The Rights of People with Disabilities: Areas of Need for Increased Protection: Chapter 6: Goods and Services

Chapter 6: Goods and Services

• Issues Addressed
• Denial of Rights
• Banking And Finance
• Health Services
• Transport and Travel
• Superannuation
• Major Issues and Recommendations

Issues Addressed

The New South Wales Anti -Discrimination Act 1977 (the ADA) makes discrimination on the grounds of physical or intellectual impairment unlawful in the provision of goods and services (ss. 49K, 49Z), subject to certain exceptions. 'Services' are defined in s.4 of the ADA to include:

• services relating to banking, insurance, and the provision of grants, loans, credit or finance;
• services relating to entertainment, recreation or refreshment;
• services relating to transport or travel;
• services of any profession or trade;
• services provided by a council or public authority.

These provisions include goods or services provided free or for a fee. Discrimination will occur where a person is refused goods or services or where the terms on which the goods and services are provided are different from those offered to non-disabled persons.

The evidence collected by project workers suggests not only that goods and services are sometimes provided to people with disabilities on different terms from those offered to non-disabled people, but that people with disabilities are very often confronted by disabling circumstances before they even attempt to obtain certain goods and services:

banks are often inaccessible; insurance and fmance companies openly deny people insurance coverage and credit based on the perception of increased risk; cinemas and theatres often have inaccessible toilets; other forms of entertainment may be prohibitively expensive for a person in receipt of an Invalid Pension; and in most States, public transport is particularly inaccessible for people with disabilities.

This chapter accepts and adopts the multi-faceted definition of services provided by the ADA. The evidence provided in this chapter is mostly anecdotal; where possible, however, certain specific State practices have been mentioned.

Denial of Rights

Banking And Finance

It appears that some providers of financial and insurance services equate disability with irresponsibility or inability to manage money or property. This has the effect of increasing the likelihood of a person with a disability being refused credit, fmancial services, or insurance, or being offered the service on less favourable terms. Some examples follow.

• Counter banking is extremely difficult for people in wheelchairs. Most of the automatic tellermachines are set up too high in the wall to be reached from a sitting position. This means a person in a wheelchair has the option of either giving a friend the keycard number or asking the friend to go inside the bank. If there are steps into the bank, this makes wheelchair entry virtually impossible. If there is a rear 'disabled access', quite often a person in a wheelchair has to flag down someone in the street and ask them to go into the bank to:

(a) find out where the access is and how to get to it; and

(b) have someone unlock the door or perform any actions to make such entrance actually accessible. Once inside the bank, a person in a wheelchair will find that all the queueing guides of poles and rope are too narrow and that the counters are too high and he/she will have to suggest that the bank clerk come round to the front. Often there are no low tables available for paperwork to be processed.

• People with intellectual disabilities have found it difficult sometimes to convince bank managers that they could run a bank account; people in institutions have found it even more difficult to do so, since they often had no previous record of banking.
• One woman with intellectual difficulties was not able to get a bankcard with a $500 limit until she pointed out to the bank that she had a current account with them that had over $1500 in it. She attributed this discrimination, however, to her low income rather than her disability.
• A charitable community group whose charter was to provide non-profit housing for people with disabilities was refused a home loan at the usual rates despite the fact that several members of the group were prepared to act as guarantors. They were offered the loan provided they supply one-third of the purchase price instead of the usual one-tenth, and pay interest at the much higher personal loan rate rather than the home owners mortgage rate (ADB 1980).
• A woman with a visual disability reported applying for a credit card from one of the major banks for added security on an overseas trip. Despite her solid income and home ownership the application was refused without explanation. When she demanded to know the reason for refusal, a junior officer of the bank intimated that refusal was due to her blindness. After representations to higher managerial staff she received a letter of apology and the credit card.
• A couple with intellectual disabilities bought a television on hire purchase which was not delivered. The company involved advised that they would not proceed with the sale since the couple may not make payments, and if the matter was taken to court the company might lose (ADB 1980).
• A disability insurance trust in the Illawarra region of New South Wales attempted to contract for house and contents insurance over a residence for people with disabilities. A few companies were approached, but all refused to extend cover. Finally a company was found to take up the contract. However, the company imposed premiums at a rate of double the usual amount because of the 'high risk'.

Health Services

Discrimination in the provision of health care arguably occurs in these ways: denial of an available service, or provision of a lesser service, or the lack of an appropriate service at all. This seems to stem from an attitude that people with disabilities are in some way less deserving of medical treatment, or that it would be of less value to them than to a non-disabled person. This attitude, as summed up by the mother of one woman with multiple disabilities, was: "what difference would it make?"

