The Social Policy of the Second Polish Republic Towards Disabled People

Introduction

The problem of disability has always been one of the most important issues for the social policy. After the period of the Partition of Poland, there were hundreds of thousands disabled people in the re-emerging country and this group was, to a large extent, internally diversified. Although we cannot say that the state policy towards this category of citizens was uniform, the way in which it attempted to solve the issues related to that social problem is worth examining. The most significant areas of such analysis are the legal bases and the types of support they guaranteed as well as the organizational and financial forms of support, the size of the population of the disabled and the extent to which the support was provided.

Legal Conditions

In the interwar Poland, the activities which aimed at supporting the disabled were not uniform and they were based on a broad set of legal acts. The most fundamental were: the regulations concerning war-disabled persons, legislation on work accident insurance and the legal bases for the functioning of social welfare. The most diversified were the solutions related to the provision of financial means to the disabled in respect of an accident at work. In the area of the former Prussian Partition, the regulations of the German insurance ordinance of 19^th July 1911 were binding and, in the area of the former Galicia, the regulations of the act on work accident insurance of 28^th December 1887. Initially, work accident insurance didn’t cover the area of the Russian Partition. The situation changed only on 30^th January 1924 with the introduction of the act which made the Austrian regulations binding in this Partition (Journal… 1924: 16/148; Chylak 2014: 72-74).

The unification of the rules concerning insurance happened in 1933 when the act on social insurance of 28^th March 1933 was introduced. It covered all people in employment, expect several groups subject to separate regulations. According to the act, the benefits included: full or partial pensions in respect of an accident at work (dependant on the degree of an inability to work as well as on the level of income), orphan’s pension, medical support and benefits-in kind as well as the provision of a place in facilities for the disabled (in return, the entire or a part of pension was deducted) (Journal… 1933: 51/396; Piątkowski 1983: 30-33).

What turned out to be of particular importance in the interwar period was finding the solution to the problem of providing support to war-disabled persons. The demand for the provision of financial means to the heroes of the struggle of independence was satisfied on 18^th March 1921 with an adequate act introduced by the Legislative Sejm. The act guaranteed the provision of pension benefits, pensions paid to widows and orphans, medical services, the provision of orthopaedic products, access to vocational retraining, social support and activities in favour of professional mobilization (Journal… 1921: 32/195; Grata 2011: 108).

The third element of the legal guarantees related to the support of the disabled were the regulations specifying the functioning of social welfare. The 1^st article of the act of 16^th August 1923 guaranteed that the basic needs of people who, permanently or temporarily, did not have any financial means or were unable to work, would be satisfied with the public funds. Such understood support was provided to “invalids, the disabled, the terminally ill, the mentally disabled” and other people unable to work. The majority of supportive activities were undertaken by self-governments and private support institutions (Journal… 1923: 92/726).

The Number of Disabled People

It is difficult to estimate the exact number of the disabled in the Second Polish Republic. The only relatively accurate data provide information on the number of registered war-disabled persons and military invalids as well as the disabled who received insurance benefits in respect of an accident at work. The number of the remaining disabled is much more difficult to estimate. Apart from the number of people staying in support facilities and mental hospitals, we can only submit the approximate estimate.

On the brink of independence, the number of war-disabled persons in Poland was estimated at about 200 000. Later, due to the registration process, it turned out that there were about 150 000 of them. As the result of the introduction of the act on disability of 17^th March 1932, this category also included military invalids and, therefore, in the mid-30s, the total number raised to 166 000 (about 145 000 - 150 000 people were permanently incapable to work). Among this group, the most frequent reason for disability were limb injuries (over half of the disabled), the second most frequent reason were head and spine injuries. About one fourth of invalids suffered a relatively minor damage to health, 60% of the population suffered moderate damage to health and 1.3% of war-disabled persons suffered serious damage to health (loss of 85% of the capacity to work) (Journal… 1932: 26/423; Statistical… 1931: 118; 1939: 293).

The number of the disabled in respect of an accident at work or occupational disease was considerably less stable. It increased proportionally to the occurrence of this type of events. In 1925, the number of the disabled in this category amounted to 45 700 and, in later years, it was increasing by a few or a dozen or so thousand a year. In 1934, there were 87 500 of them and at the end of 1937 – 97 500. Adding to this number a several thousand of the disabled receiving retirement insurance benefits, it can be assumed that the total number exceeded the level of 100 000 before the war (Statistical… 1936: 215; 1939: 307; Ubezpieczenia… 1935: 24).

