Leslie Swartz and Margie Schneider
22 December 2004
analysis
Johannesburg — TO WHAT extent did 10 years of democracy encourage full participation by disabled South Africans in society? SA has much to be proud of.
Disabled people are entitled to rights enshrined in the constitution, there is an office on the status of disabled persons in the presidency; the South African Human Rights Commission has been clear on disability rights as a human rights matter; and we have a vibrant disability sector as part of civil society .
The white paper on an integrated national disability strategy , published in 1997, remains a progressive framing document for action on disability issues on the part of government and society as a whole.
This is also a time of challenge for disabled people and their families and for those concerned about human rights. In 1998 the Community Agency for Social Enquiry found that 88% of a representative sample of disabled South Africans were unemployed, and figures cited at the recent Access 2004 national conference on disability held in Cape Town suggested that the situation has not improved.
There is a close relationship between disability and poverty, with poor people being more at risk for disablement and disability often leading to further impoverishment as disabled people lose access to jobs and bear the extra costs that may result from impairments.
To its credit SA is one of the few low- or middle-income countries that provides social security for its disabled citizens. Disabled South African adults who qualify in terms of a means test are entitled to a monthly grant of R740.
Over the past 10 years, the social development department, along with partners from the disability sector and elsewhere, have worked hard to increase access to grants for those who should be receiving them, a particular challenge in remote rural areas.
The drive to increase access has led to innovation. For example, government recognised that a hurdle facing many in need of grants was lack of access to the doctors who made assessments of eligibility for these benefits.
For this and other reasons, in 2001 regulations were promulgated that allowed for grant assessments to be undertaken by assessment panels that could include people other than doctors other health professionals and social workers , for example.
The approach has not, for various reasons, been widely implemented and a concern is that even where assessments are undertaken by professionals, different systems of assessment apply in different parts of the country, leading to questions about equity of access .
These concerns about access, however, pale into insignificance when considered alongside the looming crisis around fiscal provision for grants. According to official treasury figures, 33% more South Africans were receiving disability grants in April 2004 than April 2003, and the 2003 figures were a 30% increase on those of 2002.
In terms of numbers, about 1,3million South Africans received disability grants in April 2004 and we can conservatively estimate an expenditure of at least R11,3bn on disability grants alone (excluding assessment and administration costs) in the 2004-05 financial year.
If the number of disability grant recipients were to grow at the same rate as has happened between 2003 and 2004, it will take less than three years for the number to double, and by 2017 there would be more South Africans on disability grants than the entire current population.
Clearly, the situation needs examination, as finance minister Trevor Manuel said in October .
Some of the increase in disability payments must be due to increased access by disabled people to grants, and this is to be applauded. As access reaches optimal levels, we can expect the demand for grants by those entitled to them to level off.
Fraud is also reported to play a large role in the increase in grant payments, with concerns expressed that some medical practitioners and others may knowingly be faking assessments .
But there are also instances where a compassionate medical practitioner, faced with a desperately poor person, may take a technically unethical but understandable (and, some would argue, defensible) decision to record an able-bodied person as disabled. This can make a difference between the individual's family having no income and having R740 on which to live.
The reality is that disability grants, like pensions, are commonly the only source of income for families. Clearly, the crisis around disability grants cannot be understood as separate from issues of pervasive poverty in SA. Disability grants were never intended as a form of widespread poverty relief , but the reality of poverty and unemployment means that in many cases this is precisely how they are being used.
In SA, and in disability debates worldwide, there is agreement that disability grants should be part (and not even the most important part) of a basket of services and opportunities for disabled people.
Far more important is access to employment in the labour market, the development of skills and entrepreneurship so that disabled people can contribute and benefit from the economy and, crucially, safe, affordable and accessible public transport to allow disabled people access to their places of work .
There is a danger that the crisis in disability-grant provisioning may lead to an impression that disabled people want "hand-outs".
Like most able-bodied people, what most disabled people want is a dignified and productive life. Creating the conditions for increased economic activity for disabled people, especially in the context of widespread unemployment , is the real long-term challenge.
Swartz is professor of psychology at the University of Stellenbosch and a director of child, youth and family development at the Human Sciences Research Council, where Schneider is chief research manager.
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