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CHILDREN AND DISABILITY IN POLAND
Co-ordinator: Malgorzata Kalaska Central Statistical Office, Warsaw
MONEE Country Analytical Report 2002
The opinions expressed are those of the authors and do not necessarily reflect the policies or views of UNICEF.
UNICEF Innocenti Research Centre Piazza SS. Annunziata, 12 50122 Florence, Italy website: www.unicef-icdc.org
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CHILDREN AND DISABILITY
Country Analytical Report 2002 POLAND
by
BoŜena Balcerzak-Paradowska (ed.)
Dorota Głogosz
Izabela Hebda-Czaplicka
BoŜena Kołaczek
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Introduction
The children’s disability, their life conditions and equal opportunities, and the way
they are treated by the society - these can be treated as the basis of assessing a particular
society, its culture and how it respects humanitarian values. In the Polish society there is a
universal need for support for the disabled children and their families by the state. 98% of
participants of the representative survey carried out in 1996 (CBOS 1996) listed the families
with disabled children as those who the state should support in the first place.
A disabled child should be assured of a normal life, in conditions which guarantee
dignity, enable independence and facilitate active participation in the life of the society. The
state is responsible for creating such conditions. The state should ensure access to education,
schooling, medical care and rehabilitation, vocational training, recreation – in a way that
enables the child to achieve the highest degree of integration with society and personal
growth: intellectual, cultural and spiritual.
However, the support for the disabled child should take place at various levels:
- The macro-social level. At the level of society it is necessary to strengthen the contacts
between the disabled and able bodied children in order to foster a better understanding of
their problems and an acceptance leading to an increasingly positive attitude towards
disabled children and to a willingness to help. The basis of these activities is the education
of the society and information about the situation of the disabled children, the creation of a
friendly climate of understanding, help and acceptance.
- The institutional level. These are actions for the disabled children. Their effectiveness
depends on the access to help, its nature, the scope and level of performance. An
important part is played by the integration institutions for disabled children and young
people.
- The family level. The attitudes of the parents to the disabled child, the patterns of
behaviour and the forms of help have an enormous influence on the level of self-
realisation and activisation of the disabled child. The families of the disabled child often
need educational support such as raising awareness regarding various types of help
available.
In Poland the rights of the disabled are guaranteed by the international law regulations
ratified by Poland -–Universal Declaration of Human Rights, United Nations Charter,
Convention of the Rights of Children which Poland ratified in 1990, Standard Principles of
Equality of the Disabled, European Social Charter. The basis of the national law is the
Constitution of the Polish Republic. It states that no disability may be discriminated against,
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and that the job of the authorities is helping to assure the disabled of vocational training. and
social communication.
On the 1st of August 1997 the Diet of the Polish Republic passed a document entitled
the Charter of Rights of the Disabled Persons. It states that the disabled have a right to an
independent and active life and that they may not be discriminated against.1 Following this a
law was passed about the vocational and social rehabilitation and employment of the disabled,
including, among others, a definition of the disabled child (compare point 1).
1. Children with disability: who are they?
There is a lack of consent among doctors, pedagogues and psychologists as to the
notion of “the disabled child”. Some think that this term should only apply to the children
whose psycho-physical ability is visibly impaired due to organic disease. Others think that this
term should not be used to describe children with slight disability of organs or functions.
There is an on-going debate as to whether the term “disabled child” should include children
with emotional behavioural difficulties.
For the purposes of the current statistical analyses the term “disabled child” is applied
to persons who simultaneously fulfil three criteria: are under 16 years old, their physical,
psychological or mental state impedes or prevents (either permanently or temporarily) their
social roles, and they possess a certificate issued by appropriate authority stating the type and
degree of disability (act about the vocational and social rehabilitation and employment of the
disabled 1997). To deal with support for disabled children by the state and specialised services
the regulations are applied regarding disability certification. The appropriate authority for
certifying disability of children at the district level is the district team for disability
certification. For the purpose of certification a disabled child is a person under 16 years old,
who has an impaired ability either physical or psychological likely to last over 12 months, due
to hereditary defect, chronic illness or impairment of the system, necessitating full care or help
in meeting life’s basic needs at a level higher than that usually required for a person of a
similar age. The disability certification is a formal basis for receiving support and benefits.
Children over 16 are covered by the rules of certification of adults. The adults are certified by
the district teams for disability certification which assess the degree of disability. There are
three degrees of disability: severe, moderate and slight.
1 Resolution by the Diet of the Polish Republic dated 1st August 1997 (MP of 13th August 1997).
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Disability certification of children is necessary, among others, when applying for a
permanent disabled child care allowance (benefit for the carer) or for the care benefit (benefit
for the disabled child).2
It is difficult to establish the up to date figure of the number of the disabled children.
These children are not covered by the current statistics.3 Representative data about the
numbers and structure of disabled children in Poland was gained from the National Census
(1988) and also from the research into the state of health of the population in Poland carried
out by the Central Statistical Office GUS (1996). Subsequent full data about the number of
disabled children in Poland will be provided by the National Census (2002).
In 1988 there were 147,900 disabled children aged 0 to 14. They made up 0,5% of the
total number of children of this age.
According to the data from 19964 there were in Poland 288,100 disabled children aged
0 to 14. They made up 3,3% of the total number of children in Poland5. The care benefit was
claimed by 113,600 disabled children, which made up 39.4% of the total number of disabled
children.
2 The medical certificates regarding the child’s state of health, issued by public health care centres, are up to date to 31st December 2002. These in the past formed the basis of establishing the right to care benefit. Until now they have also been used as documents certifying the status of the disabled child. 3 There have been few reports about the situation of the disabled children, among others a report of the situation of the disabled in Poland, published by IPiSS in 2002 (Balcerzak-Paradowska ed. 2002) and an analytical report about the effect of disability on the situation of the child and their family, prepared by the Office of the Spokesman for the Disabled. Periodic surveys of the household budgets contain data regarding various types of households, but they do not specify data about households including disabled persons and so disabled children. 4 The results of the surveys from 1996 are not entirely comparable with the results of the National Census of 1988. In 1988 the disability criterion was the possession of the medical certificate (legal criterion). In 1996 a subjective criterion was adopted (the parents’ assessment – responding to questions whether due to disability or chronic illness the person has a totally or seriously limited ability to carry out basic functions for the given age). The legal criterion was dropped in favour of the fact of claiming care benefit. The surveys in 1996 did not cover children staying in social care homes. If, due to the methodological differences, we only wish to calculate the numbers of children aged 0 to 14 identified as disabled by their parents and carers, their number in 1996 is 184,400. 5 The age limit of a child was fixed at 14 (subsequently changed to 16 in 1997 in the rules about vocational and social rehabilitation and disabled employment and in the certification where a definition of disabled child was introduced).
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Table 1 Disabled children aged 0-141 and 15-17 in 1996
0-14 years Disabled children
total 0-4 5-9 10-14 15-17 years
in thou.
326,6 288,2 67,2 103,0 118,0 38,4
in %
100,0 88,2 20,6 31,5 36,1 11,8 Source: The state of health of the population of Poland in 1996, GUS
Table 2 Disabled persons aged 15-17 in 1996 in thou. by category of disability
categories of disability total men women city country
in thou.
total 38,4 14,1 26,3 12,1
legally and biologically 15,7 8,7 7,0 10,8 5,0
only legally7 4,3 2,7 1,6 3,7 0,6
only biologically 18,4 13,0 5,5 11,9 6,6
Source: The state of health of the population of Poland in 1996, GUS
Table 3 Children aged 0-14 and categories of disability in 1996 (per 100 children in total)
including aged Specification total
0-4 5-9 10-14
total 100,0 1000,0 100,0 100,0
able bodied 95,5 95,8 95,7 95,2
disabled 3,3 2,8 3,5 3,5
biologically disabled (subjectively) 2,1 1,2 2,2 2,7
receiving care benefit 1,3 0,8 1,3 1,7
with total disability 0,3 0,2 0,2 0,3
with partial disability 1,1 0,7 1,1 1,3
not receiving care benefit 0,8 0,4 0,9 1,1
with total disability 0,1 0,0 0,1 0,1
with partial disability 0,8 0,4 0,8 1,0
no subjective disability receiving care benefit 1,2 1,6 1,3 0,8
lack of data regarding disability 1,2 1,4 0,8 1,3 Source: The effect of child’s disability on the situation of the child and their family. Analytical report based on the survey of the state of health of the population of Poland, carried out by GUS in 1996.
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The most common illnesses causing children’s disability are: impairment of mobility
(in 1996 suffered by 24.1% of the total number of disabled children), neurological impairment
(22.5%) and visual impairment (20.0%). Mental handicap was suffered by 13% of children.
Among all the disabled children over 70% were not able to independently carry out various
life functions, 37.5% required constant specialist care, while 34.1% had to use such care
partially or periodically.
The majority of the disabled children live in cities - in 1996 – 64.7% of the total
number of disabled children. Per 100 children living in cities 3.7 were disabled, per 100
children living in the country – 2.8 were. The city children are completely disabled more often
than those living in the country. This is a sign of the perils of civilisation whose victims are
often children at various levels of their growth (including pre-natal). However, living in cities
enhances their life chances. They have better access to health care, rehabilitation, specialist
institutions. The country children are in a worse situation due to a lack of specialist venues in
those areas. Often, the parents are not aware of the availability of various types of help.
