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Because most intellectually disabled people cannot speak for themselves, and many of their parents are overwhelmed by the disaster that has befallen them, overburdened with their care responsibilities, the formulation of policy for intellectually disabled people is dominated by professionals, who are outside the agony of daily reality. Their primary concern is, understandably, theory not practice. Their major interest is in remaking services and policies according to some new theory, to which they hope to contribute. To many parents this makes them appear indifferent to the actual needs of people, especially those on waiting lists for housing and services who get no worthwhile service at all.

For the last 50 years the basic concepts driving top-down policies have been inclusion and community living. These poly-semantic terms are generally left unexplained and undefined. Taken at face value they seem above question. But in practice they function as a cloak to damn any opposition to the current orthodoxy in academic, professional and government circles.

Prominent in this context has been the doctrine of compulsory de-institutionalisation, which derived from the USA, where it became so enmeshed with the civil rights movement in the 1960s...

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