This chapter explores some of the conflicts and dilemmas which arise when professionals are employed by educational bureaucracies with the explicit brief of dealing with those regarded as special or disabled. It examines some characteristics and models of professionalism and the expansion of professional influence as more and more young people come to be labelled as 'special'. The bureaucratization of professional-parent relationships and the problems of the 'new' profession of special educational needs coordinator (SENCO), now a required presence in all English and Welsh schools, illustrate some of the conflicts and dilemmas. The chapter describes expanded organizational professionalism which now characterizes special education in Britain and elsewhere in 'developed' countries. Notions of autonomous professional behaviour and a service ideal have perforce become subordinated to the requirements of state bureaucracies and organizations, notably the financial needs of local education authorities and the needs of schools to have troublesome children removed or dealt with by other professionals.