2. Government responsibilities for children with disability
The needs of all disabled persons including children centre around four basic areas i.e.
treatment and rehabilitation, securing basic living conditions, education (including vocational
training), the fullest possible functioning in the community and preparation for fulfilling
social roles. The present system of help for disabled children is not perfect. However, in the
last 10 years clear steps were taken towards identifying among the actions for the disabled
those tasks addressing the needs of the disabled children and their carers.
Looking after the person and the property of the child, their upbringing and meeting
their needs is a particular duty of the parents by virtue of their parental authority. The state
and other parties involved in the education and care of disabled children and young people
fulfil their supporting and compensatory functions as follows:-
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Institutions scope of activity2/ centres, subordinate bodies
Ministry of National Education
- education, total and partial care
centres: nurseries (including integration nurseries), schools, psychological consultation centres, adoption care centres, care and training centres, (total care, partial care, after school care), foster families, therapy centres, re-socialising and re-validation centres
Ministry of Health and Social Care
- organisation and forms of health care and prevention
centres: district health care providers, district health care teams, specialist health care teams, voivodship specialist teams for care of mother and child, children’s hospitals, children‘s wards in hospitals, sanatoria, rehabilitation centres
Ministry of Employment and Social Policy
- social care including assistance for disabled children
centres: social care centres, care homes
Spokesman for the Disabled at the Ministry of Employment and Social Policy
- initiating and co-ordinating activities towards limiting the effects of disability and the removal of barriers
- collaboration with non government organisations working for the benefit of the disabled
- determining the directions of the employment policy, vocational and social rehabilitation of the disabled
- essential monitoring of the implementation of the act
- producing government programmes to improve the social and vocational life of the disabled
- preparing or assessing bill suggestions about the rehabilitation and employment of the disabled
- establishing the basis for annual financial planning relating to the implementation of tasks for the benefit of the disabled specified in the act.
District authorities
(powiat)
- rehabilitation of the disabled, the certification of disability
- meeting the basic needs of the families and children resident in the area, specialist tasks – counselling for the families and help for the child including achieving independence for the leavers of education and training centres and children’s homes
- action to limit the effects of disability and remove the barriers preventing the disabled from functioning in the society
centres: district family help centres, district teams for the certification of the degree of disability.
Voivodship authorities (self government, marshall)
- preparing voivodship programmes to improve the living conditions of the disabled including their social and vocational lives
- collaboration between voivodship institutions of government administration, districts (powiats) and councils
centres: social care homes, care centres.
National Consultative Council for the Disabled (advisory organ of the Spokesman)
- instigating action designed to integrate the disabled with the society instigating solutions to solve the problems of the disabled due to their disability, assessment of legal acts
State Fund for Rehabilitation of the Disabled
- financing and subsidising of tasks resulting from governmental and self-governmental projects targeted at disabled persons
- financing and subsidising research, evaluation, reports and analyses concerning the situation of the disabled, preparation and promotion of information and training materials,
- subsidising the construction and reconstruction as well as modernisation of establishments designed for rehabilitation
- subsidising the removal of architectural, urbanistic, transportation and communication barriers
- subsidising: rehabilitation camps, sports, culture and recreation of the disabled, rehabilitation equipment, orthopaedic equipment and auxiliary means granted to disabled persons based on separate regulations.
7 Listed are only those tasks relating to helping all the disabled including children or those exclusively directed at helping disabled children.
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Education of disabled children:
- co-operation with public institutions (by consultations and work in social commissions) to create the network of education institutions in local communities, forms and scope of their activity as well as the curricula and activities with disabled children in mainstream, integration and special centres; - promotion of the integration-based education of disabled children in the peer environment as well as initiating and supporting the activity of integration centres;
- organisation of the National Education Forum meant to promote the exchange of experience among public and non-public institutions as well as development of education (also accounting for the special needs of disabled children);
- promotion of new methods of pedagogical work with disabled children;
- running (also when commissioned by public administration) of education centres (schools, kindergartens, clubs, occupational therapy workshops);
- material support in providing equipment for education centres (including specialised equipment indispensable for the work with disabled children) and school materials for disabled children from the poor families.
health care and rehabilitation of disabled children
- instigating the creation of and running specialist medical and rehabilitation centres and hospices for children (both non-public and public at the direction of public administration)
- financial support for the above centres
- organising rehabilitation camps
- providing for poor disabled children (free or at a small fee) of medicines, medical materials and rehabilitation equipment;
- running health prevention programmes, promoting new methods of treatment, health care and rehabilitation in the community of their families and in medical communities
financial help and services for disabled children and their families
- providing for the children and their households the necessary equipment which facilitates the meeting of their life needs
- - providing services to assist the families of the disabled children to fulfil their functions (through volunteers)
Non-governmental organisations
action for social integration of disabled children and representing their interests
- promoting the problems of the disabled through the NGOs representatives’ participation in programme teams, commissions and advisory bodies of public institutions, lobbying, organising debates, conferences and public discussions, financing and publishing books, brochures and posters, media campaigns;
- collaboration in creating and realising government and self government programmes of action for the benefit of disabled children and their families (at the direction of suitable public institutions);
- action towards the removal of architectonic barriers and access by the disabled to all public buildings and service centres; organising specialist transport for the disabled;
- awareness raising campaigns directed at both the able bodied to inform them of the problems of the disabled and the disabled themselves, to facilitate their participation in the life of the local communities and peer groups.
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The tasks of the state and governing bodies directed at providing help and support for
the disabled and their carers apply to all the disabled persons including children. The
particular legal solutions specifying forms of help for the disabled children and their carers are
based on the general regulations relating to the functioning of all services and parties
established to act for the disabled. The source of these is in the executive regulations. The
plans of action for the disabled are published every year in the government “Programme of
action for the disabled and their integration with the community”. The regulation about the
vocational and social rehabilitation and employment of the disabled specifies the finances to
be spent every year to help the disabled children. And so, every year, between 5 and 10% of
the income of the State Fund of the Rehabilitation of the Disabled Persons is earmarked for
the financing of the medical, social and vocational rehabilitation of the children and young
people, and in particular: the purchase of the equipment and all devices lessening the effects
of disability,
training the parents, carers, all volunteers in the area of specialist care of disabled children and
young people, transport services, residential educational and rehabilitation centres, and all
other centres for children and young people.
In Poland there are over 6,200 non-government organisations whose aim is a range of
actions for the disabled. The majority of them are associations and foundations established
either by the disabled or by the family members of the disabled, mainly by the parents of the
disabled children. Almost 2,000 of the NGOs work solely for the disabled and sick children.
These were established in response to the problems of the disabled which were not addressed
by the government institutions, and the limited access of these persons to the services offered
by the private institutions. In the case of children these problems mainly relate to access to:
- education,
- medical benefits and drugs,
- medical rehabilitation,
- new therapy methods,
- integration problems with the social community, including with other disabled and able
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bodied children.
In all 47 various illnesses have been identified which are dealt with by NGOs in
Poland. The most organisations (445) work for the children with cerebral palsy. 441 work for
children with mental handicap. The majority specialise in working for the children with only
one illness, but they offer various types of help. In the late 90s in Poland there appeared and
began expanding a network of organisations working for the terminally ill children (mainly
cancer patients) and a network of hospices maintained mainly by private sponsors. These
institutions ensure specialist care in the home, which is essential particularly for the children
in the so called terminal stage of the illness.
A definite majority of the organisations meet (or attempt to meet) simultaneously three
aims which are essential to the Polish realities:
- providing services for the benefit of the disabled children
- the widest possible advocacy of their interests
- creating community support groups, integrating, stimulating and supporting the activities
of the disabled children and local communities around the problems of disability.
These organisations also fulfil an integrating function for the parents and carers of the
disabled children, and provide for them a forum for the exchange of information and a mutual
support centre, as such needs are hardly met by the public institutions.
In the nationwide statistics of the non-government sector there are identified 44 forms
of support for the disabled children and their families. The prevalent form is providing
services. The advocacy and protection of the interests of disabled children are much more
rare.
3. Institutional and public care of children with disability
The material, financial and in kind support has as its aim aiding the budgets of the
households with disabled children. The state involvement in this area is justified by the
necessarily higher spending by those households on meeting the specific needs of the disabled
child. This support comes in various forms.
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3.1 Financial benefits 3.1.1. Social care benefits
According to the law about social care9 those qualifying for financial benefits from
social care are persons who meet the combined income criterion10 and are at social risk. One
of the risks is disability. There are also non income based benefits. The condition of granting a
benefit may be a commitment by the applicant to return all or part of the benefit.
According to the regulations about social care the disabled children and their carers
may access the following financial benefits:
- Permanent allowance including a pensions contribution for an unemployed carer
of the disabled child.
The person entitled to claim this allowance must not be employed, and must care for
the child (even if that child has attained majority), own, adopted or temporarily fostered and
requiring constant care including personal care, systematic education, treatment or
rehabilitation.
The condition of granting this allowance is a certificate of the child’s disability stating
the need for constant contribution by carer to the child’s treatment, rehabilitation and
education.
The eligibility income criterion for this allowance is 150% of the income cricerion
adopted in the social assistance act.
This allowance is not granted when the child stays in a 24 hour rehabilitation centre or
other care centre for at least 5 days a week, or when the carer claims unemployment benefit,
a pre-pension benefit or a pre-pension allowance. This permanent allowance is not granted if
the other benefits apply.
The present amount of the permanent allowance is 418.00 zl.
