Called “Find & Treat”, it is believed that the project has saved the lives of more than 100 people since it started in 2005. The Find and Treat mobile unit reaches out and travels to more than 220 day centres and other locations used by the homeless each year to promote TB screening. We know that the service is very well-used when it comes to visit our centre – about 50 people get screened on each occasion.

The service works with homeless people, alcoholics and drug addicts, who are difficult to find and whose living conditions result in greater risk of infection from TB. The key problem is the very current drive to save money wherever possible and the move from centralised funding for such a service to the change in emphasis to GPs driving commissioning of services. Though there are many GPs that do work with homeless clients – one of the key problems that many homeless do have is registering with a GP.

At this present time, the service’s funding is due to finish in December.

What is concerning is whether current measures are really the result of “joined up” thinking where some recommendations and thought are given about where such tests will be conducted should the service be aborted.

It is not only this area that gives cause for concern. You will have seen the publicity about tieing benefits for those with a substance abuse problems with the requirement to seek treatment. Services offering such treatment are already reporting loss of funding. For example, I have been trying to refer one of our clients into a rehabilitation service once he leaves detox. We have been told by the service that instead of the six month rehabilitation period which is really vital to achieving a change in mindset for those who are re-structuring their lives without alcohol or drugs, their funding may stop in January and therefore they may be only able to offer a curtailed period of time.

We all know it is a challenging financial picture but in developing policies, it is only fair that the powers that be make sure that services can be accessed particularly if there are monetary sanctions that may occur and to protect public health in the case of TB screening.

Margaret Shapland – Advice and Welfare

There has been much made in the media of the few individuals whose housing benefit costs seem entirely disproportionate but the real story is that nearly half of all housing benefit claimants are already contributing to a shortfall in the housing benefit allocated for their properties of £100 a month.

The measures in the current budget include the most controversial plan to cut housing benefit by 10 per cent to people who have been on jobseekers allowance for more than a year from April 2013. The measure will hit around 700,000 people in the social and private rented sectors.

Caroline Davey, deputy director of policy and research at homelessness charity Shelter, states that jobseekers allowance payments can already be stopped for those deemed to be making insufficient efforts to find work. While the housing benefit system can put people off looking for work, the proposals do not tackle any of the causes, such as steep drops in payments leaving some people no better off in work. She adds:
‘They have gone for penalising claimants without reforming the broad problems of the system and have done so in a recession with rising unemployment, costs, and a child benefit freeze’

Changes in Local Housing Allowance in the private rented sector
The amount that a local authority feel it is reasonable to pay for private sector rents is set using what is called the local housing allowance which is a based on whether the property has shared facilities, is self-contained etc. Plans to set local housing allowance rates using the bottom 30 per cent of rents in an area will mean almost every claimant sees their benefit cut, according to homeless charities. At present almost half of households on LHA have a shortfall of £100 a month on average. The fear is that tenants whose benefit is far lower than their rent will eventually fall into arrears and be evicted by their landlord. They would be classed as intentionally homeless by their local authority because they have arrears, making them a low priority for help.

An example from Andy Winter, chief executive of Brighton Housing Trust, which finds private lets for homeless people, has calculated that the current local housing allowance rate of £149.59 a week for a one-bedroom flat will fall by around £28.50 when benefit is linked to the lowest 30 per cent of rents and cut by 10 per cent for those on jobseekers allowance for more than a year. Tenants will have to scrape together this shortfall from the £64.50 they receive in jobseekers allowance which covers their living costs.

Having lived on JSA myself, there is not much left over when you have paid for food, your fuel, light and water bills and if you are seeking work – all the costs relating to job-seeking. The UK has had the highest food price inflation in Europe and the cost of food shopping increased by 8% in 2009 plus the hikes in utility bills has put further pressure on people’s income. Even though the rate of increase has eased over the last year, the overall impact has been an increase in people’s cost hitting those with those on low incomes hit the most.

The current government may be right that the housing benefit system is in “dire need of reform” to quote the Chancellor but we do risk the most vulnerable and those who genuinely want to get back to work but need to improve their skills or train or go to college to be able to get a job which will cover their housing and living costs.

Margaret Shapland
Advice and Welfare

Homelessness creates such multiple risk factors to health that it is difficult for homeless people to achieve even basic health and well being. Risks include lack of nutrition, hygiene facilities, personal safety, privacy, warmth, space, access to warm clothing, money, mobility, stable, supportive relationships, and more. Health almost inevitably deteriorates as a result of being homeless – as immediate needs such as shelter, food and warmth are placed ahead of health needs. Already, homeless people suffer from significant health inequalities in comparison with people in more secure accommodation both in terms of their health status and their ability to access health services.

Mental Health Needs
• Mental health problems are a leading cause of homelessness – in one third of cases, losing a home is associated with mental health problems • Homelessness can create mental health problems for the first time and exacerbate those which already exist.
• Mental health problems were eight times as high among hostel and B&B residents and 11 times as high among people sleeping rough compared to the general population.
• People who sleep rough are 35 times more likely to commit suicide.

Physical Health needs
• People sleeping rough have a rate of physical health problems that is two or three times greater than in the general population.
• The average life expectancy for rough sleepers is 42.
• Homeless people experience significantly higher rates of health problems including respiratory disorders, skin and dental problems, musculoskeletal problems, and sexually transmitted diseases.
• The rate of tuberculosis among rough sleepers and hostel residents is 200 times that of the known rate among the general population.
• Rates of chronic chest/breathing problems and frequent headaches were twice as high among people in hostels and B&Bs and three times higher among people sleeping rough.

