Against the background of profound change now affecting the British health and social care system this report examines economic aspects of the support of people (particularly adults) with severe learning difficulties in England, and their implications for future service development. It briefly outlines ideas and data relevant to: the evolution of service funding and delivery; the nature and role of economic analysis; the findings and implications of recent studies on the (UK) delivery of care for people with learning disabilities; and future policy options and the outlook for the learning disabilities service sector during the 1990s.