As one who respects the over 25 years movement towards improving of disabled people's welfare system and activities to which devoted by people gathering this symposium, I cannot only stay applauding such efforts but here I want to point some subjects, which are derived from the above-mentioned achievements, to be discussed how to deal with.
◆①a: Present situation is more or less improving from the past one where quantitative shortage of service was most prior problem.
→ b: Subject has arisen how to assess the suitable amount of service for each person.
②a: Share of resource is relatively and gradually shifting to the welfare service field from the medical care field.
→ b: Medical side steps into the welfare service field. Qualified professions in welfare service were born and will increase.
①a and ②a are both welcomed. But ①b and ②b will bring a new problem of③.
And ①b②b→③: Qualified professions of medical care and welfare service will want to take initiative in the assessment of necessary care amount and content. Therefore the subject is care assessment, care management, care manager, and "community care" which is a half of this branch meeting's title.
How to handle these subjects becomes a new problem.
◆ ③a: Leaving the old era where opinions of disabled people were completely ignored, we are in a new era where their opinions are recognized that they have meaning and power. Some parts of them are "services provided by disabled people" which is a half of this branch meeting's title.
But
b: In a fact, it is difficult to frame a new system as it is, or put it into a previous system. The actual subject is how to balance the new system and the previous system.
&c: Even a same disabled person has different standing point and merit/demerit depending on when he is on the side of service provider, or when he is on the side of service user. Services provided by disabled people are not necessarily good for service users with disability.
Considering above①②③, what kind of system will be the best? In disabled people's movement they have criticized that disabled people themselves do not have right to decide use of budget for institutions. Situation is the same for the case of services in home. (Like the movement for consumer-control registration helper system, etc.). Therefore, from the viewpoint of user, the current system where a tax flows into organizations cannot be fully agreed even the organization is run by disabled people. On the other hand, from the viewpoint of service provider , government support to the organization is at this moment necessary.
What is the solution? It is a good example to study the case of municipal project supporting disabled people's living.
※For the theme of ◆①, some plans are proposed in following papers:
◇ Tateiwa,S. 1998 "How should we manage to go on without repeating the same failure as England", Kikan Fukushi Rodo,79:12-22(a special number featuring articles: "What's the care management")
◇ Care Management Research Committee of Human-care Association 1988 "Community based care system proposed by disabled people themselves -Disabled people's challenge to the community care in England", Human-care Association･Japan Foundation, 131p.
Home Page for information of various systems and so on:
◇"Life, Human, Society", 1996～ http://ehrlich.shinshu-u.ac.jp/tateiwa/1.htm（Japanese） http://ehrlich.shinshu-u.ac.jp/tateiwa/index.htm（English）