WORK A Journal of Prevention, Assessment " Rehabilitation
ELSEVIER
Work 5 (1995) 11-16
Access to work Employment services for people with disabilities in Scotland Joanne Pratt Division of Occupational Therapy, Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow G131PP, Scotland, UK Accepted 15 June 1994
Abstract Employment services, including work rehabilitation, for people with disabilities have traditionally been delivered through the voluntary and public sectors in Scotland. The three main statutory agencies are the Department of Employment, the National Health Service, and the Social Work Department. Although occupational therapy is an established component of work rehabilitation programs in several countries (e.g., the United States, Canada, and Australia), it is a comparatively small area of practice in Scotland. However, recent changes in health and social service development, proposed changes to government benefits schemes, as well as health and safety legislation are among the factors that will influence the continued development and expansion of employment services. As such, occupational therapy practitioners will need to look to the public, private, and voluntary sectors as potential new purchasers and employers to bring their skills to this area of professional practice. Keywords: Employment services; Occupational therapy; Scotland
1. Introduction An individual's capacity to engage in work, i.e., purposeful and productive employment activities, can be disrupted at any point by sensory, cognitive, physiological, neuromotor, or behavioral performance deficits. These deficits may be present from birth, acquired through trauma or illness, or due to environmental factors. People who develop or acquire such performance deficits may require special services if they are to gain access
to and/or maintain their participation in work activities. Social, political, economic, and cultural factors invariably influence the nature and scope of opportunities for people who require services in any community. This article examines those particular factors in Scotland that define current employment services and those issues that shape the provision of these services. Scottish industrial history mirrors that of other developed European nations that have evolved
1051-9815/95/$09.50 © 1995 Elsevier Science Ireland Ltd. All rights reserved.
SSDII051-9815(95)OOI01-C
12
1. Pratt /Work5 (1995) 11-16
from economies and lifestyles largely based on agriculture in the last century, industrialization at the beginning of this century, and technologybased industry mid-century, to the present marked-led economy of the European Community. Currently, the following industries are among Scotland's largest: the government, through local authority, health, and social services; electronics, technology, and oil industries. 2. Statutory services
Scotland has a population of 5.5 million. The estimate of disability among adults in private house-holds is 13.1% (Office of Population Censuses and Surveys, 1988) which is slightly lower than the national (United Kingdom) figure of 13.5% Government policy toward inclusion of people with disabilities in employment is based on legislation that resulted from the Tomlinson Committee Report. The resulting pieces of legislation are known as the Disabled Persons (Employment) Acts, 1944 and 1958. The 1944 Act was drafted largely in response to the pressing social need to accommodate veterans with disabilities returning from World War II. The Act provides legislative support for assessment, rehabilitation, and retraining of people with disabilities, as well as for the provision of sheltered employment. The Act also established a quota scheme, which mandates that where a work force numbers 20 employees, the number of those with disabilities should reach 3% of that work force. To monitor this provision, people with disabilities are requested to voluntarily include their names on the Disabled Persons Register, which is maintained at local job centers. The job centers provide more general services to all unemployed people. There is debate on the efficacy of the quota scheme; this will be discussed further on. The Department of Employment has responsibility to administer and deliver the support services provided for by legislation. Placement, assessment, counselling training teams (PACTs) were established in January 1993 to fulfil this
Table 1 Employment services for adults with special needs provided by the department of employment Service
Population
Employment advice Special aids/equipment Personal reader service Adaptations to premises Employer awareness training Disabled Persons Register (voluntary) Travel to work grants Working at home information Job club Job introduction scheme Job center (placement) Pact DEAservice Ability development center (training)
All unemployed people with disabilities
responsibility. Eleven teams have been created to serve Scotland. Various personnel, including occupational psychologists, technicians, and disability employment advisers (DEAs) assist people with disabilities to enter and/or retain employment. Table 1 outlines employment services for people with disabilities available through job centers. Table 2 shows several outcome measures of PACT services for the period January-March, 1993, which was the first quarter following the establishment of these teams. The data presented should be considered in view of the fact that
Table 2 PACT teach outcomes for January-March 1993
-----_._._-----_._----Employment Service (PACT) Outcomes
Percentage
Returned to mainstream employment Found new mainstream employment Sheltered employment Self-employed Referred to other services Remain unemployed Inappropriate referrals
10 10
5 1 34 40 30
Area covered includes Glasgow, Dumbarten, and Renfrew.
