C Explanatory memorandum by Ms Liliana Tanguy,
rapporteur for opinion
1 Introduction
1. I wish to congratulate Ms Reina
de Bruijn-Wezeman (Netherlands, ALDE) for her report on behalf of
the Committee on Social Affairs, Health and Sustainable Development.
It underlines once again the importance of the approach to disability
based on full respect for human rights that is at the heart of the
international instrument of reference in this field, namely the
United Nations Convention on the Rights of Persons with Disabilities
(CRPD).
Note
2. The principles of inclusion and protection of the rights of
persons with disabilities upheld by the CRPD have been of primary
importance in the texts adopted by the Parliamentary Assembly over
many years. In its
Resolution 2039
(2015) “Equality and inclusion for people with disabilities”,
the Assembly already called on member States to “give consideration
to alternatives to care in institutions, taking account of the choices
of people with disabilities”.
Note
3. The present report – which I invite our committee to support
in full – is in line with this framework. It follows on from
Resolution 2291 (2019) and
Recommendation
2158 (2019) “Ending coercion in mental health: the need for a human
rights-based approach”, unanimously adopted by the Assembly on 26 June
2019 on the basis of a report also prepared by Ms de Bruijn-Wezeman
on behalf of the Committee on Social Affairs, Health and Sustainable
Development and which the Committee on Equality and Non-Discrimination,
to which the report was referred for opinion, supported without
reservation.
4. The brief comments which follow aim simply to develop two
aspects of the present report of Ms de Bruijn-Wezeman, namely to
ensure a satisfactory alternative to deinstitutionalisation and
to underscore the importance of combating the stereotypes about
and prejudice against persons with disabilities that continue to exist.
2 Ensuring a satisfactory
alternative to the deinstitutionalisation of persons with disabilities
5. The report of Ms de Bruijn-Wezeman
clearly shows that systematic institutionalisation of persons with disabilities
constitutes a broad-scale violation of the fundamental rights protected
under international law and by the Council of Europe. Il also notes
that the progress achieved by Council of Europe member States towards ensuring
good implementation of the process of deinstitutionalisation is
uneven.
6. The alarming assessment of the institutionalisation of persons
with disabilities and the grave violations of human rights that
it entails in some Council of Europe member States require a thorough
review of policies with respect to persons with disabilities. However,
the wide variety of forms of institutions for persons with disabilities
in Council of Europe member States should also be noted, as well
as the varying extents to which they have evolved and been modernised.
Although additional efforts are expected, several member States
of the Council of Europe provide institutions that fully respect
fundamental rights and that constitute satisfactory places of permanent
or temporary residence and that allow persons with disabilities,
close carers and medico-social staff to work together.
7. It remains the case that institutionalisation of persons with
disabilities can only constitute a measure of last resort and must
be decided by the person with a disability themselves when they
are fully able to do so. Therefore, without prejudice to the need
to develop strategies for deinstitutionalisation and to combat the “culture
of institutionalisation”, where no other satisfactory solution exists,
the last resort of institutions that fully respect fundamental rights
must be maintained in order to avoid placing persons with disabilities
in a situation of isolation and exhausting carers.
8. The report notes that the process of deinstitutionalisation
requires twin financing in so far as it can only be realised if
the situation guarantees the full inclusion in society of persons
with disabilities. Therefore, for persons whose disability does
not require constant medical care, the implementation of the process
of deinstitutionalisation must be accompanied by a guarantee that
all public services will be accessible and that there are local
support structures. To respond to the problems of isolation and
solitude of persons with disabilities, such local structures must
be sufficient in number and efficient and must guarantee appropriate and
satisfactory support. In addition, the process of deinstitutionalisation
must not have as its sole objective reducing the financing allocated
to persons with disabilities.
3 Overcoming stereotypes
and prejudice
9. The CRPD, which is the fruit
of a process that lasted several decades and of the strong mobilisation
of organisations promoting the rights of persons with disabilities,
Note marks
a paradigm shift: instead of seeing disability almost exclusively
through the prism of health and social security, it underlines that
it is the obstacles encountered that create a situation of disability.
