Friday sees a Homelessness Reduction Bill before Parliament, sponsored by the MP Bob Blackman. It has the support of the Commons Select Committee and it expands the duties of local government and the categories of people eligible, calling for earlier interventions to prevent homelessness. What implications does this have for the difficult cases of complete homelessness and health?
Health breakdown is a consistent cause of homelessness and, when it affects the main income earner, it can take a whole family into homelessness. We know about the economic signals (unemployment or benefit cuts) and legal signals ( eviction or end of tenancy) leading to homelessness but what of the mental health, addiction, chronic conditions or multiple health needs of people which make it difficult or impossible for them to go back to the home they had, or has already made them homeless? Will health professionals be able to give 56 days’ notice that they believe an individual or family to be at risk?
How far will the proposed duty for local authorities to intervene go? And with health care being devolved to the new combined authority in Manchester with an elected Mayor, could this open up the possibility of integrated working with the homeless with severe health problems that has eluded previous reforms?
A useful summary has been provided by the Department of Communities and Local Government – always a good sign that the government might be behind this reform.
The Bill raises some interesting challenges. It puts a new duty on all public authorities, which clearly includes hospitals, to engage the local authority or housing authority if they anticipate homelessness at the end of a period of treatment, which most will already do. But it also opens questions about “unreasonable behaviour” and “refusal to co-operate” with new plans which can exclude people from help. A particular challenge with some of the most difficult patients with mental illness or addiction and behaviour problems. And, in any case, it is still a battle to be designated “ a priority” if you are single , not pregnant, or without a clear disability.
By the time the bill reaches its critical stages many of these issues will be centre stage at the 2017 Homeless Health Inclusion programme from the charity Pathway and the UCL institute. Now in its 5th year, this specialist conference has the added unique element that all the sessions are filmed or recorded for training and staff briefing and induction, making it one of the most valuable packages for professionals looking for solutions to tackle homelessness and the health issues that dominate these clients.
Will 2017 see a combination of new legislation, devolution and integration of local services and innovative pathways to tackle some of the most complex homeless and health issues which too often present in the same individuals? Perhaps a an early new year resolution is to make sure it does.