1. Pratt / Work 5 (1995) 11-16
there were 800 clients serviced by PACTs in their inaugural 3 months of operation. Whether this level of service use, as well as the nature of clients' needs remains the same will only be determined by comparison with continued data analysis. Two other distinct and separately funded branches of government; the National Health Service and the Department of Social Work, provide work rehabilitation programs. Services are provided through various facilities, which include occupational and physiotherapy departments, industrial rehabilitation units, adult training centers, and sheltered workshops. It is largely the case that the clients served by these programs, where available, are mainly seeking entry into employment for the first time or following recovery from conditions that have greatly altered their functional status. Communication between these three branches of government varies by region but is largely carried out by direct client referral from one service to another. DEAs offer a human link between service providers and follow a client's progress through assessment, rehabilitation, placement, and maintenance in employment. Typically, the current range and depth of employment services for people with disabilities has both strengths and weaknesses. Major criticism is directed toward the quota scheme. The original objective of this service was to overcome discrimination against people with disabilities in obtaining and retaining employment. Under the provisions of this scheme, it is a legal offence to engage some one other than a suitable person
13
with a disability if the 3% quota within the employing organization is not met. If found guilty and convicted, an employer is liable for a maximum £100 ($145) fine, three months .imprisonment, or both. However, employers can apply to a DEA for a permit that enables them to recruit one or a number of staff without disabilities if the DEA does not have suitably qualified candidates on the Disabled Persons Register. Table 3 illustrates the figures achieved in several large Scottish public sector industries. For many, the 'registered disabled' label is perceived as an obstacle to employment and training (Outset, 1989). Evidence of this may lie in the fact that the number of people voluntarily joining the Disabled Persons Register has fallen from 936,000 in 1950 to 389,000 in 1986. Additionally, the 3% figure required by the quota scheme has remained unchanged since 1946. In 1987, the National Audit Office described the quota scheme as 'ineffective, unenforceable, and incapable of achieving its aim' (Outset, 1989). This followed an investigation by a working group set up by the Manpower Services Commission in 1985 to look at ways of increasing the effectiveness of the scheme. After a consultation process, there was no clear consensus on the future of the scheme; debate centers on whether the quota scheme should be more tightly enforced or abolished. Several large employer organizations, such as the Confederation of British Industries and the institute of Personnel Management, have argued for abolishing the scheme, whereas several organizations representing people with disabilities have argued it should be strengthened.
Table 3 Public sector quota figures
Strathclyde Regional Council All Scottish regional councils Glasgow District Council Greater Glasgow Health Board South of Scotland Electricity Board British Steel Corporation (Scottish)
Registered disabled staff
Percentage
671 1,390 152 43
0.6 0.7 1.0 0.1 0.6 0.6
Source: Employment Gazette May 1989 in Outset (1989).
20 20
J. Pratt /Work5 (1995) 11-16
14
Table 4 Benefits administered by the social work department in Scotland Invalidity Benefit (contributory) • •
Invalidity pension is awarded where a client is deemed incapable of work after 6 months of sickness. Invalidity allowance: a client is able to earn up to £42 per week and receive this benefit.
Severe Disablement Allowance •
Client has to be determined to be 80% disabled and incapable of work after 6 months of sickness.
Disability Living Allowance • •
Care component: if a client requires personal care, £12-£46 per week can be awarded to meet this expense. Mobility component: £12-£32 per week can be awarded to clients with restricted mobility
Disability Working Allowance (noncontributory) •
Can be awarded to clients who are employed but who have a disability that limits their earning capacity.
3. Benefit schemes Contributory and noncontributory benefits schemes are administered by the Department of Social Work in Scotland. Benefit allowances are made to people with disabilities who are deemed incapable of maintaining an employee role after assessment by personnel from this department. Table 4 highlights current benefit schemes. 4. Occupational therapy in work rehabilitation The National Health Service and the Department of Social Work are the largest employers of occupational therapists in Scotland. Although occupational therapy has a long tradition in several types of work rehabilitation programs, this is not a large area of current practice. Where available, programs appear largely to focus on clients with behavioral and cognitive performance deficits. Services have variously been run in mental health hospitals, outpatient, and community-based units. The focus has largely been on the habilitation, rehabilitation, and/or maintenance of work skills.
