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Health issues of homeless people revealed in study
Homeless people in England are 60 times more likely to visit Hospital Accident and Emergency units than members of the general population, according to a study that reveals the extent of health problems among those who sleep rough or are stuck in temporary accommodation. The research also shows that the
proportion of homeless people with more than one health problem is far greater than would be expected given their average age of 38. The figure of about one in five is on a par with people in their 60s in the general population. Dr Vibhu Paudyal, a senior lecturer in
clinical pharmacy at the University of Birmingham and co-author of the research, said that although recent policies had resulted in some healthcare services being specifically targeted towards homeless people, more needed to be done. Among the difficulties facing homeless
people, Paudyal said some were being turned away by GP surgeries that wrongly insist patients must have proof of address, while others have faced stigma. “We need to strengthen the access, use
and outcomes of mainstream services,” said Paudyal, adding that the focus should be on prevention of health problems and that help for multiple conditions should be available in one place. Writing in the British Journal of General
Practice, Paudyal and his colleagues report how they analysed health data from more than 900 homeless patients at a specialist healthcare centre in the West Midlands, which provides access to a range of health services. The results showed homeless people were
more likely to have a range of medical conditions than the general population. Less than one per cent the general population are on the register for severe mental health problems, the proportion was more than seven times higher for homeless people, at 6.5 per cent. Just over 13 per cent of homeless men
have a substance dependence, rising to 16.5 per cent of homeless women. In addition, more than a fifth of homeless people have an alcohol dependency and almost a third had visited A&E at least once in the past year, compared with 0.5 per cent of the general population. Hepatitis C was also more prevalent among homeless people – at 6.3 per cent, compared with 0.7 per cent for the general population.
Homelessness services under threat at a third of councils
three years. Other statutory services such as providing adult
O
social care and protecting children could also suffer during the lifetime of the current Parliament. The Local Government Association estimates that councils in England face an overall funding gap of £3.1 billion in 2020/21. The LGA revealed the initial findings of its
survey of council finances ahead of the Spending Review, when it held its annual conference in Bournemouth. It disclosed that:
• 1 in 3 councils fear they will run out of funding to provide their legal duties by 2022/23;
• That number rises to almost two thirds of councils by 2024/2025 or later. The LGA estimates that councils face an overall funding gap of £8 billion by 2025;
• Almost a fifth of councils (17 per cent) are not confident of delivering all of the savings they have identified to make this year (2019/20); and
• An unprecedented rise in demand means many councils are having to spend more than they planned for in adult social care, children’s services and homelessness support. These overspends have seen councils forced to make in- year budget cuts to try and balance their books.
Between 2010 and 2020, councils will have lost 60p out of every £1 they used to receive from Whitehall to run local services. Since 2010 recorded cases of homelessness had risen 56 per cent. The next Spending Review will be make or break for vital local services and the LGA says securing the financial sustainability of councils must be the top priority.
FINANCIAL UNCERTAINTY Political uncertainty and an unresolved Brexit means the chances of the Government carrying out a full three-year Spending Review this year looks increasingly unlikely. Instead, councils may face a one-year roll-over settlement. Either way, councils urgently need some certainty
about how local services will be funded next year so they can try and plan financially for next year. The LGA, which represents councils in England
and Wales, is calling for the next Prime Minister to prioritise local public services in the Spending Review and give councils urgent certainty about future funding, business rates retention and the fair funding review. At the very least, the Government needs to confirm the continuation of key funding streams
12 | HMM August/September 2019 |
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Between 2010 and 2020, councils will have lost 60p out of every £1 they used to receive from Whitehall to run local services. Since 2010 recorded cases of homelessness had risen 56 per cent
next year and provide councils with local freedom to make decisions about council tax levels. Councils also need a guarantee they will have
enough money to meet the growing demand pressures they face next year, particularly in adult social care, children’s services, special educational needs, homelessness support and public health activity. This is the only way to ensure councils can meet
their legal duties to provide dignified care for our elderly and disabled, protect children, and prevent and reduce homelessness and protect the wide- range of other local services. Lord Porter, LGA Chairman, said: “Councils in
England face a funding gap of more than £3 billion next year, rising to £8 billion by 2025. If the Government fails to adequately fund local government there is a real risk to the future financial viability of some services and councils. “Councils would normally have started their
budget-setting planning process but remain completely in the dark about how much funding they will have next year. Communities relying on the vital local services that make a difference to their lives deserve better.”
ne in three councils fear running out of funds for delivering legal duties such as preventing homelessness, within the next
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