establish and develop programmes of rehabilitation for disabled persons.
Article 15, new paragraph 3:
3. to assist disabled persons in career development and social integration through measures to reduce architectural, physical and psychological barriers to communication and circulation.
(4) International Classification of Impairments, Disabilities and Handicaps, prepared by Professor Wood, University of Manchester, in 1981 (doc. WHO/ICD 9/Rev. Conf/74).
(5) A simplified version of classification for an agreement on a "common language" is currently being studied. An interesting study into the use of the ICIDH in surveys and statistics was published in 1990. Angelo Serio and the Rapporteur intend to have the documents published in Italian in co-operation with the ISIS (Italian Higher Health Institute) in the hope that some of the more far-fetched ideas in this area traditionally held in Italy might give way to a more important objective: that of gathering data and indicators at European level, in accordance with the WHO's 38 targets set out in "Health for All by the Year 2000".
A P P E N D I X
AD HOC CONFERENCE OF MINISTERS RESPONSIBLE FOR POLICIES ON PEOPLE
Paris 7-8 November 1991
1. At the invitation of the French Government, the European Ministers responsible for Policies on People with Disabilities held on 7 and 8 November 1991 a Conference in Paris on "Independent Living for People with Disabilities". The conference was opened by Mrs Catherine LALUMIÈRE, Secretary General of the Council of Europe and was attended by Ministers of the twenty-five Council of Europe member states, as well as by representatives of the Council of Europe Parliamentary Assembly, the Standing Conference of Local and Regional Authorities and the Commission of the European Communities. Representatives of Albania, Bulgaria, Canada, the Holy See, Latvia, Poland, Romania and the USSR, also attended as observers. The United Nations, UNESCO, ILO and OECD were also present as observers. In addition, the conference invited Rehabilitation International (RI), Disabled Peoples International (DPI), Mobility International (MI), the Confederation of Family Organisations in the European Community (COFACE), the European Network for Independent Living (ENIL) and the International League of Societies for Persons with Mental Handicap (ILSMH) to participate in the proceedings.
2. Mr Michel GILLIBERT, Secrétaire d'Etat aux handicapés et accidentés de la vie of France, was elected Chairman on the proposal of Mrs Roswitha VERHÜLSDONK, Parlamentarische Staatssekretärin of Germany.
3. At the close of their debates, the Ministers adopted the following Declaration:
1. In the past action on behalf of people with disabilities has mainly been inspired either by charity or by a concern to guarantee an income, to compensate certain groups such as war invalids, or to give them a right to special care.
People with disabilities were generally considered to be "different" from others and helpless. Charitable actions often led to their isolation and marginalisation in institutions cut off from the social environment. They rarely found any opportunities for improvement there and could not enjoy the same rights and options as everyone else.
However, with the recognition that all people are entitled to the same fundamental rights, it gradually became accepted that social and economic policies must be such as to allow all citizens to reach their full potential.
2. Surveys show that about 10% of the population have a disability. Moreover, the number of elderly people in the community is projected to increase sharply in the coming years. This means that more and more people will be directly affected either by personal disability or by the needs of members of their families, of friends and neighbours.
3. Every human being is unique and possesses a very varied range of qualities and aspirations. The existence or appearance of a disability disturbs the balance of circumstances in the lives of those affected, including the family, friends and neighbours. Disability as such, however, does not affect an individual's qualities and aspirations - it only makes it harder for that individual to achieve full potential.
4. Disability can strike anyone anywhere at any time. As disability is not uniform, the requirements of people with disabilities themselves and of those close to them vary greatly as well as the ability of the community to cope with these requirements. It follows that society should recognise that each citizen should have the opportunity to choose the way in which they participate in everyday life.
5. In recent decades, substantial progress has been made in breaking down prejudices and barriers and in developing a new approach to disability. Several factors taken together have contributed, to a greater or lesser extent, to this progress depending on the historical context and the political structures of the different countries.
Scientific progress has enabled the causes of a number of disorders to be more closely identified, treatment to be improved and the consequences of impairments and disabilities to be compensated for by means of new technology.
Legislation and government action, including public funding have, in many countries, improved appreciably the situation of people with disabilities.
Non-governmental organisations have contributed considerably in drawing attention to the human, social and economic consequences of disability. In some countries they have also provided appropriate services, often in partnership with statutory agencies. They have in particular helped to achieve greater awareness of the right of people with disabilities to independent living and to active participation in all areas of society.
A consequence of all these actions is that the rights of people with disabilities have been enshrined in international legal instruments.
6. However, work must continue; the job is not finished.
The Ministers recognise that individual areas of concern must be tackled in the context of a coherent policy whose objectives embrace all aspects of life. They recognise that people who by chance have special needs which must be met if they are to lead a normal life should have the benefit of a comprehensive policy which takes into account each moment of existence.
The Council of Europe's work has devoted considerable effort to developing a coherent policy for the benefit of people with disabilities. The present Conference on Independent Living for People with Disabilities illustrates their concern to set a new course for the future.
This new course is all the more significant as a new and larger Europe is emerging, built on the principles of democracy, the rule of law and the respect of the dignity of the individual.
