Key points

If disability in France remains difficult to quantify, it is certain that current centers for disability services as well as everyday accessibility remain insufficient.

To improve this situation, the government has decided not only to act in favor of the inclusion of people with disabilities, but also to support and rehabilitate their caregivers.

The reforms already undertaken aim to improve the integration of these populations and to facilitate their daily lives, be it through the development of inclusive housing, adapted schooling or by promoting their reintegration into the workforce.

If the reforms are a step in the right direction, their results will only be visible in the long term. It thus requires to set up, in the short term, tools to evaluate the impact of these public policies.

Key figures

Disability in France remains difficult to measure: indeed, it seems almost impossible to estimate the precise number of people with disabilities given the variety of degrees of disability and the lack of clarity surrounding this topic.

For example, the joint organization of pension and benefits institutions (ORCIP) estimates the number of disabled people to be around 12 million in France, including 1.5 million with visual impairment and 850,000 with reduced mobility. While 15,000 children are born with disabilities every year (about 2% of all births), the vast majority of people with disabilities (85%) become so after the age of 15. 878,000 people with disabilities benefit from administrative recognition of their disability and are employed, yet among those with administrative recognition of their disability, 18% were unemployed in 2015 (Ministry of Health and Solidarity, 2016).

In 2016, the Ministry of Health and Solidarity reported more than 330,000 children with disabilities attending school in 2014, among whom 85% were in regular schools.

Over 1 million adults were beneficiaries, as of 31 December 2013, of the disabled adult allowance (AAH).

Key dates

25 july 2017

Presentation of a roadmap on disability

july 2017

20 march 2018

Presentation of ways of improving the hiring and continued employment of people with disabilities and their caregivers

march 2018

Campaign promises

Disability, which was one of Emmanuel Macron’s program’s key themes, is now treated as one of the term’s priorities, which is the sign of a strong political will exceeding mere budgetary considerations.
Candidate Macron’s disability program focused on 3 topics:
  • Support for all: by proposing alternatives to placement in disability centers (their number of places for adults remains limited to 350,000) or by offering real support to caregivers. Emmanuel Macron also spoke about the implementation of a global support plan (PAG) designed to offer support tailored to individual’s needs.
  • Inclusion: candidate Macron’s ambition was to increase the participation of people with disabilities in social life:
    • By facilitating access to social or inclusive housing ;
    • By facilitating schooling ;
    • By improving access to employment. 
  • Accessibility: given that 40% of public institutions remain inaccessible to people with disabilities, one of the program’s key measures was prioritizing the accessibility of public transport and roads with the help of local authorities. The candidate also mentioned the access to vocational training, adapted for people with disabilities.

Overview

The Interministerial Committee on Disability (ICIDH) held on 20 September 2017 introduced a clear roadmap, which included all the proposals made by candidate Macron. Organizing such a committee is a sign of hope and reflects the government’s desire to make disability one of the term’s priorities. The association of the State Secretariat for Disabled People to the Prime Minister’s cabinet is another positive sign.
To date, reforms have indeed been initiated in many areas: administrative simplification, accessibility, schooling, training, employment, life course and health. Nevertheless, all of these measures remain structural, which makes any short-term evaluation particularly tricky. The government indicates that it will commit to quantitatively assessing progress made in this field, by, for example, consulting the variations in the number of school assistants, localized units for inclusive education (ULIS) networks, disabled employment rate and transport accessibility.
Key and emblematic measures of the campaign have been initiated:
  • The revaluation of the €100 per month disabled adult allowance (AAH) by November 2019, with a first revaluation in November 2018;
  • The creation of 8,000 auxiliary positions in schools in September 2017. 
It should also be noted that the Evolution of Housing and Digital Development Bill (ELAN) introduced in the Council of Ministers on 4 April 2018 presents 2 articles related to disability:
  • Article 17, which encourages social landlords to create “scalable” housing (housing easily transformable in adapted housing for persons with disabilities) ;
  • Article 45, which allows for persons with disabilities’ shared apartments to be considered as social housing. This policy represents a major breakthrough for inclusive housing, by offering a more valuable and less expensive alternative to a placement in a specialized center. Indeed, thanks to the partial pooling of the hours of support at home, cohabitations between disabled people is an opportunity for them to live independently. 
The organization, on 30 November 2017 of a national day of inclusive housing, and the presentation on this day by Sophie Cluzel, Secretary of State for Disabled People, of an inclusive housing guide for potential project bearers, also both testify of the progress made in public awareness.

Analysis

Although the Plan announced at the CIH follows the campaign promises, we can nevertheless be pleased that reforms undertaken are in line with the previous government’s action.

Nevertheless, the dogmatisms, administrative slowness and reluctance to innovate – all of which are characteristics of this sector – make it long and complex to reform. Indeed, high entry costs offset the implementation of the adopted policies along with the medium-term evaluation, as illustrated by the SERAFIN Project, launched in 2015, but which will only be effective in 2020.

Given the approximately 12 million people suffering from disabilities in France, the fact that life expectancy for people with disabilities has tripled in 50 years, and the deeply ingrained French backwardness in terms of inclusion, it is urgent to initiate in-depth reforms.

And now?

There will be several years before we can observe and assess reforms’ results. In order to sustainably transform the way in which disabled people are considered and treated in society, several options are available:
  • Encouraging the development of private initiatives: the disability sector is still too often considered as the State and the voluntary sector’s sole responsibility. Private initiatives, carried out by Societies of the Social and Solidarity Economy (ESS), struggle to find legitimacy and to develop because of an extremely restrictive and overly dogmatic regulatory framework, even though they bring insight and new sources of funding to the sector.
  • Associating people with disabilities who are affected to suggested reforms: in order to improve all the reforms undertaken and to ensure their relevance, it seems essential that people with disabilities share their expertise on the policies in progress. 
  • As such, the creation of a social utility worker (TUS) status in exchange of the disabled adult allowance (AAH) would provide an activity for a large number of disabled people who are unable to work. Their expertise could be deployed on topics such as accessibility diagnoses, data collection for digital accessibility platforms, interventions in schools during a national disability week, road safety in driving schools, tutoring in schools and businesses, etc.
  • Promoting “quick wins”: in reaction to the slow pace of the structural reforms undertaken, highlighting tangible progress in the disability sector would illustrate the fact that improvements are possible. Many actions could be carried out and would have a visible impact in the short term: 
    • Integrating a percentage of inclusive housing into the Solidarity and Urban Renewal Act (SRU)
    • Reducing the expenses on the caregivers’ jobs
    • Developing administrative support for caregivers by creating administrative assistant positions in the Departmental Houses for the Disabled (MDPH)
    • Provision of public real estate to provide space for innovative initiatives carried by the SSE: schools, inclusive housing, mutual support groups (GEM), resting places for caregivers
  • Like the 4th Autism Plan, initiating the first plan of traumatic brain traumas (TC) and brain injuries, one of the main causes of disability in France.
  • Reviewing the criteria for assigning hours of disability compensation benefits (PCH), by putting an end to exclusively physical care and developing social and psychological support.