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In this presentation Mr Bengt Westerberg, former Swedish Minister of Social Affairs 1991-1994 and leader of the Liberal Party (Folkpartiet), describes the Swedish Act concerning Support and Service for Persons with Certain Functional Impairments (LSS), puts it in context with other Swedish legislation, and reflects on its societal costs and benefits. The reform utilizes direct payments for freedom of choice, self-determination and personal responsibility and, in this way, differs from traditional Swedish welfare politics where state agencies typically combine the functions of needs assessment, financing, quality control and service provision. Mr Westerberg, who credits the Swedish Independent Living movement for introducing the concept of direct payments for personal assistance to Sweden, succeeded in getting the legislation approved by Parliament during the country's deep economic crisis at the beginning of the 1990's. In Sweden, his personal pride in the legislation he authored is well-known. 

This is a translation of the original article in swedish.

Against the backdrop of the impact of the current economic crisis on persons who depend on practical assistance by other persons with the activities of daily living the author outlines arguments for direct payments for Personmal Assistance services. These services are demand driven, superior in quality and cost-efficiiency to supply driven services such as residential institutions and support the United Nations Convention Article 19 "living independently and being included in the community".

Direct Payments for Personal Assistance make demand-driven services possible that promote freedom of choice and quality. Supply-driven services, on the other hand, are often monopolistic in-kind services that force users to adapt their lives to the needs of the service provider. The Swedish Personal Assistance Act of 1994 is an example of a Direct Payments policy. Its outcome is discussed as well as its implications for the national economy in times of economic crisis.

United Nations Human Rights, Office of the High Commissioner, Europe Regional Office convened a meeting in Brussels on May 7 2012 "CRPD and EU Structural Funds: The way ahead for Independent Living" to raise awareness about the violation of CRPD Article 19 "Living independently and being included in the community" by using EU Structural Funds for the construction and maintenance of residential institutions. The paper shows how demand-driven direct payments for Personal Assistance services, not only achieve far superior quality of services than residential institutions resulting in higher quality of life for service users at lower costs but also affect a country's economy more favorably. Thus, violating Article 19 of the CRPD is not only illegal but also wasteful in terms of human and monetary capital.

What are the important features of a national policy on personal assistance that is to promote "living independently and being included in the community" "with choices equal to others" and to enable persons with disabilities to fulfill their duties and to enjoy their rights as citizens? The presentation identifies the elements of the Swedish Personal Assistance Act of 1994 that have contributed most to the outcome of this widely acclaimed legislation.

This article introduces blind and sighted men and women who developed education and employment for blind people in China and in India from the 1830s onward, and whose pioneering efforts have disappeared from later accounts of blind people's history. This revised and much extended online version is published in April 2011: www.independentliving.org/docs7/miles201104.html and www.independentliving.org/docs7/miles201104.pdf

Presentation at National Conference, Commission for Equal Rights of Persons with Disabilities, Beer Sheba, Israel, December 1 2010

Given the increasing number of older persons relative to the working age population, record level taxes and baby boomers’ demands for self-determination and quality of life, which changes might the Scandinavian welfare model have to undergo in order to deliver long term care to all who need it? In Sweden, direct payments for personal assistance are paid to mainly younger persons with extensive disabilities. In terms of perceived quality and cost per hour of service, direct payments have been found to be more efficient than traditional local government services. But would this favorable experience hold for all persons in need of assistance with the activities of daily living – regardless of age, diagnosis and minimum needs? What would be such a policy’s cost and effects on the labor market? How could it be financed? Would it threaten younger disabled persons’ relative favorable present situation? Today’s Swedish policy of cash payments for the purchase of personal assistance services might be of interest as a long term care solution for tomorrow’s older persons.

Adolf Ratzka, Independent Living Institute, presented at the Second International Conference on Personal Responsibility on the Way to Social Change organized by Jerusalem Center for Independent Living December 2, 2010

[This article cites and quotes historical materials first collected in: M. Miles (1996) Pakistan's microcephalic chuas of Shah Daulah: cursed, clamped or cherished? History of Psychiatry 7: 571-589, from Taylor & Francis, www.tandf.co.uk/] Evidence on microcephalic children (chuas) at the shrine, and how some of them developed a capacity for independent living. Internet publication URL: http://www.independentliving.org/miles201005.html