Over the past 50 years there has been a revolution in thinking about what it is like to have a disability. It used to be conventional wisdom that people with disabilities needed to be kept separate and grouped together in residential care homes, special schools, segregated days centres or workshops. A disability was seen as a personal tragedy for the individual and their family, and the expectations of a meaningful and fulfilling life of an independent home, work, relationships and family, travel, fun, was extremely limited if not non-existent. Buildings, public transport and services didn’t need to be accessible to everyone because there was no real expectation that people with disabilities would use these facilities. More fundamentally, these ideas were underpinned by negative and discriminatory attitudes to people with disabilities, who often could be viewed as objects of derision and ridicule, or even fear. Kinder and more accepting attitudes still placed people with disabilities as different by suggesting they were somehow 'heroic' or special for getting on with life in the same way we all do.
Although people with disabilities themselves were not immune to internalising these negative perceptions and low expectations of themselves as different and outside mainstream society, from the early 70’s some disabled activist started to challenge this way of thinking. Disabled academics such as Oliver wrote about a way of thinking called the 'social model of disability' and this was defined in an important statement in 1974 by the Union of Physically Impaired Against Segregation (UPIAS):
“… we define impairment as lacking all or part of a limb, or having a defective limb, organism or mechanism of the body and disability as the disadvantage or restriction of activity caused by a contemporary social organisation which takes little or no account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities.” (Oliver, 1996, 22).
This turned ideas of disability on its head. For example, the fact that a person used a wheelchair was not a 'problem' in itself as understood by the social model of disability. This only becomes problematic when the social world excludes them and has buildings with narrow doorways or flights of steps. If the world was built and designed in a way that thought about the members of the public who couldn’t walk or see or hear as equal and valued citizens, then the built environment would reflect this. The social model of disability gave a way of understanding the situation for people with disabilities that mobilised them to campaign, not by accommodating their personal impairment, but by recognising the social forces that denied their citizenship.
The social model of disability and campaigners for change did not only include expectations for a physically accessible world, but acknowledged people might need practical or emotional support to live life independently and make a contribution to society. What becomes crucial is about who is in control of this support. But the issue of power and the importance of people with disabilities being in control remain central. Simon Brisendon (1978) articulated this early in the struggle to demand to be able to live independently, rather than be forced to live in a residential care home. He declared to be independent did not mean “someone who can do everything for themselves, but to indicate someone who has taken control of their life and is choosing how that life is led”. The role of the Personal Assistant then becomes the vehicle whereby that control over everyday routines is afforded to the person with a disability. The skills of the PA lie in being able to support and facilitate whatever the person with the disability wants to do.