Many disability groups argue that disability health services are often starved of properly trained staff, particularly specialists, and that this results in a lowered standard of health care for people with disabilities. This may be especially crucial where early intervention will improve the degree of disability experienced, or lessen the deterioration of a person's condition. For example, therapists, who can make a vast difference to people with disabilities (particularly to children with access to early intervention services), are in chronically short supply. This lack of trained staff has an impact both on the quality and quantity of services available to the people in need.

Outright denial of medical services also occurs due to simple prejudice. The question of denial of life saving procedures to newly born children with severe disabilities is one of the most difficult to resolve. Denial of such treatment involves a medical officer making a value judgment about the value of a life spent with a disability and deciding it has no value at all. This raises complex moral and ethical considerations concerning passive and non-passive euthanasia which cannot be addressed here.

A further issue is that of inappropriate treatment meted out to people with disabilities. The practice of giving hysterectomies or tubal ligations to women with an intellectual disability in place of a more usual form of contraception or menstrual management, without that person's informed consent, or without some form of 'substitute' consent sanctioned by society (e.g. via guardianship or court proceeding), cannot be justified.

This raises several issues. Any surgical procedure always carries an element of risk to the patient, and where the procedure is not medically necessary the risk is also incurred unnecessarily. Where such a procedure is carried out without medical justification it can also smack of eugenics. There is also the question of the denial of the rights of the woman involved to normal development, to maintain her own physical integrity and to have children if she should so wish. Furthermore, such a procedure could amount to unlawful assault.

Northern Territory (NT)

Access to health services can be particularly difficult for people in isolated communities. The NT project worker's report paid particular attention to the health needs of Aboriginal people, particularly those with disabilities.

The Review of Northern Territory HACC Urban Services 1987 noted in all areas, the shortage or lack of appropriate health resources. This was particularly evident in Katherine, Tennant Creek and Alice Springs. This has a detrimental effect on services such as assessment, active treatment and maintenance therapy, and advice about home-modifications.

Some examples follow.

• The parent of a small child, who has an extremely rare disability, described her experiences in Alice Springs and stated that she believes that the attitude of a particular pediatrician has made her efforts to assist her child extremely difficult. The parent believes that the pediatrician insists on being the expert in every area and rarely refers on to other specialists. The diagnosis of this child's disorder was made in Alice Springs and the parents asked for a second opinion. They have had to pay their own travel costs and accommodation each time they have gone to SA. The original diagnosis has been disputed, as this particular disorder was considered static and there are physical signs that the situation is changing. The parents have not been able to get to Adelaide to investigate further as the financial burdens they have incurred nearly resulted in them losing their house. This child is three years old and is not speaking. He attends preschool one afternoon per week and sees a speech therapist who the mother describes as 'hopeless'. He has had no comprehensive assessments for early intervention purposes and there has been no information forwarded from the doctor to the Education Department.
• NT Health administers the PATS scheme which enables a patient to travel interstate to receive medical treatment, if it is not available in the NT. The scheme allows an escort to accompany the patient; if nursing support is required a nurse will accompany the patient. If the person is an inpatient receiving treatment, the escort receives one week's accommodation allowance to stay outside the hospital. This causes escorts (usually parents) enormous expense if ongoing treatment is required. A community worker stated that people who protest about this and submit their accounts will usually have them paid; she felt, however, that this discriminated against the quiet majority and added unnecessary stress to the escort's situation.
• At Lake Nash, near the Queensland border, reportedly in late 1984, a child was born with a harelip and other assorted problems. The child was losing weight and the parents became concerned. The child was taken to Mt Isa Hospital and subsequently transferred to Brisbane. Several months later, the Lake Nash teacher and his wife went to visit the child in Brisbane to take photos for the parents, who were unable to stay with the child for the duration of its recovery. The teacher asked when the child would be allowed to return home and was told that the child was to be fostered out, as directed by the matron at Mt Isa Hospital. The parents were not aware of this and certainly had not given their consent. The child is now living in Mt Isa with family friends, in order to be close to the appropriate services. An Aboriginal health worker at Lake Nash also lost a child after sending him to Mt Isa for treatment of diarrhoea. Despite NT Welfare's attempts to negotiate with the Queensland Government, the child was never returned.
• It is reported that an Aboriginal child may go into hospital with a broken leg or some other acute medical condition, and yet may also exhibit problems such as runny ears, skin disease or trachoma, and will be treated only for the acute medical condition and discharged. Some people believe that such problems are part of the Aboriginal condition.
• A Darwin man who has haemophilia and arthritis is required to travel to Sydney for treatment. He has been treated there for many years and yet has to justify this every time. The usual referral would be to Adelaide. There is no one in the NT who has expertise in haemophilia. He has regular reminders from the Adelaide Blood Bank, who maintain that he uses in excess of his allocation of blood products, a point that he would dispute. He is able to maintain full time employment, although he exceeds his sick leave entitlement every year. He expressed concern at the added costs of his disability to himself and his family, and believes that such items as new shoes, aids and other expenses should be able to be claimed as a tax deduction, since it is through the provision of these that he is able to maintain full time employment. He reports that it is relatively rare for an adult haemophiliac to be able to do this and believes that he should not be financially disadvantaged as a result.

