This is a detailed and concise account of post-war policy and practice relating to people with learning disabilities. The book aims to discuss the dramatic changes that occurred for people with learning disability over a period of 50 years. Policy is detailed through three of the four sections of the book where both UK and international policy and practice shifts are told through the years of 1948–71 and then 1971–2001. The international focus considers devolution and the impact that regional parliaments have had on the development of policy, and there are chapters from Norway and Sweden, Canada, Australia and USA. The final part of the book provides narratives and personal accounts from people who experienced life as a person with a learning disability in a large institution, and for whom the shifting tides of policy – the promotion of citizenship, or at least the promotion of independence – meant a very different life than experienced in the institution.

Part One has two chapters about ideology and ideas written by the editors, which provide helpful definitions of the terms citizenship, care, community and learning disability and difficulty. Citizenship is not directly linked only to care, but to the everyday life activities that most people with learning disability have become accustomed to. These chapters are an excellent detailed and concise account of the issues and events that influenced how care largely replaced control in British social policy. Documentation of the emergence of service user and carer groups is necessary and well done here, as well as the theories underpinning policy and practice and the resulting ways society recognises people with learning disability.

Part Two has three chapters about organisations and structures, again from 1948 to 2001, and examines how control then care and then citizenship were arranged. This charts the involvement of service users and carers into the development and planning of services, the running of services and their eventual impact on policy, also noting the lack of change for the few service users who experience severe disabilities or ‘challenging behaviours’, and who remain in smaller institutions not unlike those from ages before. The third of these chapters is about devolution, and looks at how Scotland, Wales and Northern Ireland have produced different embodiments of policy and practice, in particular Northern Ireland where the political landscape impacts on a stronger rights and community focus, and thereby is readier to accept and run with the social model of disability rather than shift from person-centred care.

Part Three has four chapters about the UK experience from an international perspective: from the USA, Canada, Australia and Norway and Sweden. Chapter 6 about the USA is an informative account of public officials, populist movements and the culmination of shifts to influence policy and practice. The synchronicity with which the golden age of the institution occurred and fell is demonstrated through this book, and these four chapters provide an analysis of how societies struggled to replace the wrong of the institution without having a plan about what the right in the community may look like. Chapter 7 from Norway and Sweden examines how institutions were closed, people with the most severe disabilities were moved, and there was a move towards community homes where people who have physical disabilities live alongside older people and people with learning disabilities. Chapter 8 critically examines what has delayed the setting up of adequate community services after institutional closure in Ontario, and Chapter 9 tells the narrative of an Australian woman living in institutional care and her move into the community.

Part Four is about experiences and brings together the perspectives of different stakeholders. Chapters 10 and 13 provide narrative accounts of women previously living in institutional care or children's homes and who move into the community. One of these is about a woman who has severe disability and the narrative is taken from an ethnographic study of her life in her previous (more oppressive) place and her community placement. Chapter 13 looks at the different work that people with learning disability were undertaking and their treatment in the workplace. These chapters are pivotal in the book and illustrate well the influence of the ideas, policies and practices that impacted dramatically on people's lives. Chapters 11, 12 and 14 present the perspectives of families, workforce issues and the voluntary sector respectively. Families and the voluntary sector have significantly influenced how care has been organised and orchestrated. The latter chapter depicts the fragmentation of the voluntary sector and the fluidity of ideas and priorities within the sector, and the campaigns that often brought families and workers together to bring about change. The final chapter recognises the aspirational aspects of policy and that for some people with learning disability and their families little has changed.

It is important to know the history and legacy that influence current policy, research and practice. It is quite astonishing that the golden age of institutionalisation was dominant so few years ago, and accounts which reflect changing ideas are needed to chart our passing through territory. This book does just that. Service user perspectives are now recognised as essential to ongoing debate and change, but some service user perspectives are more difficult than others to gather and disseminate. This book is strengthened for demonstrating the influence those ideas had on the lived experiences of people with learning disabilities.