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Ideology, ideas and care in the community, 1948-71

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To understand the changes over the period we are examining, with dramatic policy shifts from institutional segregation to integration, then from integration to inclusion and citizenship, it is important to examine changes in ideology. In this chapter, the focus is particularly upon ideologies that led to the discrediting of the types of solutions adopted in the early part of the century—segregation, exclusion and control—and the adoption of policies with care as their central leitmotif. Dates have ideological significance. The year 1944 saw an Education Act in which, according to Sheena Rolph, ‘many of the worst aspects of the [eugenic] ideology were enshrined in legislation; segregation, “ascertainment” and the concept of “ineducability”’ (2005a–f, p. 14). In 1948 the NHS was founded, which took responsibility for mental deficiency institu-tions from local authorities, voluntary organisations and private providers, signalling the dominance of a medical model. At the end of the period these trends were to an extent reversed. In 1970 the Education Act gave all children the right to an education, and 1971 saw Better Services which is seen as a landmark in the move to community care, and signalled the end (though very slow) of the NHS’s control of services. We can see the early 1970s as a watershed, the time when policy makers adopted the relatively optimistic ideas associated with researchers who made the case for regarding people with mental handicaps as able to benefit from a comfortable environment, contact with the wider world and education.