The public sector in most industrialised countries of the world has expanded considerably since the Second World War. One effect of this development has been the gradual transfer of responsibility for socialisation and care from informal primary groups, first and foremost the family unit, to the public sphere of formal organisations. The character of the relationship between many severely handicapped persons and their surroundings has therefore also changed. Previously they were dependent on family members and other close ties, whereas now they are more often dependent on public support. Their lives are therefore affected to a greater extent by the way this support is provided, and likewise more vulnerable to how their condition and needs are viewed by the society in which they live.