International Development Committee Inquiry into FCDO and disability-inclusive development -

Written Evidence from Hope and Homes for
Children - 04/09/2023

Who we are

Hope and Homes for Children is an international NGO that works to protect children from being confined to institutions (commonly referred to as orphanages). We draw on almost 30 years of expertise in deinstitutionalisation, working with governments, funders, civil society organisations, families and children to create the conditions for long-term reform.

The UK commitment to deinstitutionalisation

At the 2018 Global Disability Summit, hosted by the UK, the UK government adopted a ground-breaking policy position on children and young people in institutions, which noted the harm of institutionalisation and stated the government’s commitment to ensuring that all children “realise their right to family care and that no child is left behind”.[1] It committed the UK government to tackling the underlying drivers of institutionalisation and working towards the long-term process of deinstitutionalisation.

This declaration, which was unique among OECD countries as it applied to all UK government departments, established the UK as a champion of global care reform. Its principles were incorporated into the FCDO Disability Inclusion and Rights Strategy 2022-2030:

We continue to support the global commitment to shift from institutional care of children to community and family-based care. De-institutionalisation is a long-term process that requires quality, accessible and inclusive structures and services at both government and community levels. We will continue to tackle the underlying drivers of institutionalisation and strengthen protective systems for children with disabilities.

Why we are making this submission

In this submission, we will outline why care reform and deinstitutionalisation is such a vital part of the UK achieving its goals on disability inclusion and rights, as well as its wider development goals, and address two specific questions for the inquiry:

The adequacy of FCDO’s new disability and inclusion rights strategy as a framework for approaching disability-inclusive development. Here, we will outline how monitoring, evaluation and funding mechanisms can be clarified to ensure that FCDO’s words on deinstitutionalisation, most recently in the Disability Inclusion and Rights Strategy, are clearly matched with measurable actions.

The role of the UK in disability inclusion within the global humanitarian and development community. Here, we will highlight a recent FCDO co-hosted event “A Vision for Better Care and Child Protection in Ukraine's Recovery” as a positive example of the strategy in practice.

The harm of institutions

The 5.4 million children living in institutions across the world[2] form one of the most vulnerable and marginalised groups in society, exposed to a system that harms their development and systematically violates their rights. Violence, abuse and neglect in institutions is pervasive[3] and the long-term harm to children’s development is demonstrated by over 100 years of evidence.[4] Crucially, the majority of children in institutions are not ‘orphans’; approximately 80% have at least one living parent.[5]

The overrepresentation of children with disabilities in institutions

Around the world, children with disabilities are disproportionally placed in residential institutions.[6] Even in countries that have reduced the number of children in institutions, children with disabilities often remain institutionalised, left behind in the care reform process. This is in contravention of the right to independent living and family life, as stated in the UN Convention on the Rights of Persons with Disabilities.[7]

The overrepresentation of children with disabilities in institutions is a symptom of a society in which persons with disabilities are discriminated against, socially excluded and deprived of necessary support.

The harm of institutionalisation on children with disabilities

Children with disabilities growing up in institutions suffer the consequences of extreme neglect, inappropriate treatment practices and lack of oversight. This can result in physical underdevelopment and motor skills delays (such as muscle atrophy from a lack of movement and exercise), psychological harm, and in some cases, premature death[8]. In addition, evidence demonstrates that many institutions fail to provide children with disabilities with even the most basic levels of education.[9]

Institutions can expose children with disabilities to extreme levels of violence. There is considerable evidence of reported physical, emotional and sexual abuse, discrimination, and violence, including food deprivation, forced sterilisation and electroshock therapy without anaesthesia.[10]

The alternative

The commitment to support global care deinstitutionalisation efforts in the strategy is welcome; this will require the FCDO working with international and local civil society organisations and experts, multilateral institutions and international governments. To support governments working on reforming their care systems, we have produced a Roadmap to Care Reform – Families. Not Institutions. This roadmap demonstrates how identifying and tackling the drivers of why children with disabilities are separated from their families and placed in institutions provides a valuable entry point to understand the nature, location and mix of services needed to best support children with disabilities and their families. Experience in different contexts demonstrates that care reform inclusive of children with disabilities is possible and in doing so opens the door for creating more inclusive services for all in the community. (This is just one example of many useful civil society resources that are available on this topic.)