It is extremely difficult to estimate the number of the disabled falling into the above mentioned category. According to the limited data collected during the census of 30^th September 1921, there were 76 100 invalids in Poland, out of whom 59 500 were people above 19 years old. In the mid-20s, the Ministry of Labour and Social Welfare assumed that the number of the disabled above 18 years old amounted to about 100 000. The estimate number of disabled children was on the level of about 25 000. Therefore, the total number of the disabled in Poland was on the level of about 125 000. We should also add to this calculation the number of the mentally ill, however in this case, the accurate data are even more difficult to obtain. At the beginning of the 20s, the Ministry of Public Health estimated that there were 38 000 mentally ill people who required on-site treatment in Poland but the estimate, based on the comparison with other countries, indicated that there could be about 45 000-60 000 people with this type of disability in the country (Ministerstwo… 1926: 122-124; Luniewski 1934: 452-453; Pierwszy… 1927: 58-59).

In the mid-20s, the number of the disabled who were covered by neither work accident insurance nor the legislation on disability was estimated at 160 000-180 000. Though it seems that it is still an underestimate. The document, prepared for the Ministry of Social Welfare in 1933, estimated that there were about 200 000 disabled people (MSW: 530/22-25) who were not covered by the insurance or benefit support. This number needs to be increased by further 25 000 of people with reduced mobility. Therefore, the total number of the disabled can be estimated at 500 000, although in this case, it can also be an underestimate.

Money Benefits for the Disabled

Money benefits were the common form of support provided to the disabled. They were only available to those who were covered by the regulations on disability benefits, social insurance and the pension benefits of public servants. Therefore, in the discussed period, the permanent financial support included pensions for war-disabled persons, military invalids and disabled civilians as well as those incapable to work as the result of an accident at work and the family members of a deceased claimant (pensions paid to widows and orphans). Therefore, this collectivity was considerably bigger than the number of the disabled alone covered by the adequate legal regulations.

War-disabled persons constituted the highest number of beneficiaries. In accordance with the act of 1921, work disability benefits were paid to those whose degree of inability to work was estimated at the level of at least 15%. At the end of the 20s, there were about 109 000 people entitled to receive work disability benefits and, in later years, the number increased to 133 000. Because some invalids chose to stay in employment, in 1932, benefits were paid to 112 400 of the disabled. This number was topped up by 65 700 of widows, 62 500 of orphans and 15 400 of parents of the deceased disabled. Therefore, the total number of people receiving work disability benefits amounted to 256 000. This number was, however, reduced by the legal changes introduced between 1932-1933. The result was the reduction of the number of invalids who received benefits to 77 800, i.e. by over one third. Later, the rules concerning the benefit provision were relaxed again and, in 1938, the number of beneficiaries increased to 97 900 and the number of all paid benefits exceeded the level of 200 000 (Statistical… 1930: 355; 1933: 125; 1939: 294).

The number of benefits paid to the disabled in respect of an accident at work or their family members was looking differently. The highest level was achieved just before the outbreak of the war when the number of the disabled entitled to receive benefits equalled the number of war-disabled persons receiving benefits. In 1925, 45 700 people received benefits in respect of an accident at work and, in 1937, this number increased to 97 500. Pensions in respect of an accident at work were also paid to the family members of the deceased claimant. In 1937, the number of such benefits reached the level of 27 000. Therefore, the total number of pensions in respect of an accident at work was on the level of 125 000 (Statistical… 1939: 307; Ubezpieczenia…: 24).

The rules concerning the provision of benefits were very diversified. They mainly depended on the degree of disability. The level of benefits received by war-disabled persons was regulated by the legislator, whereas the level of benefits paid in respect of an accident at work depended on the previous income of the disabled. The level of benefits paid to war-disabled persons was relatively high and the level of benefits paid to those more seriously injured needs to be evaluated in a positive way. The situation was different in the case of benefits paid in respect of an accident at work. Their level could only reach the maximum of two third of the lost income, which means it was low. In the 30s, the most seriously injured received benefits which, on average, were three times lower than the benefits paid to war-disabled persons with the same degree of disability (Sobocinski 1934: 52-58; Modlinski 1932: 107-109; Piatkowski 1983: 33).