9 The law about social care of the 29th November 1990 with subsequent changes. 10 At present the following income criteria apply: (net amounts) per single person – 461.00 zl; for the first person in the family – 418.00 zl; for the second and subsequent persons in family over 15 – 294.00 zl for every person under 15 – 210.00 zl. The sum total thus allowable becomes the income criterion which is comparable with the combined income. If the combined income does not exceed this level, the family are entitled to non-returnable financial aid.
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Table 4
Permanent Allowance to the persons caring for a disabled child. The amount of benefit and the
number of those claiming during the years 1998-2000
years specification
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
numbers claiming in thou 88 108 118 136 155 176 201 58 31 61 69
benefits granted in mln. zl 35,2 56,1 83,5 134,1 211,5 318,1 327,7 143,3 94,5 182,6 228,4
Source: Statistical Annuals GUS for years: 1994, 1997, 1999, 2000, 2001.
- Temporary allowance
The aim of this allowance if to support the family whose income is not sufficient to
meet the life necessities, among others due to disability, if the disability increases the living
costs because of the need to access rehabilitation activities, purchase orthopaedic or other aids
or gear enabling the functioning in the community, maintaining and using a wheel-chair.
The period of entitlement to this allowance depends on the individual situation of the
person or family, providing the income criterion is met.
- A set purpose allowance and a special set purpose allowance.
The aim of this allowance is meeting an essential life need (in particular covering part
of all of the costs of treatment or medication).
It is not income based and is non-returnable.
- An entitlement to health benefits
Those in receipt of a permanent allowance are entitled to health benefits.
3.1.2. Other social benefits
- Family allowance (granted by preference)
The person entitled to this allowance is the legal guardian of the child.
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This person is entitled to the allowance regardless of the age of the child11 if the child
is severely or moderately disabled, provided that the moderate disability arose while the child
was entitled to the benefit. The period of allowance entitlement may be extended in cases of
breaks in education caused by the illness of the child who remains a student (the allowance is
payable during the break). A single parent of a disabled child is entitled to a double amount
provided the child is entitled to the care benefit.
The income criterion is determined by universal methods (for the remaining families). It is an
average monthly income per head in the family gained during the calendar year preceding the
benefit period; it does not exceed the amount equal to 50% of the average monthly pay as
declared by the Chairman of the Central Statistical Office for the purposes of pensions for the
calendar year preceding the benefit period.
- Care benefit
The person entitled to receive it is the legal guardian of the child.
The condition of entitlement is a certificate of disability stating the need for constant
contribution by the carer to the process of treatment and rehabilitation. This benefit is not
income based. If the child needs constant care, this means that the child is disabled.
The benefit is payable until the child reaches the age of 16, or longer, if the child
continues to need care, at the most until the age of 24.
The benefit is not payable when the child stays in a social care home, treatment centre
or residential care home.
At present the care benefit is 135.96 zl. Who the benefit is paid by depends on the
person entitled to receive it: the employer, KRUS, district employment office, social care
centre or ZUS.
- Childcare leave extended due to the state of health of the child
The people entitled to this are a working mother or father of the child, in accordance
with the rules of the Code of Employment. The leave lasts up to 72 months, until the child
reaches 18. It can be taken in up to four parts. The condition of entitlement is the child’s
certificate of disability.
11 According to universal principles family allowance entitlement is for a child up to the age of 16, or up to 20 it
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- Childcare allowance
The person entitled to this is the person on extended childcare leave due to the state of
health of the child.
The duration of the entitlement is until the end of the childcare leave, but no more than
72 months.
The income criterion applying from 1st June 2002 to 31st May 2003 – the average
monthly income per head in the family in 2001 must not exceed 540.00 zl.
It is not payable if the childcare leave is less than 3 months, if the personal care of the
child ceases, if the entitled person begins to work or starts own business activity, receives
pension or retirement benefit, if the monthly combined income exceeds the amount which
makes up 60% of the average wage in the previous calendar year, or in the case of the ceasing
of employment.
- Retirement benefits for persons entitled to early retirement because of caring for the
disabled child.
Up until 1st January 1999 it was possible to get early retirement if one was born after
31st December 1948 and was caring directly for a disabled child. In February 1999 there was
introduced a permanent allowance including a pension/retirement contribution paid for by the
social care. Persons who until the 31st December 1998 satisfied all conditions for receiving
retirement benefit (20 years’ worth of insurance contributions for a woman and 25 years for a
man) and had not managed to apply in time, may still apply for this benefit.
- Financial contribution to a rehabilitation camp (from the PFRON resources)
This is an entitlement for persons up to the age of 16, who qualify for the care benefit.
The participant receives between 50 and 100% of the lowest wage, the necessary carer
between 40 and 80% of the lowest wage. This amount may not exceed the contribution
payable to the disabled participant.
3.2. Tax deductions (applies from 1992, i.e. from the time Polish tax law introduced a
duty on private persons to pay income tax)
The law about income tax payable by private persons determines the following
exemptions allowed for disabled persons and persons bringing up a disabled child: income
that child is in full time education.
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allowance free from tax, expenses on which tax can be deducted (before calculating tax),
expenses which may be deducted from the tax calculated.
Tax free income includes: family allowance and care benefit, childcare allowance,
social care benefits, benefits received according to separate regulations for vocational, social
and medical rehabilitation of the disabled from the PFRON resources and from place of work
rehabilitation funds.
Tax free expenses for the given year may be: expenses connected with childcare for
the disabled child, own or fostered, who is under 16 and has a certificate of disability. These
expenses include: the costs of adapting and equipping a home for the needs resulting from
disability and adapting a car, the purchase and repair of individual equipment, devices for
rehabilitation, a stay at a sanatorium, rehabilitation-education centres, rehabilitation
manipulations; medicines when a doctor states that they are necessary, for a sign language
translator, an ambulance to get to necessary manipulations; for travelling in own car (car
owners with disabled children under 16 are entitled to up to the equivalent of three lowest
wages); public transport fares used during a stay at a rehabilitation camp, in a sanatorium or
during camps for disabled children.
Tax exemptions apply mainly to the following costs: taking own and adopted disabled
children to primary and high school, including those with integrated classes, special schools
located away from the children’s permanent or temporary residence.
3.3. Other forms of help (entitlements, discounts, exemptions, help in kind and in
services)
- Free transport for disabled pupils
It is the council’s duty to provide for the disabled pupils free transport and care during
travelling to the nearest primary or high school, special education centre, special residential
centre for children and young people requiring specialist methods of teaching
and a centre providing education for severely disabled pupils.
- Discounted travel for disabled children and young people on public means of
transport (buses and trains)
Disabled children and young people and one carer are entitled to a 78% discount. For
the carer the discount only applies for the journey from home to the place attended by the
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disabled child such as nursery, school, residential care home and so on.
- Telecommunication services
Half of the costs of connecting to the telephone network, installing the telephone and
the standing charge are paid by the legal carers of disabled children with impaired hearing
and speech, if they must use text-phone or video-phone. If they wish to get a special telephone
for them, they must pay for it themselves.
- Privileges in public institutions
The carer of the disabled child is entitled to be dealt with without queuing in public
institutions and shops.
- Not following certain road signs
The drivers of disabled persons with movement difficulties are allowed not to follow
certain road signs such as the no stopping sign or no parking sign, providing they are taking
extra care.
- Parking privileges in town
Paid car parks in towns must have designated parking places for cars carrying disabled
persons with movement difficulties.
- Benefits for disabled pupils
Disabled pupils are entitled to free text-books in special schools, part-paid stay at
residential education centres (in special cases of hardship the child may be temporarily or
permanently exempt from paying, or the fee may be reduced); suitable equipment at the place of
study; the purchase of specialist didactic aids; the support of psychological growth and the
effectiveness of study through the help of psychologists and specialist teaching, speech and
language therapy and other therapeutic activities, the psychological and pedagogical support for
the disabled children, parents and teachers.
- Duty free purchase of rehabilitation equipment allowing or facilitating the process of
medical or vocational rehabilitation of the disabled, and the goods specially adapted as
educational or cultural aids, to raise their vocational qualifications.
3.4. Target programmes financed by PFRON
SIGNPOST – helping the disabled to acquire orthopaedic objects, aids and
communication. This programme covers:
a) help with acquiring orthopaedic objects, aids and technical treatment measures. This
targets, among others, disabled children and young people in education up to 26 years of
age entitled to care benefit, children declared disabled staying in social care homes, care
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centres, children’s homes – and thus deprived of the entitlement to care benefit. This is
provided by district family help centres.
b) help with purchasing computer equipment. This targets, among others, disabled
children and young people in education up to 26 years of age entitled to care benefit. This
programme does not cover the disabled children and young people staying at residential
education centres and similar institutions, except for those who are finishing their
education in such centres. This is provided by the PFRON branches.
c) help with purchasing electric wheel-chairs. This targets, among others, disabled
children and young people up to 26 years of age entitled to care benefit, children declared
disabled by public health centre, who stay in a children’s home or other residential
educational centre, and are thus deprived of care benefit. This programme does not cover
those who have received contribution towards the purchase of a wheel-chair as part of the
PFRON target programme within the last 5 years. This is provided by PFRON branches. “Computer for Homer” – help with purchase of electronic equipment and
software enabling work for the blind and visually impaired.
The purpose of this programme is financial assistance for the blind and visually
impaired in accessing modern computer equipment together with appropriate hardware and
software. It targets, among others, disabled children and young people up to the age 18. This
programme does not cover persons who have received a financial subsidy from the PFRON
resources for the purchase of computer equipment as part of other target programmes within
the last 3 years. The help is in the form of interest free loan from PFRON resources granted
for a period of 5 years (the applicant must contribute at least 10% of the purchase price). This
is provided by PFRON branches.
