What you do about disability depends very much on what you think causes disability. If a wheelchair user can’t get on a bus you might think this is because of their impairment. You might therefore think the answer is to cure or treat the person’s impairment. Or you might think it’s because the bus isn’t designed so wheelchair users can get on it. If so, the answer is to redesign the bus so they can. One response is fix the person. The other is fix the bus!
The social model was developed by disabled people and it is supported by organisations led by disabled people. It says disability is caused by barriers that arise because society (including buses!) is not designed to accommodate people who have impairments. It is these barriers that disable people who have impairments. They stop us from being included in society and participating on an equal basis. If these barriers are removed, a person may still have an impairment but would not experience disability.
So, what are these barriers? They include:
We are disabled by other people’s fear, ignorance, low expectations and assumption that they know best what we want and need and sometimes by their hatred and contempt.
We are disabled when we cannot get into shops, public buildings, workplaces, museums, restaurants and other buildings because of how they are designed. They may not have ramps, lifts or accessible toilets. There may be no loop system or poor signage that people with visual impairments can’t see. Outside, pavement kerbs may not be dropped, there is no textured pavement at crossing and no noise to let people with visual impairments know when to cross.
We can be excluded by the way things are organised, like meetings, events, or services. For example, not enough time is allowed for appointments, or to get meeting papers translated into Braille, or the event starts too early for people who need support to get up in the morning and have to arrange accessible transport to be able to arrive in time.
These can arise when print is too small, materials are not produced in plain English or Easy Read, or there are no sign language interpreters. Images of disabled people show us as tragic victims and heroic survivors, rather than just normal people trying to get on with our lives.
None of these barriers are inevitable, so neither is our exclusion.
The Medical Model says disability is caused by impairments that need to be treated, managed or cured.
It is the individual person who has the impairment who needs to be changed, not society. Disabled people become passive recipients of services and medical professionals take control over our lives.
Of course this is not to say people who have impairments never need healthcare services. But unless social model barriers are identified and removed throughout society, we will continue to be disabled. And unless such barriers are removed from the way healthcare is delivered, far from addressing disability, healthcare services will only disable us even more.