Inclusion matters

orange bandToday (3 December) CM Health celebrates International Day of Persons with Disabilities, a United Nations sanctioned day that celebrates progress in breaking down barriers, opening doors, and realising an inclusive society for all. I’m joined by Ezekiel Robson, who is passionate about raising awareness, understanding and acceptance of people living with disabilities and their achievements. Ezekiel has been a community appointed representative on CM Health’s DiSAC (Disability Support Advisory Committee) for the past ten years, and recently joined our Patient & Whaanau Centred Care Consumer Council.

Ezekiel Robson
Ezekiel Robson

I grew up in Manurewa, so South Auckland is what I have always known. Growing up in this multicultural community, with a high proportion of maaori and pacific people gives me a particular ‘lens’ on the world. I have always had a vision impairment, and while there is no treatment, I have learned to find alternative ways to navigate the world around me, which relies so heavily on visual interaction. Many people may consider this a disability but it’s just another part of me, and my uniqueness – not all impairments ‘need fixing’ or can be ‘fixed’.

I have a strong connection to my community, and I want it to be an inclusive place. What I mean by that is I want it to be a place where people have a sense of belonging and good physical access to local community services and supports, whether it’s for healthcare, employment or education, public transport or even routine grocery shopping, as well as social and family activities at parks, playgrounds and libraries. The reality is a lot of people don’t feel empowered by the inaccessible design of paths, streets, and buildings, or welcomed by the attitudes of some people in their community – they feel marginalised. The reason I do what I do is to use my experiences and abilities to help people feel connected with their communities.

A report produced by Te Pou: Mental health, addiction and disability workforce development shows that people with mental health conditions have a life expectancy reduced by up to 25 years compared with those who don’t. Similarly, a Ministry of Health report on people with intellectual disabilities shows poorer health outcomes and lower average life expectancy of 18 fewer years for men and 23 fewer years of life for women. The research also shows that when these people come into contact with health and disability services, their physical health is being neglected. What this tells me is that we need to look beyond a person’s disability and deal with the health condition or ailment they came in with. They should be treated as people first, their health condition second and their disability third, if relevant.   CM Health’s Mental Health Unit has been taking a close look at how they can make the interface between mental health and physical health services, particularly in localities much more seamless.

CM Health is also committed to ensuring people with disabilities are represented and have a voice.   This includes membership on the Consumer Council, input into the co-design of services, guidance on wayfinding and raising the profile of disabled people by promoting International Day of Persons with Disabilities on 3 December at Ko Awatea. The theme this year is: ‘Inclusion matters: access and empowerment of people of all abilities’, and the associated colour is orange.

The Human Rights Commission states that “the estimated one billion people living with disabilities worldwide face many barriers to inclusion in many key aspects of society. As a result, people with disabilities do not enjoy access to society on an equal basis with others. It is important to focus on the ability and not the disability. By promoting empowerment, real opportunities for people are created.”

The challenge is how do we have a workforce that has the right attitude and information so people can provide the best care and support?   Do we provide training or is there a better way? How can we collect data on patients with disabilities? Currently, we collect statistics on gender, age, culture, etc. However, we don’t consistently collect information on impairments. For example, how many people with vision impairment stayed in the cardiac service? How many Deaf people have used maternity services this year? This information would be helpful to ensure we provide the most appropriate services.

People can also take personal action in their jobs to show that inclusion matters. If you are a nurse on the ward and a visitor with a disability arrives to see a patient, don’t charge ahead – wait to see that the person is following you. A colleague was talking to me the other day about a couple, who were both using wheelchairs for mobility. The staff member said to the patient being discharged – “Is there anyone that can come and help you.” The patient’s partner was sitting right there and felt excluded and disregarded as being the person to help. Most often people with disabilities are seen as the passive recipients of care as opposed to providing help for others. We need to work together to reduce assumptions and the associated stigma.

In the future, I’d like to see our workforce look more like the people we serve. Just as we like to see more maaori and pacific people in healthcare careers, I’d like to see the diversity of our workforce include people who have disabilities. This diverse group of people have valuable skills and experience to offer.

Ezekiel and Geraint

 

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Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

2 thoughts on “Inclusion matters”

  1. Good point about the workforce including more people with impairments. However people, some with significantly disabiling conditions, are already working for CMH.

    I work more productively because I have the support of great team,who don’t mind the inconveniences assocaited with my health and mobiity issues- e.g. needing to have a higher chair when I sit for long periods and stiffen up . They are inclusive in their approach, and practice what they preach within the team as well as when they work with children and families. They are awesome!

    1. Hello Enid, thank you for speaking up – this is exactly what I hoped to see! No doubt CMH already has some very valuable staff with impairments or chronic conditions, and colleagues with inclusive attitudes. December 3rd is a day to remember to acknowledge all these staff and their co-workers – my hope is this blog gives us an opportunity to share and hear of such experiences.

      From an HR perspective, it can be complex, knowing who these folks are, and connecting with them to ensure lessons can be learnt, and contributions acknowledged!

      It’s a real challenge for employers everywhere to develop positive, pro-active systems to routinely ask all new and existing staff if they identify as disabled or have different access needs to do their jobs. But it is something we must work through together, if we ever want to see more people with disabilities in meaningful employment.

      Asking for or providing those supports shouldn’t feel like a burden for anyone involved, simply a case of ‘reasonable accommodation’.

      Human Rights Commission guide on assisting persons with disabilities in understanding their rights to request reasonable accommodation:
      https://www.hrc.co.nz/files/7814/4848/7923/imm_reasonable_accommodation_guide.pdf
      Accessible version here:
      https://www.hrc.co.nz/files/6414/4848/7924/imm_reasonable_accommodation_guide.doc

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