Note In
so doing, it incites our societies to remove these barriers and
places the emphasis on inclusion and the full enjoyment of human
rights by persons with disabilities.
10. Ms de Bruijn-Wezeman’s report clearly shows that institutionalisation
can deprive persons with disabilities of their autonomy – contrary
to Article 19 of the CRPD –, and that institutionalisation leads
to worse outcomes in terms of quality of life, as it hinders both
the implementation of an individualised approach and inclusion in
society. Once decided – often without the consent of the person
concerned, violating the right to integrity and to liberty – such
situations can last for a lifetime.
Note
11. These practices can be explained by the persistence of stigmatisation
and prejudice against persons with disabilities. They are the result
of erroneous stereotypes that are very widespread in our societies
and that continue to influence not only individual behaviour towards
persons with disabilities but also laws and public policy with respect
to them.
12. Yet, as disability rights movements have been emphasising
for the last 50 years, contrary to what many believe, “the real
problem is the failure of society to eliminate barriers, provide
the required support and embrace the disability experience as part
of human diversity”.
Note This problem
is further aggravated by the imbalance between the voices of persons
with disabilities and those of other stakeholders as well as by
the refusal to take into account the lived experience of persons
with disabilities.
13. To guarantee effectively the rights of persons with disabilities
and combat discrimination against them, it is urgent to overcome
stereotypes and to continue raising the awareness of all sectors
of government and society to the need to eliminate negative attitudes
and pejorative stereotypes linked to disability.
Note
14. To this end, Article 8 of the CRPD already calls on States
to work actively to raise awareness throughout society as to the
dignity and rights of persons with disabilities. States are for
example invited to run campaigns aiming to promote positive perceptions
of persons with disabilities within society, as well as recognition
of their skills. They are invited to take action to achieve this
through the education system and training, and to encourage the
media to portray persons with disabilities in a manner consistent
with the purpose of the CRPD which is, according to Article 1, “to
promote, protect and ensure the full and equal enjoyment of all
human rights and fundamental freedoms by all persons with disabilities,
and to promote respect for their inherent dignity”.
15. Strategies aiming to combat actively the persistent stereotypes
and prejudices against persons with disabilities will be indispensable
to carry out deinstitutionalisation successfully and promote inclusion.
This is why I consider it important to include a recommendation
to this end in the draft resolution submitted to the Assembly for
debate.
4 Concluding remarks
16. As Ms de Bruijn-Wezeman rightly
pointed out during her exchange of views with our committee on 11 March
2022, disability can affect every one of us.
17. Deinstitutionalisation of persons with disabilities constitutes
an essential element of the effective implementation of the CRPD,
and notably of its Article 19 on living independently and being
included in the community. Alternatives to placement in institutions
exist and are being implemented with excellent results in some of
our member States, such as the Netherlands and Iceland, as was also
underlined during our meeting on 11 March 2022. The development
of such alternatives as well as effective awareness-raising in society
are needed for the process of deinstitutionalisation to be successfully
implemented and to guarantee the inclusion of persons with disabilities
in society.
18. While having recourse, as a last resort, to institutions for
persons with disabilities must be avoided, some member States are
implementing good practices by developing specialised institutions
that fully integrate persons with disabilities and involve close
carers and medico-social staff. For member States that so wish and where
it represents the most satisfactory solution, placement in institutions
that fully respect fundamental rights must be defended without prejudice
to investments in deinstitutionalisation.
19. It is time to guarantee full access of persons with disabilities
to their rights. Ms de Bruijn-Wezeman’s report proposes a way forward
as regards deinstitutionalisation. I invite the committee to support
the report fully, and to strengthen it by proposing one amendment
to the draft resolution, aiming to contribute, through public awareness-raising
campaigns, to overcoming stereotypes and prejudice against persons
with disabilities.
