A/HRC/43/41/Add.3
disabilities, either directly or indirectly through third-party providers. Such benefits and
services, which include housing, loan schemes, residential support, in-home support,
personal assistance and other community services to support independent living, are
regulated in the Health and Care Service Act, the Labour and Welfare Administration Act
and the Patients’ and Users’ Rights Act. The latter grants persons aged less than 67 who
have a substantial, long-term need for assistance the right to receive user-controlled
personal assistance. That right also includes respite care for parents of children with severe
disabilities living at home.
56.
While welcoming these positive initiatives, the Special Rapporteur noted significant
gaps in the provision of such services, whereby municipalities have discretionary power in
deciding the types and amount of services and benefits to be provided. For instance,
persons with disabilities expressed concern that some municipalities granted an insufficient
number of hours of user-controlled personal assistance and limited the scope of its use to
basic needs. Because some municipalities provide very few options to those in need of
support, often coupled with long waiting times to access services, some persons with
disabilities decide to move another jurisdiction to gain access to better quality support.
Others opt to file a complaint to access the rights and benefits they are entitled to, which
could take a long time, even years, before the final decision is taken, while others take no
action for fear of losing other entitlements. In its 2018 report, the Health and Social
Services Ombudsman notes a 14 per cent increase in complaints concerning user-controlled
personal assistance between 2017 and 2018, which includes both applications that were
denied and the allocation of fewer hours than the person in question believed were
warranted.14
57.
The fragmentation of support services also makes it very difficult for persons with
disabilities with lower levels of education and economic resources to navigate the system,
understand their entitlements and how to access them, and claim their rights; while those
who are more educated and better off financially face fewer challenges in that regard.
58.
According to data provided by the Ministry of Health, in 2018 there were 66,046
persons living in institutions where health-care services were provided. There were 41,791
persons living in nursing homes (mostly older persons with dementia) and 24,255 in
residential care homes, including persons with intellectual, psychosocial and severe
physical disabilities. The Special Rapporteur is particularly concerned that an increasing
number of persons with intellectual disabilities live in compounds or group homes
exclusively for persons with disabilities, with common areas and facilities for daily
activities. Often these are former institutions of varying sizes converted into single
apartments, or new buildings especially designed to host persons with disabilities with
high-support needs, with staff on duty 24 hours a day seven days a week. In other
municipalities, the reception of services is conditional on living in a specific setting or
facility, thus denying persons with disabilities the right to choose where to live.
59.
The Child Welfare Act states that children and youth who live in conditions that
may be detrimental to their health and development should receive the necessary assistance,
care and protection in a timely way. As a measure of last resort, that can include the
placement of a child in institutional care. In January 2019, there were 419 child welfare
facilities in Norway (excluding Oslo) hosting some 1,154 children. The number of children
with disabilities among them is unknown. The Directorate for Children, Youth and Family
Affairs stated that two new childcare institutions with a total capacity of 12 children were
being built to meet the needs of children with disabilities in need of health-care services and
long-term out-of-home care.
60.
The Special Rapporteur urges the Government to take immediate measures to
address this trend that could lead to the reinstitutionalization of persons with disabilities and,
in coordination with all municipalities and county governors, implement supported housing
programmes that ensure the right of all persons with disabilities to live independently in the
community with choices equal to others. In relation to children with disabilities, efforts
14
12
The Health and Social Services Ombudsmen, annual report 2018, p. 10.
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