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This chapter critically explores the factors that have shaped policies for disabled and chronically sick people over time. It provides a policy typology that summarises historic developments and then considers post-war developments in substantive policy for disabled people. It argues that although conceptually policy frameworks have become much more progressive, the impact of policy change has been much more limited. It highlights the fact that disability and poverty continue to be familiar realities and that a price being paid for more responsive and self-directed packages seems to be a narrowing of access to and greater conditionality underpinning disability support. The chapter explores policy frameworks that help contextualise substantive discussion; outlines barriers to wholesale improvements in the lives of disabled people; considers substantive policy changes in the areas of social care, social welfare and the transition to adulthood; argues that there is still a long way to go in affording enabling and equitable policy solutions for many disabled people.
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