Adults with neuromotor, physiological, and sensory performance deficits have mainly been served by existing occupational therapy programs, i.e., entry into or return to work might be one goal of a general rehabilitation program for a person with an acquired or developmental medical condition. Few occupational therapy services in Britain focus exclusively on work rehabilitation for these client groups. Additionally, workhardening programs, which emphasize returning an injured worker to his or her same employment, are not yet widely available in Britain. There is, however, an increasing awareness of the potential for development in this area of practice. 5. Discussion Several changes in social and political emphasis currently being implemented offer opportunity for expansion of occupational therapy practice in the area of work rehabilitation. European countries, including Scotland, have a strong tradition in social welfare. As Britain joins its European partners in attempting to equalize living standards for European Community citizens, social policy is invariably being influenced. Safety in the workplace and access to employment opportunities are only two of many areas being assessed. Additionally, charities and independent service providers are receiving government grants to develop projects that meet a recognized need. Table 5 lists several examples of initiatives within the voluntary and private sectors delivering employment-related services to adults with special needs. The funding of the National Health Service is being reorganized, creating hospital trusts and, as such, responsible for their own financial management. Rehabilitation services within these institutions are being contracted to provide services to 'purchasers', including budget-holding general practitioners, among others. Marketing services to new purchasers will be an increasingly essential activity for occupational therapy practitioners. Private, public, and voluntary sector employers could number among future service users. Additionally, the Department of Social Security is replacing the Invalidity Benefit with an In-
15
1. Pratt /Work5 (1995) 11-16
Table 5 Examples of initiatives within the voluntary and private sectors in Scotland offering employment services for adults with special needs AgencyName Remploy Community industry
Status
Nature of service
Client group
9,000
Voluntary
Sheltered
All client
10,000
Voluntary and private
Training for nationally recognized qualification
All special needs and unemployed
Voluntary
Training Support Placement Adaptations
Visual Deficits
Voluntary
Habilitation of work skills
All client groups
No.
Royal National Institute for the Blind
REHAB
1000
Disability Resource Centre
Skill development Into work program
ENABLE (Scotland)
Strathclyde Business Development
100
Voluntary
Europe social fund grant scheme
capacities Benefit in April 1995. A number of changes are envisaged and are already occurring as a result of this. The period of benefit entitlement will be drastically reduced for a start. Also, a determination will be made on whether the applicant is fit for any type of work. Skilled and thorough functional assessment would greatly enhance this process and could be provided by occupational therapy personnel, among others. Employers within both the public and private sectors are demonstrating increasing awareness and interest in developing wellness and support services in house. Many large employers have long operated their own occupational health departments, staffed largely by physicians and nursing personnel. Previously, rehabilitation would be available only through referral to statutory services. On-site rehabilitation services could be de-
OPEN (supported employment)
All client groups
INSTEP (Integrated Supported Training Employment)
Cognitive deficits
Employment grants Job opportunities
All unemployed
veloped by personnel in practice either in trust hospitals, privately, or through direct employment by industry. One current example of the changes taking place is evidenced by an increasing number of employee assistance programs being offered to assist employees with psycho social deficits that affect their functional performance in the workplace. Finally, both international and local disability movement organizations are doing much to call attention to the lack of access for people with disabilities to the same employment opportunities as the nondisabled. This issue is closely linked to a demand for greater human rights, a rejection of medical and charity models of disability, and towards the embracement of a social model (Oliver, 1980). Employment services that both alleviate barriers and create opportunity will empower citi-
16
J. Pratt / Work 5 (1995) 11-16
zens with disabilities to achieve a higher quality of life through engagement in productive, remunerable activities. 6. Conclusion Employment services for people with disabilities in Scotland continue to evolve in response to economic, social, and political trends. Occupational therapy is one profession that could contribute to current work rehabilitation services as well as influence the nature and development of future services. To achieve this, occupational therapy practitioners will need to build links with new, nontraditional employers in the public, private, and voluntary sectors, because it is these areas that government policy supports as the emerging purchasers and providers of our skills. 7. Appendix Additional publications available
Department of Employment publications Ability Development Center, Adaptations to Premises and Equipment, April 1993. Advice on Joining the Disabled Persons Register, 1988. Employing People with Disabilities, October 1992. Job Club, December 1990. Make it Work, June 1993. PACT (Placement, Assessment, Counselling and Training) May 1992. Personal Reader Service, January 1991. Special Aids to Employment, April 1993. The Job Introduction Scheme, 1986. Travel to Work Grants, March 1993. Working at Home with Technology, March 1993. Department of Social Services publications Disability Living Allowance Non-contributory Benefits for Disabled People, December 1992.
