Does Policy Impact Equitable Access to Services? A Critical Discourse Analysis of Discharge Policies in Paediatric Rehabilitation

Having the choice to access rehabilitation services is a right of disabled children. In Ontario, Canada, paediatric rehabilitation services are provided by Children’s Treatment Centres (CTCs), and many manage missed appointments using discharge policies. The impact of discharge policies on access to rehabilitation services is unknown. This study critically examined the language of policies around missed appointments and impacts on service access. Using qualitative critical discourse analysis, text from discharge policies was analysed, considering how marginalised groups (e.g., low-income families, culturally diverse families) may be affected by CTC discharge policies. Discourses of family-centred service, health equity and the perpetuation of established power relations within paediatric rehabilitation were represented in the language of policies. Current policies place the organisation in a position of power, de-value family choice and risk infringing on the right of disabled children to access paediatric rehabilitation services when desired.