“PEGASUS” – help with activisation of the disabled through removing transport
barriers. (The Programme of the Government Ombudsman for the Disabled).
The purpose is the realisation by the disabled of their right to free movement through
the removal of transport barriers preventing them from functioning in the social and
vocational life – and by the same token, providing them with access to the goods and services
and comprehensive rehabilitation. This targets, among others, disabled children and young
people up to the age 18, with a hearing impairment, severe mental handicap, childhood
cerebral palsy, autism or blindness, if they qualify for care benefit, children treated as slightly
disabled without one leg. This programme provides assistance with the cost of purchasing an
ordinary car without equipment, purchasing a car with installed gear appropriate to the type of
- 19 -
disability, purchasing and installing the gear in the car. The price of the car without the
equipment must not exceed 200%, and with it – 250% of the maximum amount of loan. The
car must not be older than 3 years old. The programme is carried out in the form of interest
free loan from the PFRON resources granted for a period of 5 years. It is provided by the
central and district branches of PFRON.
A programme of financial subsidies for the disabled for the purchase of
orthopaedic objects and aids – provided by district centres of family help.
The aim is to subsidise the purchase of orthopaedic objects and aids. This targets,
among others, disabled children and young people entitled to care benefit, children declared
disabled by a public health care centre who are staying in a social care home, a residential care
centre or a children’s home, or other care educational institution, and thus are deprived of the
care benefit. The parents or carers of the disabled children with gross monthly income less
than 80% of the average wage per member of household, or 100% of the average wage in case
of persons living alone, may receive financing from the PFRON resources to cover their own
contribution to the costs of purchasing orthopaedic objects and aids (when such a
contribution is required), and also to the cost of purchasing specialist orthopaedic equipment
and aids. This is provided by district family help centres.
“Hedgehog” – handbook for the parents of the disabled children.
The handbook contains advice and information about the possibilities of treatment and
rehabilitation of the disabled children, the basic rights and benefits for these children and their
families, their educational options, basic information regarding their up-bringing and the first
systematic register of educational integration institutions from all over Poland, including
references to their architectonic adaptations for the disabled children. The handbook contains
a register of selected non government organisations and institutions working for the benefit of
the disabled children, a list of educational superintendents and inspectors in charge of
integrated education, and a list of educational integration venues with references to their
architectonic adaptations for the needs of the disabled children.
Removal of the architectonic barriers
There continue to exist in Poland many space (architectonic) barriers limiting the
movement of the disabled. This is why the parents and carers of the disabled children often
point to problems with movement of the child away from home, participation in cultural
events, access to medical venues (MPiPS 1998). The building regulations state that all newly
- 20 -
built public buildings must be accessible for the disabled at the same level as they are
accessible for the able bodied people. Because of these regulations the State Fund for the
Rehabilitation of the Disabled Persons (POFRON) carries out numerous programmes of loans
and financial contributions for the purpose of removing architectonic barriers in existing
buildings, both residential buildings and service, cultural and public institutions. The
pavements and pedestrian crossings are also being adapted for the needs of the disabled (low
curb, sound signalling at pedestrian crossings). The positive effects of this programme are
visible across the whole nation. The non-government organisations and public media have
contributed considerably to these changes by publicising them through their campaign
entitled “A struggle against three steps” (Integracja 2001).
The growth of communication services
In 1993 the government adopted a programme of the development of communication
services for the disabled (Program ... 1993). When new buses are ordered by the transport
authorities, people in charge pay attention to their adaptation for disabled access e.g. low and
wide entrance with movable floor, secure wheelchair space, appropriate sound recorded
information about the progress of the route etc. Such buses are being acquired by the public
transport authorities in all main cities. Apart from generally accessible communication there
are also specialist transport facilities being developed, though still not in sufficient numbers of
localities. These are available on payment of a fee to the disabled and their carers. These
services are financed by the funds of the local authorities and the loans and contributions by
PFRON (Integracja 2001).
Also, the telecommunication firms have been obliged to ensure access to the street
telephone booths for the needs of the disabled, which is visible on the streets of many cities
(Program... 1993).
From the point of view of the social integration of the disabled it is also very important
that a project called “Teleworking” was developed. This is financed by PFRON, the Ministry
of Employment and Social Policy and non government organisations. This project aims to
facilitate finding employment for the disabled (in the first instance only for the blind and
visually impaired) through equipping them with computers and access to the internet. The new
information transfer technologies are helping to break down the barriers to social integration
of the disabled , their children and their organisations which have their own web-pages on the
internet12, allowing them to exchange information and views, get help, make peer contacts,
12 The information about this programme comes from the PFRON internet page.
- 21 -
access a wider social circle. Since the mid 90s there has also been an increased interest of the local authorities in
creating educational integration centres, and integrated, generally accessible play areas for the
children. These are paid for in part by the PFRON resources and by donations from non-
public sponsors (GUS 2001).
Moreover, thanks to the active co-operation of the non-government organisations and
at their initiative, new information books are being produced for the disabled. A very popular
one is a handbook of social help organisations KLON, local handbooks about all local social
institutions, both public and social. The non-government organisations in Warsaw have
produced, in co-operation with the local authorities, information books for the disabled
entitled “Warsaw without barriers”. They contain a list of all public institutions, cultural and
service venues accessible for the disabled and a list of institutions with identified barriers.
3.5 The care assistance
The system of care assistance offers a range of help to the carer of the disabled child
such as an entitlement to the care leave (compare 3.1.2.), services (care and specialist care);
and social work and specialist counselling (e.g. psychological, rehabilitation camps for the
disabled children and adults), social care.
3.5.1. Institutional forms of care for the disabled child
Social care homes
The disabled children have an entitlement to use these, if they do not require hospital
treatment but require a specialist round the clock care, and have an appropriate referral based
on the certificate issued by the district team for certification of the degree of disability.
These homes may be used when the care services are impossible, or their organisation
is not in a position to guarantee safe functioning at the place of residence.
Part of all social care homes in Poland is earmarked exclusively for the children and
young people, and they are designed to address a particular disability , e.g. homes for
intellectually impaired children and young people up to the age of 30. Apart from public and
non-public social care homes (e.g. run by convents) there have also recently appeared private
care homes charging full or part fee.
- 22 -
Table 5 Social care homes for children with mental handicap in years 1990-1996
years specification
1990 1991 1992 1993 1994 1995 1996
number of centres 115 121 120 119 122 122 120
number of residents 9739 9752 9821 9216 9538 9540 9185 Source: GUS, 1995, 1997
Table 6 Children in various types of care placements in years 1990-2000 (as on 15th December)
specification 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
SOSW 32575 33702 34631 34951 33379 33100 32505 32295 32085 31652 31776
DPS 9739 9752 9821 9216 9538 9540 9185 8423 8462 7763 8235
ORW no data no data no data no data no data no data no data no data no data no data 3371 Source: Kolankiewicz M. (2002). SOSW – special education training centres, DPS – social help care domes ORW – rehabilitation training centres
3.5.2 Community Care Centres
Specialist care and education centres provide for the disabled children a whole day
stay, meals, basic care, recreation, cultural, educational and rehabilitation and revalidation
activities. They are designed for children over 3 years old and young people.
Table 7
Special education and training centres and young people’s education and training centres.
Centres and residents in the years 1990-2000
specification 1990 1991 1992 1993 1994 a 1995 1996 1997 1998 1999 2000
Special education and training centres
centres 428 437 452 450 440 436 434 427 429 437 442
residents a 32575 33702 34631 34951 33379 33100 32505 32295 32085 31652 31776
the blind and visually impaired 1205 1382 1464 1496 1251 1408 1413 1425 1293 1468 1284
the deaf and hearing impaired 3680 3682 3782 3763 3465 3396 3333 3395 3236 3208 3080
chronically ill 1167 1970 2403 2212 1349 670 880 744 808 658 396
impaired mobility 552 482 560 534 377 256 296 282 281 301 604
mentally handicapped 24164 24340 24345 24663 23693 23619 22825 23037 22473 21902 21976
Young people’s education and training centres
centres 50 52 51 50 47 48 47 47 45 47 48
residents 3062 3630 3250 3051 2702 2779 2729 2823 2699 2855 2866 Source: GUS 1990-2001 GUS Statistical Annual
- 23 -
Table 8 Centres working within young people’s training establishments.
Centres and residents in years 1995-2000
1995 1996 1997 1999 2000
specification centres
resi-dents
centres resi-dents
centres resi-dents
centres resi-dents
centres resi-dents
training clubs 153 8735 176 8485 177 9122 238 11800 192 13500
young people’s social therapy centres 7 577 8 632 11 851 12 1100 14 1800
rehabilitation and training centres - - - - - - - - 72 3400
Source: GUS Statistical Annual 1996-2001.
One form of help are rehabilitation holiday camps for the disabled adults and
children.
The system of help for the disabled children and their carers is comprehensive and
versatile. The legal bases of assistance are adequate. The subsequent years of the construction
of the public system of support for the disabled children indicate the creation of specialist
solutions addressing specialist needs of the disabled children. However, in spite of the wide
variety of action offered, the needs of the disabled children are not being met to a satisfactory
degree. The local governments planning their social help care activities, and the non
government organisations have a partial awareness of the level of meeting the needs of the
disabled children. The meeting of these needs depends on the numbers and qualifications of
the support staff, the finances of the state budget and the awareness of the carers of their rights
and public institutions whose aim it is to assist disabled children.