Sick or Disabled? April 1994. Which Benefit? October 1993. General publications Careers Service, Strathclyde Education, 1993. Community Industry, Community Industry, Motherwell. ENABLE, ENABLE, Glasgow, 1993. Erskine Hospital Workshops, Erskine Hospital. Iriterwork, Remploy. Mainstream Training, Dykebar Hospital, 1993. Project Info, pisability Resource Center, Paisley, Oct. 1993. Renfrewshire Employment Liaison Initiative (RELI), Strathclyde Business Development, 1993. Who are we? Remploy. Acknowledgements The assistance of Kris in gels, PACT team, Department of Employment, Glasgow South and Renfrewshire, and Vincent McKay, Division of Occupational Therapy, Glasgow Caledonian University, in the preparation of this article is acknowledged with gratitude. References Christiansen, C. and Baum, C. (1991) Occupational Therapy: Overcoming Human Performance Deficits, Slack, New Jersey. Hopkins, H. and Smith, H. (Eds.), (1989) Willard and Spackmon's Occupational Therapy, 5th Edition. Lippincott, Toronto. Morrison, M.H. (1993) Rehabilitation and return to work: Do Other Countries Succeed? Work 3, 48-54. Office of Population Censuses and Surveys in Outset. (1989) Disabilities: Training and Employment Issues, a Resource Guide. Local Government Training Board and Outset. Oliver, M. (1990) The Politics of Disability, McMillan, London. Outset. (1989) Disabilities: Training and Employment Issues, a Resource Guide. Local Government Training, Board and Outset.
ELSEVIER
Work 5 (1995) 11-16
Access to work Employment services for people with disabilities in Scotland Joanne Pratt Division of Occupational Therapy, Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow G131PP, Scotland, UK Accepted 15 June 1994
Abstract Employment services, including work rehabilitation, for people with disabilities have traditionally been delivered through the voluntary and public sectors in Scotland. The three main statutory agencies are the Department of Employment, the National Health Service, and the Social Work Department. Although occupational therapy is an established component of work rehabilitation programs in several countries (e.g., the United States, Canada, and Australia), it is a comparatively small area of practice in Scotland. However, recent changes in health and social service development, proposed changes to government benefits schemes, as well as health and safety legislation are among the factors that will influence the continued development and expansion of employment services. As such, occupational therapy practitioners will need to look to the public, private, and voluntary sectors as potential new purchasers and employers to bring their skills to this area of professional practice. Keywords: Employment services; Occupational therapy; Scotland
1. Introduction An individual's capacity to engage in work, i.e., purposeful and productive employment activities, can be disrupted at any point by sensory, cognitive, physiological, neuromotor, or behavioral performance deficits. These deficits may be present from birth, acquired through trauma or illness, or due to environmental factors. People who develop or acquire such performance deficits may require special services if they are to gain access
to and/or maintain their participation in work activities. Social, political, economic, and cultural factors invariably influence the nature and scope of opportunities for people who require services in any community. This article examines those particular factors in Scotland that define current employment services and those issues that shape the provision of these services. Scottish industrial history mirrors that of other developed European nations that have evolved
1051-9815/95/$09.50 © 1995 Elsevier Science Ireland Ltd. All rights reserved.