Transport and Travel

A significant number of people with disabilities are denied any access at all to public transport and are therefore unable to use the services provided at low cost to the general community. The irony is that people with disabilities tend to be poorer than the general community and therefore more in need of cheaper public transport and less able to afford expensive alternatives.

Victoria

In Victoria, public transport, described by interviewees as never being particularly accessible to people with disabilities, appears to be getting progressively worse.

The special taxi scheme was reported to be unreliable and haphazard. Stories abounded of taxis being late, turning up on the wrong days, drivers being rude, and some allegedly taking 'visitor routes' to destinations (especially if the passenger was perceived as having an intellectual disability). At the same time, many other drivers were considered extremely helpful. Nevertheless, many of the expenses paid by taxi passengers with disabilities would not be experienced and certainly not endured by non-disabled people.

Moves to replace heavy rail systems with a light rail system in Melbourne were also causes of concern to users of public transport with disabilities. While the heavy rail system was accessible (with some difficulty) to people with physical disabilities, its proposed replacement was considered not so accessible. Some 20 complaints were lodged with the Commissioner for Equal Opportunity concerning this matter between September 1987 and February 1988. Following unsuccessful attempts at conciliation, the matters were referred to the Equal Opportunity Board. Under the terms of the Equal Opportunity Act, all complaints were, for various reasons, dismissed. The fact remains that public transport is less accessible to people with disabilities. In relation to these complaints, the Equal Opportunity Board transmitted to the Metropolitan Transit Authority its belief that pending the provision of a light rail system accessible to persons with disabilities, the provision of two extra Demand Responsive buses with the intention of providing a more flexible, and perhaps a weekend service to the impaired, whilst by no means a cure, would alleviate a presently unsatisfactory situation.

New South Wales

In NSW, the Disabled Taxi Service is a subsidised service administered by the State Urban Transport Authority. The scheme enables people with a severe physical or intellectual disability to travel in taxis (both ordinary and special wheelchair accessible taxis) at half the metered rate. To qualify, the disability must be severe and permanent and be one of the following types of disabilities:

• permanent inability to walk;
• total wheelchair dependence;
• severe ambulatory problems;
• total loss of vision or severe vision impairment;
• intellectual disabilities causing unacceptable behaviour problems or
  requiring constant assistance by another person.

The main problems with the Disabled Taxi Service are its cost and notorious unreliability. Taxi fares, even when halved, are high. The Australian Quadriplegics Association has estimated that the weekly cost of using the service to and from work can be around $100. This should be compared with the cost of transport to work for a non-disabled person using a train or bus, which would average approximately $12. Given that people with disabilities are generally already poorer than their non-disabled counterparts, this enormous cost seems doubly unfair. The unreliability of the service also causes significant problems for people with disabilities. According to users of the service, it is not uncommon to wait two to three hours for a taxi which was often booked the night before, or is the subject of a regular booking. This is obviously unacceptable to working people or people attending appointments with doctors or therapists, as it is essential to them to arrive on time. Whilst public transport is sometimes late and is subject to cancellations and breakdowns, regular delays of two hours would simply not be tolerated - either by the consumers or by the service providers. It seems grossly discriminatory that people with a disability not only pay more for their transport, but in addition receive a far inferior service than regular users of public transport.

Northern Territory

In Darwin, there appears to be adequate provision of parking spaces for disabled drivers. This scheme has been assisted by the newly introduced by-laws authorising policing to discourage non-disabled drivers from using reserved spaces. Unlike drivers' licences, special parking permits, such as those issued to people with disabilities, are only valid in the State of issue. Hence a person with disabilities from another State who has a special parking permit cannot park legally in a reserved space whilst in the NT.

There is a bus system operating in Darwin. Several service providers also have their own buses, some of which have wheelchair hoists. A consultancy commissioned by the Department of Transport and Works is looking into the viability of adding special purpose buses to the existing public Darwin Bus Company services. This is felt to be necessary, as thus far there has been little cooperation by those who are in possession of special purpose buses.

There is no public transport system in Alice Springs. There are no special purpose taxis. The Bindi Centre has a bus to transport some clients to the Centre. There is no public transport system in Katherine, although Kalano Community Health has a bus which goes to some of the fringe camps around Katherine.

In Tennant Creek, there are no footpaths beyond the main street. The footpath which does exist is described as being 'pretty stony', basically forcing a person in a wheelchair to use the road itself. The Coordinator of the Fuliwood Centre described a new recreational facility which has just been completed, as having great facilities for people who have a disability - provided that such persons can negotiate the shingles out the front in their wheelchairs.