3.6. Education of disabled children
3.6.1. The education system for the disabled children (see Appendix 2)
Education is particularly important in the process of the social rehabilitation and
integration of the disabled children. In the 90s the education integration became the preferred
method of educating and care for the disabled children. This principle leaves has not yet been
fully implemented in the area of the education system. There are integration nurseries and
schools or integration classes in mainstream nurseries and schools. However, the growth of
these is too slow to meet the needs. First of all, there is a lack of adequately trained teaching
staff and suitably equipped centres, including those without architectonic barriers. The
majority of children, therefore, continue to attend special primary and high schools. Creating
- 24 -
such schools is to a large degree justified by the necessity of adapting the curriculum and
various activities to the children’s abilities.
In the school year 2002/2003 in Poland the disabled children attend the following
organisational structures:
1/ mainstream nursery classes and schools (mainstream classes, specialist teaching,
integration and therapy classes)
2/ integrated nurseries and schools
3/ special centres i.e.:
3.1/ special nurseries
3.2/ special primary schools
3.3/ special “gymnasium” (these were created in 1999/2000 as an extra level of the
education system)
3.4/ special post-gymnasium schools (from 1st September 2002) i.e.:
a/ special vocational schools
b/ special high schools “lyceum” (specialised, general, technical)
c/ special post-lyceum schools
3.5/ nursery and school classes in health care centres and social care homes
3.6/ education care centres consisting of boarding nursery or school designed for those
children who for some reason are unable to attend nursery or school at their place of
residence.
3.7/ extra curriculum activities organised in health care centres and medical treatment
centres
4/ individual education and training, organised at the place of stay of the child who is
temporarily or permanently unable to attend nursery or school due to a motor dysfunction,
chronic or other illness.
The special education – organised for the disabled children with special educational
needs – includes mainly primary schools, the gymnasiums and the post-gymnasium schools. It
is based on the following principles:
- at the primary and the gymnasium level - the special school may function independently
or constitute an integral part of another school, which organises special classes for
disabled children including integration classes, therapy classes, specialist teaching and
mainstream classes. Individual teaching is also a possibility.
- 25 -
- at the level of technical and vocational high school and the lyceum – the special schools’
curriculum and organisation is adapted to the needs and abilities of the disabled children.
Their role is to prepare the young disabled people for vocational work. Special schools
may function independently or as an integral part of another education and training centre
or a health service centre.
Special education and training centres are meant for the disabled children and young
people over the age of 3, who due to their disability are not able to attend nursery or school.
Since September 1991 there exists in Poland a system of public and non-public
education (Act of 7th September 1991 about the education system). Until 1998 the public
education system remained the responsibility of the government administration and the local
self-government. Following the reform of the political regime and the reform of the education
system since 1999 it is the local authorities which are in charge of establishing and running
public nurseries including those with integration classes, and special nurseries, primary
schools and gymnasiums, including those with integration classes, except for special primary
schools and special gymnasiums. The district authorities are in charge of establishing and
running of public special primary schools, special gymnasiums and special post-gymnasium
schools including those with integrated classes (Act of 25th July 1998 about the change of Act
about the education system).
3.6.2. The disabled children’s access to different levels of education
Nurseries
The disabled children are covered by nursery education from 3 to 6 years of age like
the able bodied children. At the age of 6 they are entitled to a year’s reception class. During
the years 1989-1992 disabled children only used special nurseries, but since 1993 they have
also used integration nurseries. In the second semester of 1992/93 35.4% of the disabled
children in nurseries attended integration nurseries, and in the year 2000/01
this figure rose to 70.1% (compare Table 9).
- 26 -
Table 9 Number of disabled children in nurseries and nursery classes
Number of children School
Year total in special nurseries in integrated nurseries in nursery classes
1990/91
1991/92
1992/93
1993/94
1994/95
1995/96
1996/97
1997/98
1998/99
1999/2000
2000/2001
5768
5340
7900
8797
8626
8366
8675
7200
7300
8500
8700
5768
5340
5100
5200
4365
4376
4400
2700
2700
2000
2600
....
....
2800
3597
4261
3990
4275
4500
4600
6500
6100
no date
no data
2724
2665
2959
1995
1543
1402
no data
518
no data ...- this did not exist Source: „Education and training in the school year 1997/98” Information and Statistical Reports GUS 1998 Warsaw, „Statistical Annual of the Polish Republic” GUS years 2000 and 2001.
The mainstream nurseries are the least often attended by children with a psychological
illness, visually impaired and mentally handicapped (Results of the research into the state of
health of the population of Poland in 1996, GUS calculations in 1999 for the Balcerzak-
Paradowska report ed. 2002). On the other hand, the special nurseries during the years 1990-
1996 were used mainly by children with chronic illnesses. The numbers of children with
particular illnesses have undergone considerable changes (compare Table 10). This is because
children with some types of disability are now being admitted to integrated nurseries.
Table 10 Number of children in special nurseries by type of disability
Specification 1990 in % 1995 in % 1996 in %
The blind and visually impaired 279 4,8 409 9,4 703 16,1
The deaf and hearing impaired 229 4,0 96 2,2 557 12,7
Chronically ill 4103 71,1 2089 47,9 1461 33,4
Mobility impaired 434 7,5 617 14,1 627 14,3
Mentally handicapped 723 12,6 1154 26,4 1028 23,5
Total 5768 100,0 4365 100,0 4376 100,0 Source: GUS Statistical Annual for years 1992, 1996, 1997 and own calculations
- 27 -
The using of various types of institutional care (mainstream nursery, integrated nursery
or special nursery) depends on the place of residence.
In the country children use nurseries less frequently than in the cities, due to the weak
development of the network of nurseries in the country. The more people that live in the
household with the disabled child living in the country, the less often is that child covered by
institutional care (the results of the research into the state of health of the population in
Poland, GUS 1999).
Primary Schools
Disabled children are obliged to start primary school at the age of 7, like all children,
and they can continue their primary schooling until the age of 21. Children who because of
their state of health or type of disability are not able to begin primary school at the age of 7,
are allowed to continue nursery education until the age of 10.
Primary classes with disabled children are smaller: between 6 and 12 children.
Integrated classes have between 15 and 20 children, 3 to 5 of whom are disabled.
A considerable majority of disabled children attend special primary schools, although
since the mid 90s their number continues to drop, while the number of children grows in the
mainstream special classes, integrated classes and therapy sessions (compare table 11) which
is a positive feature. Table 11 Number of disabled children in primary schools by types of teaching
School Year Total Special School
Special Class in Primary School
Integrated Class in Primary School
Mainstream class and individual teaching
Therapy class in Primary
School
Compensation Class in Primary School
1989/90 99578 83645 15796 ... ... ...
1990/91 101680 84317 17363 ... ... ... ...
1991/92 100101 83295 16806 ... ... ... ...
1992/93 98544 82171 16373 ... ... ... ...
1993/94 98365 83591 14774 ... ... ... ...
1994/95 87169 83495 11747 1837 ... ... ...
1995/96 99381 82999 6613 2036 4158 902 2673
1996/97 118896 80556 7222 2491 5802 3349 19476
1997/98 124305 80353 7352 3590 9681 3753 19576
1998/99 121526 77161 7529 4216 11925 3793 16902
1999/2000 92535 59397 4654 5033 12608 2537 8305
2000/2001 104380 52020 3207 49153a no data no data no data Source: „Education and Training in the school year 1997/98” GUS, „Statistical Annual “ GUS years 1992,2000, 2001
Whereas in the school year 1995/96 only 9.8% of the disabled children were educated
- 28 -
in mainstream schools (apart from special schools and special classes), in 2000/2001 this
figure rose to 47.1%. Since 1999 the number of disabled pupils in primary schools has
dropped generally due to reforms in the education system (since 1999 primary school has only
6 grades).
The dominant type of children’s disability in Poland is intellectual disability. Until the
late 90s these children were mainly educated in special schools. Mentally handicapped
children make up about 80% of disabled pupils, but among handicapped children as many as
about 90% are children with slight mental handicap (compare table 12).
Table 12 Pupils aged 6-17 and over in special primary schools by type of disability
Pupils
In absolute figures In % Type of disability
1995/96 1998/99 1999/2000 1995/96 1998/99 1999/2000
Total 82999 80353 57424b 100,0 100,0 100,0
1. Total mentally handicapped
including:
- slight degree of handicap
2.Linked handicap
3. Mobility impaired
4. Blind and visually impaired
5. Deaf and hearing impaired
6. Chronically ill
7.Autistic
8.Others
62517
56100
657
1759
1401
3488
10638
--
2539
61978
54237
350
1240
1048
3407
6061
41
6228
46040
39283
1471
1015
890
2658
2411
192
2747
75,3
89,7
0,8
2,1
1,7
4,2
12,8
xx
3,1
77,1
87,5
0,4
1,5
1,3
4,2
7,5
0,0
7,7
80,2
85,3
2,6
1,8
1,5
4,6
4,2
0,3
4,8 Source: Statistical Annual GUS years 1996,1999,2000 and own calculations.
a All classes together: integrated, mainstream, therapy and compensation classes. bSmaller number of pupils due to the education reform (since 1999 primary school only has 6 grades)
- 29 -
A principal factor determining the children’s chances of starting education is the type of
illness, type of disability and the place of residence. Mentally handicapped are not often educated in
the ordinary class of the mainstream primary school, while visually and hearing impaired often are.
Children with illnesses of the circulation system do not often attend integrated classes in primary
schools, but mentally handicapped more often do.