The adequacy of FCDO’s new disability and inclusion rights strategy as a framework for approaching disability-inclusive development.

While the inclusion of deinstitutionalisation in the strategy is a positive step, and builds on the 2018 cross-departmental commitment, what have not been included so far are clear monitoring, evaluation and funding mechanisms to demonstrate that these commitments have been turned into action. There has been no reporting on the deinstitutionalisation commitments of the UK since the 2018 policy was put in place; this makes it challenging to evaluate the extent to which the FCDO is truly prioritising this agenda.

To ensure the adequacy of the disability inclusion and rights strategy in terms of its commitments to support global deinstitutionalisation efforts, the FCDO should answer the following questions:

-          How is the FCDO delivering on the commitment to support global deinstitutionalisation efforts?

-          How is it ensuring that it is tackling the drivers of institutionalisation?

-          How is it communicating this priority and its perspective on not funding institutions in its call for funding and in its dialogue with partner countries?

-          How is it reporting on this goal? 

-          What will success look like? 

-          How does it ensure that the projects it supports are in line with this commitment? 

-          How is FCDO promoting this priority on the global stage both bilaterally and multilaterally?

One challenge to effectively monitoring progress on deinstitutionalisation is the lack of reliable data in each country on the number of children in the institutional system, as well as their specific needs. This is an area where the FCDO is well placed to deliver on its commitment to advance global deinstitutionalisation efforts; working with countries on developing robust monitoring systems for all children in institutions.

The role of the UK in disability inclusion within the global humanitarian and development community

We wish to highlight an event that was an excellent example of the FCDO working alongside international partners and civil society as part of the 2022-2030 Disability Inclusion and Rights Strategy.

On June 23rd 2023, the FCDO, along with the Government of Ukraine, UNICEF, Lumos, and Hope and Homes for Children, co-hosted “A Vision for Better Care and Child Protection in Ukraine's Recovery”, a side event to the Ukraine Recovery Conference, at the FCDO offices. This event brought together senior figures from the Government of Ukraine, the European Commission, the UK Government, the UN and Ukrainian civil society to explore how to work together to ensure that the Government of Ukraine is supported in its care reform efforts, with a particular focus on inclusive measures that address the unique needs of children and individuals with disabilities.

At the event, the following senior international figures declared their support for the care reform process:

• The Minister of Social Policy of Ukraine, Oksana Zholnovych, presented Ukraine’s ambitious Better Care agenda and called for all those in the room to join Ukraine and publicly commit to supporting the reform process
• Denise Brown, UN Humanitarian Coordinator for Ukraine, spoke of the UN’s commitment to supporting the Government of Ukraine’s journey towards care reform
• Danae Dholakia, UK Special Envoy for the Ukraine Recovery Conference, reiterated the UK’s ground-breaking 2018 commitment to support global care reform efforts
• The Vice President of the European Commission, Dubravka Šuica, reiterated the EU’s support for Ukraine’s care reform process and, crucially, stated that “the quality and success of the deinstitutionalisation…will be an important benchmark for measuring Ukraine’s preparedness for accession.”
• Philippe Cori, Regional Director for Europe and Central Asia, spoke about what will be needed to make this reform a success, including support for the social workforce and concrete funding commitments.

All of these senior representatives of international governments and multilateral institutions came together at the FCDO and publicly committed to working together to support a care reform process in Ukraine that is inclusive of children with disabilities. This event showed what can be achieved when the FCDO works with international governments, multilateral institutions and civil society to shine a light on this important topic. It showed that the potential is there for the FCDO to use its position as a global convener of these actors to advance the agenda outlined in the Disability, Inclusion and Rights Strategy.

We wish to formally thank the FCDO for hosting this event and encourage further use of the UK’s ability to convene key actors to accelerate the global shift away from institutionalisation and towards family and community based care.