Its implementation requires a close and continuous collaboration with Central and East European countries, so that they can benefit from the experience of their European partners in the area of integration of people with disabilitites.
7. The Ministers confirm their commitment to a coherent overall policy for the benefit of people with disabilities and to the development or improvement of action programmes in order:
- to avoid all discrimination and to eliminate prejudice, detrimental to their dignity;
- to organise efficiently the prevention and reduction of the consequences of impairment or disability;
- to enable people with disabilities to participate fully in society, while recognising their right to independence;
- to recognise the needs of families, friends and neighbours who provide care and support to people with disabilities.
8. For this purpose, the Ministers approve the general policy and measures described in the proposal of the Committee on the Rehabilitation and Integration of People with Disabilities (CD-P-RR) on a coherent policy for people with disabilities and propose that the Committee of Ministers should recommend it to be followed by member states, and invites them as well to provide a regular stock-taking in form of an up-date of the report on legislation on the rehabilitation of people with disabilities, at the widest possible European level. It would be useful if these reports also contain illustrations of concrete results achieved.
a. The Ministers make a special appeal:
- to the national and local authorities:
* to take the measures needed to ensure equal rights and opportunities for people with disabilities including in particular access to employment, as described in the coherent policy for people with disabilities, and particularly to provide personal support whenever needed;
* to ensure the fullest possible co-ordination between the ministries, the authorities and the services involved in providing personal assistance to people with disabilities, to avoid unco-ordinated action, conflicting decisions and gaps in policies and services;
* to ensure full participation of people with disabilities, individually or in association, as appropriate, in the decision making process concerning all aspects of their lives, through their representatives in the case of people unable to act on their own behalf;
- to all those concerned with services used by the public, to maintain in constant awareness of the needs of people with disabilities;
- to the media to promote an image of people with disabilities as full citizens entitled to live an ordinary life.
b. The Ministers welcome the renewal of the European Social Charter and underline the need to extend the scope of the rights spelt out in the Charter in order to cover as much as possible the measures proposed in the coherent policy for people with disabilities.
9. The Ministers propose to the Council of Europe the setting up of a pan-European network of projects on independent living and equality of opportunities for people with disabilities. As a fundamental principle, projects should be run with the full and active participation of people with disabilities.
This network should aim at multiplying examples of good practice, particularly with regard to:
- access to life in society (education, employment, leisure, ..., transport and urban environment, ...),
- support (personal, technical and financial),
- information on services and facilities for independent living.
This could be achieved, inter alia, by encouraging the exchange of information and experience on ongoing projects, by reciprocal visits, training activities.
10. The Ministers ask the Committee of Ministers to entrust the Committee on the Rehabilitation and Integration of People with Disabilities with the task of preparing the measures necessary for the implementation of this network in relation to its running, its financing and its working methods.
This should be carried out in association with government representatives, international non-governmental organisations and representatives of international organisations, and in particular with the European Community.
11. The Ministers express their satisfaction at the success of the conference, and wishing to follow it up, agree that a ministerial conference should be held in the near future on a specific theme.
At the conference, the Ministers and heads of delegations of Bulgaria, the Czech and Slovak Federal Republic, Hungary, Poland and Romania indicate their needs, both technical and financial, in the field of rehabilitation and professional training of people with disabilities, such as prostheses, bio-prostheses, rehabilitation engineering, rehabilitation and professional training centres and ask the Council of Europe for its help and assistance in the matter, possibly through its member states.
The conference ask the Secretary General of the Council of Europe to bring these questions to the attention of the Committee of Ministers of the Council of Europe for their examination and evaluation.
Reporting committee: Social, Health and Family Affairs Committee.
Budgetary implications for the Assembly: None.
Reference to committee: Doc. 5894 and Reference No. 1601 of 30 June 1988, Doc. 6246 and Reference No. 1685 of 3 July 1990.
Draft recommendation: adopted unanimously by the committee on 4 February 1992.
Members of the committee: Mr Pini (Chairman), Mrs Håvik, Mr Rathbone (Vice-Chairmen), Mrs Albrink, MM. Banks (Alternate: Mr Soames), Beix, Bowden (Alternate: Sir Dudley Smith), Curto (Alternate: Mrs Aguiar) Diaz de Mera, Ferris, Fiandrotti, Foschi, Gouteyron, Gusenbauer, Mrs Haarstad, Mrs Haglund, Mrs Haller, Mrs Halonen (Alternate: Mrs Dromberg), MM. Jurgens, Karakaş, Koehl, Koulouris, Liapis, Libicki, Joaquim Marques, Menzel, Meyer zu Bentrup, Mikan, Ottenbourgh, Mrs Özver, MM. Palacios, Pasquino, Pécriaux, Psaila Savona, Mrs Ragnarsdottir, MM. Regenwetter, Reimann, Mrs Rossi, Mrs Rothmayerova, Mr Schwimmer, Mrs Soutendijk-van Appeldoorn (Alternate: Mr Eisma), Mr Ternak, Mrs Ugrin, Mr Wielowieyski.
NB: The names of the members present at the meeting are underlined.
Secretaries of the committee: Mr Hartland and Ms Meunier.