In the case of both systems, the rules and the level of benefits paid to the family members of the deceased claimant were also quite different. Pensions paid to widows were on the level of 30% of a regular pension of the late husband and pensions paid to orphans on the level of 20%. In the case of work accident insurance, the situation was slightly different. Pensions paid to widows were on the level of 20% of the income of the late husband (pensions paid to orphans were on the similar level), which meant that they constituted nearly one third of the maximum benefit the deceased claimant was entitled to receive. In 1933, the level of pensions paid to widows was raised to 30% of the average income of the late husband which, in the case of the less injured, meant that they were on the level comparable (or even higher) to the pensions received by the disabled injured in an accident (Journal… 1932: 26/238; 1933: 51/396; Modlinski 1932: 107-108).

The Institutional Support Provided to the Disabled

Formally, in the Second Polish Republic, the set of available tools of support was very extensive. The problem was the subjective scope of the support provided to the disabled. As in the case of money benefits, war-disabled persons as well as the disabled entitled to receive work accident insurance were more privileged than the rest of the disabled for whom the provided support was generally facultative and the number of beneficiaries had nothing to do with the scope of the problem.

The most extensive support was offered to was-disabled persons and military invalids. It included outpatient and inpatient treatment, the right to benefit from sanatoriums and health resorts, social care and the provision of prosthesis. As in the case of war-disabled persons, the right to medical services and the prosthesis implementation was guaranteed to the disabled receiving benefits in respect of an accident at work. However, in this case, the allocated means were considerably lower than in the case of the treatment of war-disabled persons financed from the state budget (Leczenie… 1930: 1-3).

The institutional support offered to war-disabled persons was complemented by the activities of the institutions which offered vocational retraining or provided care in the case of complete incapability to an independent existence. In the 20s, a several hundred disabled people took part in various trainings financed from the state budget every year. War-disabled persons, who were completely unable to work and were not taken care of, could benefit from, so called, houses for the disabled where they received free accommodation (with all additional costs covered) and medical care. The houses were located in Plock, Lviv and Vilnius (Sprawozdanie… 1924: 280-281).

The support provided to disabled citizens looked different than in the case of war-disabled persons and military invalids as well as the disabled in respect of an accident at work. Considering their high number indicated above as well as their considerable needs, it is difficult to draw any positive conclusions. In the mid-20s, there were only eight specialized facilities for the disabled over 18 years old and twenty-four for children. However, with time, the situation improved and the number of the facilities increased by several dozen. Yet still, in the 30s, there were not enough beds in the specialized facilities for the majority of the disabled in need (Ministerstwo… 1926: 122-124; Rudzinska 1938a: 224; Rudzinska 1938b: 86).

The organization of inpatient care provided to the mentally ill was a separate issue. The number of beds in specialized treatment facilities was permanently insufficient. In the mid-20s, there were 11 000 beds available for patients in mental hospitals but further 11 000 were needed. The coming years brought a significant increase in the number of beds in hospitals and, in 1934, there were already 14 500 of them. Despite this improvement, the needs were still greater as it was estimated that further 20 000 beds were required (Statistical… 1935: 189; Luniewski 1934: 453-454).

Conclusions

In the Polish social policy towards the disabled, certain groups were clearly more privileged than others. They benefited from the system of money benefits, medical support and even the extensive forms of professional mobilization. The remaining disabled citizens were the second point of interest for the state authorities. Despite the fact that their number was equally significant, they were not entitled to receive money benefits and they could only benefit from the institutional support to a limited extent. This type of support was generally insufficient (in comparison to their needs) and its provision was limited only to the poorest and the most disabled. Therefore, within the existing system, the majority of them could not count on any type of support and they continued to remain outside the sphere of interest of the social policy implemented by the state and self-governments.

To sum up, in the interwar period, the Polish social policy towards the disabled was half way towards modernity. An example of the modernization activities was, undoubtedly, the way of dealing with the problems and the needs of war-disabled persons. Also, the direction of changes taking place in the area of work accident insurance had a similar dimension. The attitude towards the remaining categories of the disabled was still traditional. This, however, didn’t result from the unwillingness towards more active policy but from the lack of the actual possibility to adequately satisfy the existing needs.

Literature