When a disabled child lives in the country, this considerably lessens their chance of
attending mainstream, integrated or special primary school: over 32% of disabled children living in
the country do not attend school, compared to about 23% of disabled children living in cities.
(Results of research into the state of health of the population of Poland in 1996, GUS statistics in
1999 for the B. Balcerzak-Paradowska report ed. 2002).
The level of education of the parents also effects the chances of the children’s education: the
lower the level of education of the head of the family, the bigger the percentage of children who are
not being educated. (GUS, 1999).
Gymnasiums
Due to the educational reform since 1999 there is a new type of compulsory school, a three
year gymnasium. This is a three year school which follows the 6 year primary school. Because they
have not been around for long enough, it is only possible to say that in 2001 the percentage of
disabled children attending mainstream gymnasiums rose, and the percentage of disabled children
being educated in special gymnasiums dropped considerably.
Table 13 Disabled children in gymnasiums
Specification
School Year 1999/2000
total
total in %
School Year 20002/2001
total
total in %
Gymnasiums
(integrated classed, compensatory classes, therapy classes, mainstream classes, one to one teaching) 3 232 15,9 18 569 35,3
Special classes in gymnasiums 656 3,2 1 672 3,2
Special gymnasiums 14 724 72,6 30 034 57,2
Special vocational schools 1 656 8,2 2 246 4,3
Total 20 268 100,0 52 521 100,0
Source: GUS Statistical Annual of the Polish Republic GUS years: 2000,2001 and own calculations.
- 30 -
Post-gymnasium schools
A great majority of the disabled special high school pupils attend special vocational
schools. However, the percentage of pupils in those schools dropped from about 95% during
1989-1991 to 90% in 2001 (compare table 14). The number of young people in mainstream
lyceums is insignificant, but it is slowly growing.
Table 14
Disabled young people in post-gymnasium schools
School Year Secondary schools of
general education Basic vocational
schools
Technical schools and vocational secondary
schools Total
1989/90
1990/91
1991/92
1992/93
1993/94
1994/95
1995/96
1996/97
1997/98
1998/99
1999/2000
2000/2001
356
421
417
437
526
553
882
1000
1149
1255
1198
1698
24086
24500
24684
25641
25826
26502
26895
27046
27384
28136
29412
30747
1051
896
874
932
971
1085
1139
1183
1344
1461
1542
1646
25493
25817
25975
27010
27323
28140
28916
29229
29877
30852
32152
34091
in %
1989/90
1990/91
1995/96
1997/98
1999/2000
2000/2001
1,4
1,6
3,1
3,8
3,7
5,0
94,5
94,9
93,0
91,7
91,5
90,2
4,1
3,5
3,9
4,5
4,8
4,8
100,0
100,0
100,0
100,0
100,0
100,0 Source: GUS „ Statistical Annual” for years 1992, 200, 2001, GUS „Education and Training in school year 1997/98” and
own calculations.
The assessment procedure for allocating placements in special and integrated schools is carried
out
by psychological – pedagogical advice services under the Department of Education.
As in the case of special primary schools, the biggest group of pupils of the basic vocational
training schools was consisted of young people with slight mental handicap; in the secondary
- 31 -
schools of general education (lyceum) it was basically only the chronically ill; in the technical
schools and vocational secondary schools – the blind and visually impaired, the deaf and hearing
impaired and the chronically ill (GUS 1992).
The access to secondary education depends on the place of residence and the location of the
schools and on the type of disability. In 1996 over 26% of the young people aged 15 to 19 were not
being educated (GUS 1999). The majority of young people are of the opinion that disability hinders
or prevents schooling. This is particularly noticed by the blind, the deaf and the mentally
handicapped.
The higher the level of education of the parents the more all types of families regret the poorer
educational opportunities for the disabled young people aged 15 to 18 (GUS 1999).
3.6.3. Special education and training centres
Disabled children and young people unable to attend nurseries and integrated or special schools
stay at special education and training centres. In the years 1989 – 2000 the number of residents in
these centres did not change significantly. These centres mainly look after mentally handicapped
children who make up about 70% of the residents (compare table 15).
Table 15
Number of disabled children in special education and training centres
by type of illness
1990 1995 2000 1990 1995 2000 Specification
in absolute figures in %
Total
Of that:
32575 33100 31776 100,0 100,0 100,0
The blind and visually impaired
The deaf and hearing impaired
The chronically ill
Mobility impaired
Mentally handicapped
1205
3680
1167
552
24164
1408
3396
670
256
23619
1284
3080
396
604
21976
3,7
11,3
3,6
1,7
74,2
4,3
10,3
2,0
0,8
71,4
4,0
9,7
1,2
1,9
69,2
Source: GUS Statistical Annual years 1997, 2001 and own calculations
3.6.4. Changes forecast in the system of disabled children’s education
The projected reform of the education system for the children with special educational needs
envisages a unified system of education for children and young people from 3 to 18. For the
- 32 -
children with complex disabilities (coupled handicap, mental handicap, autism etc.), a separate
educational route after completing the gymnasium.
The District (powiat or voivodship) Centres for Special Education are to become an important
element of the reformed system of education. Their responsibilities will include among others:-
- diagnosis in order to establish the best types of support for the child,
- disability certification and selecting suitable centres which will best support the child’s growth
(integrated nurseries, special nurseries, education and training centres),
- monitoring school attendance,
- supporting the child’s family when the child is at risk of abnormal development (Kantyka,
2001).
The reform of the education system aims to create optimal conditions for each child’s
development. It envisages inclusion of the disabled in the mainstream system of education,
irrespective of their physical, intellectual, social, emotional or other predispositions.
The education of the disabled children has developed a new look. In general, it aims for
integrated learning based on the following principles:
- education for all i.e. universal education for all children irrespective of the type and degree of
disability
- education as the highest quality action, based on the interactive teaching methods, developing
personal resourcefulness and social skills
- education as a dynamic process i.e. enabling the child to attend school at their rate of growth
- education as challenge through ensuring the open access, i.e. the opportunity for moving
between different types of school at every stage of schooling depending on the child’s need
(Kwapisz 2001, Balcerzak-Paradowska 2002).
4. Children with disability in families and in communities
The majority of disabled children are brought up in families. In most cases these are families
where there is only one disabled child (60%). However, over 13% of them come from families
where they had disabled brothers or sisters, and 27% from homes where there were also other
disabled household members.
- 33 -
Table 16
Disabled children in households
Disabled children in households Type of household
in absolute figures in %
Total 288 144 100,0
- with only one disabled child 170 500 59,2
- with only disabled children (two or more) 39 836 13,8
- disabled child or children plus disabled head of household 23 433 8,1
- disabled child or children plus disabled head of household and
their partner
14 598 5,1
- disabled children and other people (e.g. grandparents) 17 931 6,2
- other households with disabled children 21 846 7,6
Source: unpublished data from GUS from the research into the state of health of population in 1996
Several disabled people in the household happen more often in the country than in the city
(50.6% and 35.5% respectively). This is due among others to the fact that extended and more
numerous families are to be found more often in the country, but also to the poorer access to the
medical services and a lower level of medical knowledge leading to a worse state of health among
rural population compared to the city population.
More and more disabled children are ending up in quasi families: foster families and family
children’s homes (GUS 2001). At the same time the state pro-family policies aim to limit the
number of children (including disabled children) in social care homes and traditional children’s
homes. To achieve this aim social benefits are granted to poor families and new legal frameworks
are created
for setting up and subsidising by the local authorities of foster families and family children’s homes.
Child adoption centres are also being supported (Program... 1993, Pro-family policy... 1999). Foster
families and family children’s homes caring for disabled children are entitled to the same support by
the public institutions as the biological families.
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Table 17
Foster families
Specification 1990 1995 1999 2000 2001
Foster families in total 29 531 35 838 43 378 39 877
- of that, those caring for children with abnormal pattern
of growth 895 1 863 3 010 no data
Children in foster families in total 37 215 46 106 55 797 50 122
- of that, those with abnormal pattern of growth 942 1 982 3 299 3 609 5 981
Source: Statistical Annual GUS 2001
There is insufficient data to show changes relating to the numbers of disabled children
cared for in biological families compared to care institutions. The statistics analysis regarding the
numbers of disabled children in all types of public care and rehabilitation centres indicates that
fewer and fewer children stay in these centres. For example in 1999 there were 15 medical
treatment and training centres i.e. residential centres caring for children round the clock, providing
rehabilitation, medicines and medical materials). These had 753 children. In 2000 there were 11
such centres with 566 children.
The reason for the falling number of the treatment, training and rehabilitation centres for children is
not only due to the state pro-family policy but also with the reform of the system of health care.
Several such institutions have been closed down due to high running costs. The establishments still
working have limited the scope of the services they provide (e.g. smaller range of care, shorter stay
for children, smaller number of places) or they have limited the range of free services and replaced
it with services paid for by the child’s parents or carers.
The child’s disability necessarily means more care which limits the opportunities for parental
employment. This is the situation in every other family caring for a disabled child. Most of these
parents point out that they have to limit their job due to the child’s disability, and one third of
parents indicate an absolute impossibility of doing a job because they must care for the disabled
child.13
13 Information regarding the living conditions of the whole population of families with disabled children comes from the research carried out by the Central Statistical Office in 1996 (GUS 1997)
- 35 -
Diagram 1. The effect of the disability of child by age group on parental employment in %
16,5
3,1 4,82,2
38,134,7
43,7
33,6
7,312,6
0
10
20
30
40
50
0-2 3-6 yrs 7-9 yrs 10-12 yrs 13 -14 yrs
deterioration impossibility
Source: unpublished data from GUS research into the state of health of population in 1996
It was the city parents of disabled children rather than those living in the country that pointed out
more often the impossibility of carrying out a professional job, and the parents of younger children
rather than e.g. teenagers. The rural parents found it easier to combine the two types of duties
because, among others, a considerable number of rural families are extended families, and the
presence of other family members (usually grandparents) enables the sharing of care of the disabled
child.