SSDII051-9815(95)OOI01-C
12
1. Pratt /Work5 (1995) 11-16
from economies and lifestyles largely based on agriculture in the last century, industrialization at the beginning of this century, and technologybased industry mid-century, to the present marked-led economy of the European Community. Currently, the following industries are among Scotland's largest: the government, through local authority, health, and social services; electronics, technology, and oil industries. 2. Statutory services
Scotland has a population of 5.5 million. The estimate of disability among adults in private house-holds is 13.1% (Office of Population Censuses and Surveys, 1988) which is slightly lower than the national (United Kingdom) figure of 13.5% Government policy toward inclusion of people with disabilities in employment is based on legislation that resulted from the Tomlinson Committee Report. The resulting pieces of legislation are known as the Disabled Persons (Employment) Acts, 1944 and 1958. The 1944 Act was drafted largely in response to the pressing social need to accommodate veterans with disabilities returning from World War II. The Act provides legislative support for assessment, rehabilitation, and retraining of people with disabilities, as well as for the provision of sheltered employment. The Act also established a quota scheme, which mandates that where a work force numbers 20 employees, the number of those with disabilities should reach 3% of that work force. To monitor this provision, people with disabilities are requested to voluntarily include their names on the Disabled Persons Register, which is maintained at local job centers. The job centers provide more general services to all unemployed people. There is debate on the efficacy of the quota scheme; this will be discussed further on. The Department of Employment has responsibility to administer and deliver the support services provided for by legislation. Placement, assessment, counselling training teams (PACTs) were established in January 1993 to fulfil this
Table 1 Employment services for adults with special needs provided by the department of employment Service
Population
Employment advice Special aids/equipment Personal reader service Adaptations to premises Employer awareness training Disabled Persons Register (voluntary) Travel to work grants Working at home information Job club Job introduction scheme Job center (placement) Pact DEAservice Ability development center (training)
All unemployed people with disabilities
responsibility. Eleven teams have been created to serve Scotland. Various personnel, including occupational psychologists, technicians, and disability employment advisers (DEAs) assist people with disabilities to enter and/or retain employment. Table 1 outlines employment services for people with disabilities available through job centers. Table 2 shows several outcome measures of PACT services for the period January-March, 1993, which was the first quarter following the establishment of these teams. The data presented should be considered in view of the fact that
Table 2 PACT teach outcomes for January-March 1993
-----_._._-----_._----Employment Service (PACT) Outcomes
Percentage
Returned to mainstream employment Found new mainstream employment Sheltered employment Self-employed Referred to other services Remain unemployed Inappropriate referrals
10 10
5 1 34 40 30
Area covered includes Glasgow, Dumbarten, and Renfrew.
1. Pratt / Work 5 (1995) 11-16
there were 800 clients serviced by PACTs in their inaugural 3 months of operation. Whether this level of service use, as well as the nature of clients' needs remains the same will only be determined by comparison with continued data analysis. Two other distinct and separately funded branches of government; the National Health Service and the Department of Social Work, provide work rehabilitation programs. Services are provided through various facilities, which include occupational and physiotherapy departments, industrial rehabilitation units, adult training centers, and sheltered workshops. It is largely the case that the clients served by these programs, where available, are mainly seeking entry into employment for the first time or following recovery from conditions that have greatly altered their functional status. Communication between these three branches of government varies by region but is largely carried out by direct client referral from one service to another. DEAs offer a human link between service providers and follow a client's progress through assessment, rehabilitation, placement, and maintenance in employment. Typically, the current range and depth of employment services for people with disabilities has both strengths and weaknesses. Major criticism is directed toward the quota scheme. The original objective of this service was to overcome discrimination against people with disabilities in obtaining and retaining employment. Under the provisions of this scheme, it is a legal offence to engage some one other than a suitable person
13
with a disability if the 3% quota within the employing organization is not met. If found guilty and convicted, an employer is liable for a maximum £100 ($145) fine, three months .imprisonment, or both. However, employers can apply to a DEA for a permit that enables them to recruit one or a number of staff without disabilities if the DEA does not have suitably qualified candidates on the Disabled Persons Register. Table 3 illustrates the figures achieved in several large Scottish public sector industries. For many, the 'registered disabled' label is perceived as an obstacle to employment and training (Outset, 1989). Evidence of this may lie in the fact that the number of people voluntarily joining the Disabled Persons Register has fallen from 936,000 in 1950 to 389,000 in 1986. Additionally, the 3% figure required by the quota scheme has remained unchanged since 1946. In 1987, the National Audit Office described the quota scheme as 'ineffective, unenforceable, and incapable of achieving its aim' (Outset, 1989). This followed an investigation by a working group set up by the Manpower Services Commission in 1985 to look at ways of increasing the effectiveness of the scheme. After a consultation process, there was no clear consensus on the future of the scheme; debate centers on whether the quota scheme should be more tightly enforced or abolished. Several large employer organizations, such as the Confederation of British Industries and the institute of Personnel Management, have argued for abolishing the scheme, whereas several organizations representing people with disabilities have argued it should be strengthened.
