This document summarizes a presentation by Dr. Simon Duffy on maintaining a vision-driven system for supporting people with intellectual disabilities in western democratic countries. Duffy discusses several challenges, including resistance to change, funding still being locked into segregated services, and austerity cuts targeting disabled people. He argues that new strategies need to be more philosophical, personal, political, and peer-focused. Duffy also notes that the best social innovations develop through engagement with real problems and values, are inspired by powerful values of citizenship, and are shared through peer networks.