Diagram 2. The effect of disability on professional work of parents in %
0,1 0,1
35,6 3732,3
8,3 9 7,1
50,9 4954,3
5,1 4,5 6,4
0
10
20
30
40
50
60
Total City Country
improvement deterioration impossibility no effect hard to say
Source: unpublished GUS data from the research into the state of health of population in 1996
- 36 -
It is parents with many children who are the most affected by the impossibility of professional
work due to the child’s disability (especially if the age differences between the children are small)
and the single parents. For these parents limiting or not having a job may equal falling into poverty
trap.
A lack of data makes it impossible to estimate the number of disabled children living in poor
families. Existing GUS surveys show that disabled children live most often in households where, in
spite of economising, it is difficult to make ends meet. In 1996 every sixth family with a disabled
child could only afford the cheapest food and clothes, while every eighth such family could not
even afford this modest expense.
Diagram 3. Disabled children by the situation of households
7,4
44,6
16,7
17,9
12,8
0,6
enough money for all we ecoomise but we have difficulties with large shopping
enough money for the cheapest food and clothes enough moey for the cheapest food but not clothes
not enough money for the cheapest food or clothes lack of data
Source: unpublished GUS data from the research into the state of health of population in 1996
There are extra material needs linked to having a disabled child compared to a family with able
bodied children. Almost three quarters of the total number of families with disabled children have to
make do without meeting these needs due to lack of money. In the case of the poorest families (the
ones who do not even have enough money for the cheapest clothes or food) this figure was 95%.
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Table 18
Disabled children aged 10 to 14 by the situation of households
and the most frequently limited expenses linked to disability in 1996 – in %
Households with disabled children
Type of expense Total
in which there is not enough
money for even the cheapest
food and clothes
Total 100,0 100,0
- no need to limit expenses 26,6 5,0
- limiting expenses 73,4 95,0
in that households limiting expenses on:
- treatment and rehabilitation in residential centres 12,1 10,4
- treatment and rehabilitation in day centres 7,0 6,9
- purchase of rehabilitation and medical equipment 8,1 13,3
- purchase of medicines and hygienic materials 12,0 27,5
- better food 33,7 54,6
- school/nursery 2,1 4,0
- recreation 28,4 37,7
- paid care 13,4 9,8
- other expenses 11,9 10,3
Source: unpublished GUS data from the research into the state of health of the population in 1996
The most frequently limited need is the provision for the child of better food and recreation.
When meeting the recreational needs it is not simply the cost that is a deciding factor, but also
a very small range of recreational services offered to the disabled child. In a large number of
families with a disabled child the expenses that become limited are the costs of treatment and
rehabilitation in the treatment care centres and also medicines and hygienic materials, which
over one quarter of the poorest families with children cannot afford. The expenses for the
rehabilitation and orthopaedic equipment are limited less often. The families least often lack
money for the educational services for disabled children as these are free, apart from having to
buy the text books and stationery.
The lack of money to meet the needs linked to the child’s disability is mainly reported by the
rural families. These have limited or given up their expenses far more often than the city
families.
- 38 -
Table 19
Disabled children aged 0 to 14 by the degree of meeting their needs linked to disability in 1996 –
in %
Specification Children
Total (288,100) 100,0
needs fully met 15,1
needs met to a significant degree 24,1
needs met to an insignificant degree 26,5
needs not met 24,1
no such needs 9,4
lack of data 0,8
Source: unpublished GUS data from the research into the state of health of the population in 1996
For the poorest families with a disabled child, who cannot afford the cheapest food and
clothes it is only possible to meet many needs linked to the child’s state of health thanks to the
free health care benefits (e.g. round the clock medical care and rehabilitation in public centres,
discounts in the costs of orthopaedic equipment, the services of free rehabilitation or
education centres). Many such institutions charge for their services according to the family
income. The persons whose income does not reach a certain ceiling get them for free. In other
cases the higher the income, the more the charge.
Even though it is the rural families that more often lack money for the cheapest clothes and
food, it is the city families whose finances are more often affected by having a disabled child.
This may be due to having to use paid care outside of the family, but possibly also a generally
higher living standard of living in the cities.
The negative effect of the child’s disability on the family finances was pointed out by the
families with more than one disabled person, especially those where the parents were
disabled.
Over half of single parent families felt a considerable deterioration of finance due to the
child’s disability. It may seem surprising that over one third of families with four or more
children did
not state that the child’s disability caused a deterioration of their living conditions. This may
be because most of these families live in difficult conditions anyway, not because they have a
disabled child, but because they have a large number of children.
- 39 -
The necessity to limit expenses linked with the child’s disability means that the needs of
other members of the household and family also remain unmet. Almost three quarters of the
families with disabled children reported urgent problems. This group includes the problems
linked directly to the state of the child’s health, but also others such as the family’s living
conditions.
Such a situation was reported by nearly two thirds of families with disabled children;
slightly more in cities (38%) than in the country (31%). The needs which most often remain
unmet are: medical rehabilitation, improving housing, provision of medicines and suitable
doctor’s care. It is worth mentioning that in 7.5% families with a disabled child the urgent
need was a change of carer or the stating of a job by carers/parents.
Table 20
Disabled children aged 0 to 14 by the most urgent needs of household in 1996 r. – in %.
Specification Children in households
Total (288,100) 100,0
-medical rehabilitation, increasing efficiency 22,3
- improving living conditions 20,7
- provision of medicines 17,1
- doctor’s care 15,5
- orthopaedic and rehabilitation equipment 8,5
- gaining or change of work of carer 7,5
- installing the phone line 6,4
- school/nursery for the child 6,2
- out of school care for the child 6,0
- getting a flat 4,6
- purchase of a car 4,4
- help with daily living activities 3,3
- others 10,8
- no urgent needs 28,8
Source: unpublished GUS date from the research into the state of health of the population in 1996
The family is the basic community where the disabled child lives. The acceptance of a
disabled child is as important as the care and help given. The parental attitudes betraying
emotional distance or over-protectiveness may lead the child to develop a low self esteem.
- 40 -
The majority of the parents of disabled children state that the disability does not effect family
ties. In some cases it is pointed out that the disability strengthens these ties, the child’s health
concerns increase emotional engagement of the parents and fosters family closeness.
Unfortunately there are cases where disability deteriorates family relations.
This is illustrated by the GUS research from 1996.14
The effect of disability on family ties:
- improvement 14.8%
- deterioration 9.2%
- no effect 69.9%
- hard to say 6.8%
Source: GUS / 1996/, MPiPS/1998/
The parents of children living in cities more often stress the consolidation of the family which
experienced the disability of a child. The rural families find the situation harder to accept.
Away from the family the child’s natural community is the peer group. Playing and learning
together allows children to develop and learn various social roles, and to feel a fully fledged
member of the peer group. The mainstream, specialist and integrated institutions provide
opportunities for peer contact depending on the age of the child.
In 1996 the youngest children (0 to 2 years) most often (86.9%) did not participate in special
activities. The children of 3 to 6 years (54.6%) more often participated in activities organised by
mainstream nurseries (28%). A small group of children (3.6%) attended special centres for the
disabled children, and 2.0% attended integrated nurseries. (GUS 1996)
For the children aged 7 to 14 school is the place of integrating with their peers. In 1996 the
disabled children most often (70%) participated in activities in a mainstream school. 3.1% of
disabled children attended integrated schools.
Part of the children remained at home due to their state of health and received home tuition (6.9%).
The degree of disability caused 37% of children not to be educated or participate in special
activities.
What effects the development and social integration of disabled children is the opportunity to
14 The source of date in this part, as in many others, are the results of the research into the state of health of the population of Poland, carried out in 1996 by the Central Statistical Office GUS.
- 41 -
participate in culture and recreation. This allows to develop interests, raising the intellectual level of
the child and to internalise values together with a large group of peers or adults. The disability
mostly does not effect the child’s participation in culture and recreation.
This is illustrated by the GUS data from research in 1996:
- 42 -
The effect of child’s disability on access to culture and recreation
Access to
culture recreation
- improvement 0.6% 1.5%
- deterioration 18.7% 31.0%
- impossibility 5.7% 6.3%
- no effect 64.6% 50.9%
- hard to say 10.4% 10.1%
Source: GUS /1996/, MPiPS /1998/
Country children have a limited access to culture and recreation. The main reason is a lack of
cultural and recreational centres in the country.
The process of integration and socialisation also happens through contact with the family
friends. The attitude of these persons to the disabled child and their family forms the basis of a
friendly or unfriendly community.
Most of the parents with a disabled child state that the state of health of their child does not effect
the relations with other people. However, almost one fifth of families experienced a deterioration of
such contacts.
This is illustrated from the GUS research in 1996.