Table 3 Public sector quota figures
Strathclyde Regional Council All Scottish regional councils Glasgow District Council Greater Glasgow Health Board South of Scotland Electricity Board British Steel Corporation (Scottish)
Registered disabled staff
Percentage
671 1,390 152 43
0.6 0.7 1.0 0.1 0.6 0.6
Source: Employment Gazette May 1989 in Outset (1989).
20 20
J. Pratt /Work5 (1995) 11-16
14
Table 4 Benefits administered by the social work department in Scotland Invalidity Benefit (contributory) • •
Invalidity pension is awarded where a client is deemed incapable of work after 6 months of sickness. Invalidity allowance: a client is able to earn up to £42 per week and receive this benefit.
Severe Disablement Allowance •
Client has to be determined to be 80% disabled and incapable of work after 6 months of sickness.
Disability Living Allowance • •
Care component: if a client requires personal care, £12-£46 per week can be awarded to meet this expense. Mobility component: £12-£32 per week can be awarded to clients with restricted mobility
Disability Working Allowance (noncontributory) •
Can be awarded to clients who are employed but who have a disability that limits their earning capacity.
3. Benefit schemes Contributory and noncontributory benefits schemes are administered by the Department of Social Work in Scotland. Benefit allowances are made to people with disabilities who are deemed incapable of maintaining an employee role after assessment by personnel from this department. Table 4 highlights current benefit schemes. 4. Occupational therapy in work rehabilitation The National Health Service and the Department of Social Work are the largest employers of occupational therapists in Scotland. Although occupational therapy has a long tradition in several types of work rehabilitation programs, this is not a large area of current practice. Where available, programs appear largely to focus on clients with behavioral and cognitive performance deficits. Services have variously been run in mental health hospitals, outpatient, and community-based units. The focus has largely been on the habilitation, rehabilitation, and/or maintenance of work skills.
Adults with neuromotor, physiological, and sensory performance deficits have mainly been served by existing occupational therapy programs, i.e., entry into or return to work might be one goal of a general rehabilitation program for a person with an acquired or developmental medical condition. Few occupational therapy services in Britain focus exclusively on work rehabilitation for these client groups. Additionally, workhardening programs, which emphasize returning an injured worker to his or her same employment, are not yet widely available in Britain. There is, however, an increasing awareness of the potential for development in this area of practice. 5. Discussion Several changes in social and political emphasis currently being implemented offer opportunity for expansion of occupational therapy practice in the area of work rehabilitation. European countries, including Scotland, have a strong tradition in social welfare. As Britain joins its European partners in attempting to equalize living standards for European Community citizens, social policy is invariably being influenced. Safety in the workplace and access to employment opportunities are only two of many areas being assessed. Additionally, charities and independent service providers are receiving government grants to develop projects that meet a recognized need. Table 5 lists several examples of initiatives within the voluntary and private sectors delivering employment-related services to adults with special needs. The funding of the National Health Service is being reorganized, creating hospital trusts and, as such, responsible for their own financial management. Rehabilitation services within these institutions are being contracted to provide services to 'purchasers', including budget-holding general practitioners, among others. Marketing services to new purchasers will be an increasingly essential activity for occupational therapy practitioners. Private, public, and voluntary sector employers could number among future service users. Additionally, the Department of Social Security is replacing the Invalidity Benefit with an In-
15
1. Pratt /Work5 (1995) 11-16
Table 5 Examples of initiatives within the voluntary and private sectors in Scotland offering employment services for adults with special needs AgencyName Remploy Community industry
Status
Nature of service
Client group
9,000
Voluntary
Sheltered
All client
10,000
Voluntary and private
Training for nationally recognized qualification
All special needs and unemployed
Voluntary
Training Support Placement Adaptations
Visual Deficits
Voluntary
Habilitation of work skills
All client groups
No.
