Possibilities and challenges for Nordic countries

Within the project surveys have been sent out and three workshops have been carried out with three target groups.
  • The Council on Nordic Cooperation on Disability
  • Researchers on disabilities
  • Experts from authorities and organisations.
An overview of the emerged views is below.

Implementation of rights and legislation

Experts repeatedly brought forward that the Nordic countries in general have the legislation needed and that it is comprehensive. The existing problems the individuals face in their daily life are found especially in the implementation of the legislation. The prevailing self-image that the Nordic countries are best at providing support to persons with disabilities may be a contributing factor in that decision-makers are not seeing the shortages.

Decentralised service

In the Nordic countries the responsibility for support and service lies mainly within the municipalities. Know-how and resources vary significantly between the municipalities, leading to inequality. In a tightened national economy, the risk for even broader inequality increases. Municipalities often interpret national legislation according to their own guidance and regulations, which differ between municipalities. The possibility of moving is also limited when the decisions supporting you in one municipality are not automatically transferred to another municipality. Instead, a new assessment of needs is performed, which may lead to a decrease in the quality of support.

Marketization

Private actors are increasingly becoming service providers, which leads to changes in the requirements. This also means more possibilities for the individual, but in some cases also the responsibilities change. This is the case for example within assistive equipment where the individual buys their own equipment making the individual handling repairs and service together with the supplier and making consumer legislation applicable. The development towards the individual becoming the customer has caused different views among the disability movement. Some are positive, some negative. The combination of a decentralised community organisation and the increasing number of systems of choice may in itself cause challenges for the individual and groups with extensive needs.
It’s obvious that we have a long, long way to go to fill the requirements of Article 19
Rannveig Traustadottir, Professor Emerita, University of Iceland

Increased focus on legislation

In several Nordic countries the individual has the possibility to appeal the decisions on efforts. This increases the possibilities for the individual but leads to an increased need for lawyers and legal advice. This may lead to inequality depending on the availability of such advice, and also that an increasing number of negative decisions are made by the municipalities or the government, knowing that everybody does not have the possibility to further their case. 

Guidance and support

Successful examples on personal budgeting are generally based on an existing teamwork between the party assisting with the personal budgeting and in the choice on how to use the means. An important requirement is, however, that this party is unbiased in relation to the alternatives on offer. If the adviser or  fitter has economic incentives, for example to a certain supplier, or has a public task but is prevented from giving detailed information or advice due to legislation (public procurement), the individual must receive the information/advice in some other manner in order to be able to make an informed choice.

Old traditions and norms

In many activities for support and services for persons with disabilities, many within the professions have worked for a long time and in many activities, there are still old conceptions and norms present. A key part of the implementation of the CRPD is that there should be change in paradigm, from seeing persons with disabilities as objects for charity to bearers of rights with the same rights as everybody else. Personal budgeting and individualised working methods, together with efforts such as competence development and awareness, may speed up the change in paradigm.

Simplified thinking and the need for cooperation

In countries with developed welfare systems, such as the Nordic countries, there are often organisational simplified thinking in the form of several responsible parties for support and service, regulations as well as for costs. For those with many and extensive needs this often leads to a large cooperation need and many regular contacts. Cooperation within the systems, such as coordinators, are important in order to solve these problems.

Personal budgeting

Personal budgeting makes it possible for the individual to shape the support in the desired manner. But it also requires that the individual has the knowledge and/or a network of knowledge in order to be able to make a choice. Education and knowledge are also necessary.
Possibilities
  • the individual can prioritise based on their own situation, needs and wishes.
  • the individual can become more motivated to make changes and carry out life projects.
  • to make choices based on their own life situation.
  • to choose another provider if not satisfied.
  • less bureaucracy concerning rules and requirements on following procured alternatives or decided on beforehand.
Challenges
  • The individual must become more involved with their solution and not all have the knowledge or network to make an informed choice.
  • To choose from different providers may vary significantly between municipalities and parts of the country.
  • The responsibility is transferred to the individual, regarding for example assistive equipment, and other legislation, such as consumer legislation, becomes applicable in repairs.
  • In order to monitor that the system is used as planned, leads often to the development of an administrative control device which can be both costly and challenging for the personal integrity.
  • In systems for personal budgeting costs are more transparent compared to regular activities since they are embedded in a larger operation, which may lead to a backlash and a distorted focus.
  • If there are only a small number of alternatives to choose from, the risk is that the freedom of choice becomes an illusion.
  • The sum received by the individual do not correspond to the needs and becomes more a basic level.
  • A risk for increased inequality.