The effect of child’s disability on human relationships
- improvement 3.5%
- deterioration 18.6%
- no effect 69.9%
- hard to say 7.5%
The majority of families with a disabled child are not able to meet the needs linked to the state of
- 43 -
health of the child. They should receive adequate help. This should be provided mainly by public
institutions whose responsibility it is to do so. However, their activities are assessed by most parents
as inadequate. According to research in 1996 over 45% of parents do not approach anybody for
such help. The remaining families approached health care centres (33%) and social help centres
(21.8%). However, these institutions provide mainly medical assistance (less and less of it; only
periodically and as a consultation) and financial help. The parents of disabled children very often
report the need for recreation, contact with the peer group, social integration. The meeting of these
needs is limited by lack of money (the lessening range of discounted entry tickets for events put on
by non-public institutions and the growing poverty of families) as well as architectonic barriers and
barriers of awareness. There have been created a number of non-public institutions, both
denominational and non-denominational, which try in different ways to meet various needs of the
disabled children and their families. However, there are few actions leading to creating
communities.
Such activities integrating the community of the disabled children or their parents has not so far
been properly supported (e.g. by providing a venue or advice) on the part of the local authority,
which are responsible for solving problems of the disabled children and their parents in the local
area (Juros 1999).
In Poland there are many social organisations supporting disabled children and their families in their
locality. (compare point 2).15 However their activities are assessed by the carers as inadequate,
mainly because they are not equally distributed around the country. The most such organisations
work in large cities and well developed areas (30% of all foundations supporting disabled children
are in Warsaw). Small towns and villages and areas less well developed economically have few
public institutions supporting disabled children and their parents, and few non government
organisations. Access to the medical and rehabilitation services, educational centres for the disabled,
cultural centres, leisure centres, legal advice centres and information centres in small towns and
villages is definitely inadequate. Such organisations should integrate the children’s parents/carers,
be their forum to exchange information and mutual support centre.
Such needs are hardly met by public institutions. At the same time around one third of the NGOs
in Poland work solely for the benefit of a very small local community, and over one half solely for
the benefit from a given region. Because of this, as can be seen from the research of GUS (MPiPS
15 Keeping in mind that such organisations have only been free to set up since 1998.
- 44 -
1998), the disabled children and their parents/carers can usually only rely on their own family for
help.
Non government organisations help 16.1%, of which almost 20% in towns and 9.1% in the country.
21% of the children’s carers did not know about the existence of an organisation which might help a
disabled child and their family (in the country as many as 30% of parents/carers did not know).
The higher the level of education of parents (and thus more knowledge, coping strategies in various
situations e.g. in public offices, access to information etc.) the more often these parents maintained
contact with non government organisations: they created them, worked in them and used them.
- 45 -
Appendix 1
Specification Legal Basis
Child care system in Poland
This system is basically regulated by four acts: - Act – Family and Care Code dated 25 February 1964 (Dz. U. 1964 No 9, pos. 59 & changes), - Act re the education system dated 7 September 1991 (Dz. U. 1996 No 67, pos. 329 & changes), - Act re procedures regarding minors, dated 26 October 1982 (Dz. U. 1982 No 35, pos. 228 & changes), - Act re social help dated 29 November 1990 (Dz. U. 1993 No 13, pos. 60 & changes).
Status of disabled person Act dated 27 August 1997 re vocational and social rehabilitation and employment of disabled persons (Dz.U.97.123. 776 & changes)
Certification of child’s disability
Act dated 1 December 1994 re family and care allowances (Dz. U.1998 no 102, pos. 651& & changes) Ordinance by Minister of Labour and Social Policy dated 1 February 2002 re criteria of assessing disability in persons under 16 years old (Dz.U.02.17.162). Ordinance of Minister of Labour and Social Policy dated 21 May 2002 re certification of disability and the degrees of disability (Dz.U.02.66.604).
Social care system benefits
Act dated 29 November 1990 re (Dz.U.98.64.414 & changes) Ordinance of Minister of Labour and Social Policy dated 10 March 1997 re specific principles of granting temporary allowance (Dz. U .97.26.140). Act dated 6 February 1997 re universal health insurance (Dz.U.97.28.153 & changes). Proclamation by Minister of Labour and Social Policy dated 14 May 2002 re valorisation index, amounts of income after valorisation and amounts of social help benefits, and amount forming the basis of determining the amount of some social benefits from the 1st June 2002 (M.P.02.19.338). Ordinance of Minister of Labour and Social Policy dated 15 September 2000 (Dz. U. no. 82 pos. 929)
Institutional and community help within the social help system and the education system
Ordinance of Minister of Labour and Social Policy dated 18 December 1996 re types of specialist care services and qualifications of persons providing such services for persons with mental disturbances, principles and procedures of charging for these services and conditions of part or full exemption from payment of charges (Dz. U .97.2.12). Resolution of Directors of National Fund for Rehabilitation of Disabled Persons dated 22 March 2000 replacing resolution no 31/99 of the said Directors dated 25 January 1999 re ratifying principles of subsidising rehabilitation camps from PFRON resources. Ordinance of Minister of National Education dated 21 February 1994 re types, organisation and ways of working of public care and training and resocialising centres (Dz.U. of 28 March 1994.)
Social insurance benefits Act of l December 1994 re family allowances, care and training allowances (Dz. U. of 1998 , No 102, pos. 651 & changes) Ordinance of Minister of Labour and Social Policy of 2 August 1999 re determining patterns of documents and other evidence necessary
- 46 -
for establishing entitlement to family allowance, care and training allowance and specific principles and procedures of payment of these allowances (Dz. U. of 1999 No 68, pos. 761) Ordinance of Minister of Health and Social Care of 26 January 1998 re the states of health and specific rules, conditions and procedures of issuing certificates forming the basis of receiving care benefit for the child (Dz. U. of 1998, No 15, pos. 70).
Tax system Act of 29 August 1997 Tax Regulation (Dz.U.97.137.926 & changes). Act of 26 July 1991 re income tax from private persons (Dz.U.93.90.416 & changes). Ordinance of Minister of Finances dated 24 March 1995 re executing some regulations of the Act of income tax from private persons (Dz.U.95.35.173 & changes). Ordinance of Minister of Finances of 24 March 1995 (Dz. U. no 35, pos. 173).
Act of 7 September 1991 re education system (Dz.U.96.67.329 & changes). Act of 20 June 1992 re entitlement to discounted travel on public means of transport (Dz.U.92.54.254 & changes). Act of 21 December 2001 re changing the Act re entitlement to free and discounted travel on public transport and re changing other Acts (Dz.U.02.4.34). Act of 6 February 1997 re universal health insurance (Dz.U.97.28.153 & changes). Act of 20 June 1997 re road traffic regulations (Dz.U.97.98.602 & changes). Ordinance of Minister of Infrastructure of 29 January 2002 re determining types of documents confirming entitlement to discounted travel on public means of transport (Dz.U.02.8.74). Ordinance of Minister of Transport and Maritime Economy and Internal Affairs and Administration dated 21 June 1999 re road signs and signals (Dz.U.99.58.622 & changes) Ordinance of Minister of Infrastructure of 30 January 2002 re sample parking card for disabled persons and its price (Dz.U.02.13.126) Ordinance of Minister of Labour and Social Policy dated 25 June 2002 re determining types of responsibilities of the district (powiat) which may be financed from the resources of PFRON (Dz.U. 02.96.861).
Help with dealing with public offices (Dz.U. of 1998 , No 64, pos. 414 & changes). Subsidising rehabilitation equipment Act of 6 February 1997 re universal health insurance (Dz.U.97.28.153 & changes).
Ordinance of Minister of Health of 10 October 2001 re specific list of orthopaedic objects, aids and technical means of treatment, the amount of own contribution to their purchase, basic criteria of granting them, periods of usage, and also orthopaedic objects due for repair (Dz.U.O1.121.1314). Ordinance of Minister of Health of 10 October 2001 re limits on prices of orthopaedic objects, aids and technical means of treatment, designed for the same use but at various prices, and limits on costs of repairs of orthopaedic objects (Dz.U.01.121.1313). Ordinance of Minister of Labour and Social Policy of 25 June 2002 re types of responsibilities of the district (powiat) which may be financed from the resources of PFRON (Dz.U.02.96.861).
Target Programmes by PFRON Act no 7/2000 of the PFRON Board of Directors of 21 March 2000 re ratifying target programme entitled “Computer for Homer” – help
- 47 -
with purchasing electronic hardware and software enabling the blind and visually impaired to work, changed by Act no 11/2002 of the PFRON Directors of 5 March 2002 Act no 124/2002 of the PFRON Board of Directors of 11 April 2002 re adopting procedure for realising programme “Computer for Homer”. Act no 8/2000 of the PFRON Board of Directors of 21 March 2000 re adopting procedure for realising target programme entitled “Pegasus – help in mobilising the disabled through the removal of transport barriers” changed by Act no 9/2002 of the PFRON Board of Directors of 5 March 2002. Act no 123/2002 of the PFRON Board of Directors of 11 April 2002 re adopting procedure for realisation of the “Pegasus” programme.
Early Retirement Sentence of the Constitutional Tribunal of 4 January 2000 (Dz.U.00.2.26).
Benefits for disabled pupils Order no 29 MEN of 4 October 1993 .(Dz. Urz. MEN z 1993 r. No 9, pos. 36). Ordinance of MEN of 15 January 2001 re rules for granting and organising counselling and teaching assistance in public nurseries, schools and centres (Dz. U. of 2001, No 13 pos. 110)
Duty exemption on rehabilitation equipment and devices
Ordinance of Minister of Health of 18 June 2001re exempting from duty rehabilitation equipment and devices facilitating or enabling the process of medical and vocational rehabilitation of the disabled and goods especially adapted for the aims of scientific or cultural studies, raising professional qualifications of these persons (Dz.U. of 2001 no 77, pos. 705).
- 48 -
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