Royal National Institute for the Blind
REHAB
1000
Disability Resource Centre
Skill development Into work program
ENABLE (Scotland)
Strathclyde Business Development
100
Voluntary
Europe social fund grant scheme
capacities Benefit in April 1995. A number of changes are envisaged and are already occurring as a result of this. The period of benefit entitlement will be drastically reduced for a start. Also, a determination will be made on whether the applicant is fit for any type of work. Skilled and thorough functional assessment would greatly enhance this process and could be provided by occupational therapy personnel, among others. Employers within both the public and private sectors are demonstrating increasing awareness and interest in developing wellness and support services in house. Many large employers have long operated their own occupational health departments, staffed largely by physicians and nursing personnel. Previously, rehabilitation would be available only through referral to statutory services. On-site rehabilitation services could be de-
OPEN (supported employment)
All client groups
INSTEP (Integrated Supported Training Employment)
Cognitive deficits
Employment grants Job opportunities
All unemployed
veloped by personnel in practice either in trust hospitals, privately, or through direct employment by industry. One current example of the changes taking place is evidenced by an increasing number of employee assistance programs being offered to assist employees with psycho social deficits that affect their functional performance in the workplace. Finally, both international and local disability movement organizations are doing much to call attention to the lack of access for people with disabilities to the same employment opportunities as the nondisabled. This issue is closely linked to a demand for greater human rights, a rejection of medical and charity models of disability, and towards the embracement of a social model (Oliver, 1980). Employment services that both alleviate barriers and create opportunity will empower citi-
16
J. Pratt / Work 5 (1995) 11-16
zens with disabilities to achieve a higher quality of life through engagement in productive, remunerable activities. 6. Conclusion Employment services for people with disabilities in Scotland continue to evolve in response to economic, social, and political trends. Occupational therapy is one profession that could contribute to current work rehabilitation services as well as influence the nature and development of future services. To achieve this, occupational therapy practitioners will need to build links with new, nontraditional employers in the public, private, and voluntary sectors, because it is these areas that government policy supports as the emerging purchasers and providers of our skills. 7. Appendix Additional publications available
Department of Employment publications Ability Development Center, Adaptations to Premises and Equipment, April 1993. Advice on Joining the Disabled Persons Register, 1988. Employing People with Disabilities, October 1992. Job Club, December 1990. Make it Work, June 1993. PACT (Placement, Assessment, Counselling and Training) May 1992. Personal Reader Service, January 1991. Special Aids to Employment, April 1993. The Job Introduction Scheme, 1986. Travel to Work Grants, March 1993. Working at Home with Technology, March 1993. Department of Social Services publications Disability Living Allowance Non-contributory Benefits for Disabled People, December 1992.
Sick or Disabled? April 1994. Which Benefit? October 1993. General publications Careers Service, Strathclyde Education, 1993. Community Industry, Community Industry, Motherwell. ENABLE, ENABLE, Glasgow, 1993. Erskine Hospital Workshops, Erskine Hospital. Iriterwork, Remploy. Mainstream Training, Dykebar Hospital, 1993. Project Info, pisability Resource Center, Paisley, Oct. 1993. Renfrewshire Employment Liaison Initiative (RELI), Strathclyde Business Development, 1993. Who are we? Remploy. Acknowledgements The assistance of Kris in gels, PACT team, Department of Employment, Glasgow South and Renfrewshire, and Vincent McKay, Division of Occupational Therapy, Glasgow Caledonian University, in the preparation of this article is acknowledged with gratitude. References Christiansen, C. and Baum, C. (1991) Occupational Therapy: Overcoming Human Performance Deficits, Slack, New Jersey. Hopkins, H. and Smith, H. (Eds.), (1989) Willard and Spackmon's Occupational Therapy, 5th Edition. Lippincott, Toronto. Morrison, M.H. (1993) Rehabilitation and return to work: Do Other Countries Succeed? Work 3, 48-54. Office of Population Censuses and Surveys in Outset. (1989) Disabilities: Training and Employment Issues, a Resource Guide. Local Government Training Board and Outset. Oliver, M. (1990) The Politics of Disability, McMillan, London. Outset. (1989) Disabilities: Training and Employment Issues, a Resource Guide. Local Government Training, Board and Outset.