Access to healthcare
• In spite of the severity of their health problems, homeless people frequently experience great difficulties in accessing health care.
• They are 40 times more likely to not be registered with a G.P.
• Yet they are four times more likely to use Accident and Emergency than the general population.
• Difficulties with access include: significant administrative barriers to GP registration, need for flexibility and accessible opening hours such as drop in or same day appointment and need for outreach to ensure that homeless people access services. That’s why we feel lucky to have primary health and mental health services on –site as this promotes ease of access and immediate assistance for clients.

We hope that in the current economic climate and the political drive for savings, such services continue to be offered to some of the most vulnerable and excluded populations

Margaret Shapland – Advice and Welfare

22% of all clients were female in this month; again, numbers are skewed in favour of clients from outside the borough – 31% of whom were female compared to just 11% within the borough. This means that proportionately there are fewer male clients coming to the centre from outside the borough at 69% (89%) in Southwark.

African clients dominate with 38% of all clients in this group. European clients follow at 34% and 17% of all clients come from a White British background. Again, we see a variation when we compare our home borough to clients who come from outside – in Southwark, 39% of clients are European, 27% are White British and 23% are of African ethnicity. The picture outside the borough shows an overwhelming bias in terms of African clients who now contribute almost half of all clients seen – 49%, followed by 31% from European backgrounds and just 10% who are White British. Besides Eritrean clients who remain the largest group of African clients at 15, Ethiopian clients are now becoming a substantial group contributing 13 in this month.

26% of all clients came from A10 countries in this month, followed by 24% who have ILR/refugee status and 19% who are British citizens.

Overall, 45% of clients were sleeping out, 11% were settled, 17% were roofless and 27% were in other forms of accommodation. We are continuing to see a fairly large number coming from a variety of accommodation even though all the winter shelters are closed but we are now working with people who are placed in two permanent shelters and in the Dellow Night-stop where a number of clients from Hackney Winter Shelter were decanted.

The service saw 27 new housing clients in this month and continued to work with 14 clients who had approached the service in previous months. Of these clients, 29 were from outside of Southwark. Of the new clients, we were able to work with 18 (6 had no live benefits or ID and 3 had no recourse) There were also 2 clients already in accommodation – one of whom is wanting a transfer and one person who was already in a Salvation Army Hostel outside the borough. We placed 28% in this month but 2 clients either refused a property or failed to keep an appointment, 2 are on waiting lists and 2 have housing appointments but not in this month. Of the 14 clients we are working with from previous months, we have placed 4 (29%). Four have refused offers of accommodation or will not accept any option other than social housing and four have been non-contactable despite phone calls to their mobiles where that has been possible.

The VoiceMail4All service provides homeless people with their own 0208 voicemail number on which they can receive crucial messages about accommodation, employment, healthcare and other important support needs. Our clients also receive their own 0800 number which they call to pick up their messages for free from any payphone or landline.

VoiceMail4All has proven to be invaluable to those clients who do not have any other form of contact. Being able to provide a voicemail number means that our clients never need to miss a message about accommodation that becomes available, about job interviews, about healthcare appointments or about news from their family. VoiceMail4All is also very helpful when clients are trying to keep in contact with lawyers, the home office or passport offices.

One Manna Society client had this to say about VoiceMail4All; “I think VoiceMail4All is essential in helping me move on with my life. I am trying to find work and I need the number so employers can contact me. One time I was called on the number for an interview. My friends also call me. I check my number every day.”
Laura Rumley VoiceMail4All Co-ordinator

The Conservative Party

What the Conservatives indicate will be a foundation of their homeless agenda will be a more “joined-up” approach across Government departments – those mentioned being Work and Pensions, Health, Justice and Defence so that we avoid the following “Homelessness organisations report great frustration that they are unable to resolve even simple issues because no one within a relevant Government department believes that it is within their remit” They make it clear that any Housing Minister will adopt a multi-disciplinary approach and that the current street count practice of “bracketing down” where local authorities which produce returns on street counts where the numbers are really 15 rough sleepers can reduce the number of rough sleepers to the lowest number in that return bracket of 11-20 (so, in this case it would be reported as 11). The street counts estimate that there are 483 rough sleepers nationwide. In reality, we know that there are more – they are just not picked up during street counts.

Specifically, they recommend the following:
Work and Pensions Reform of the Housing Benefit System in order to seek ways to end Housing Benefit being a disincentive to work, the proposed Welfare to Work programme (which will pay voluntary bodies and others by results when they enable people to move from long term welfare into work for a sustained period), lifting restrictions on voluntary work, providing the resource of an address at which persons of “no fixed abode” can receive mail.

Health Specifically, the Conservatives have outlined three main areas to tackle – the relationship between mental health and homelessness, a more flexible funding framework for local primary care trusts so that health provision through third sector organisations can receive funding through this route and better access to GP services for homeless persons.
Justice To reduce the revolving door potential for many prisoners, changing how prisoners get paid for work so that some is diverted to a Victim’s fund, some for day to day needs in the prison and an amount saved as a “nest egg” when they leave prison aimed at helping provide a deposit or rent in advance
Defence A commitment to improving service leaver’s access to social housing and temporary accommodation, training for new careers, housing and appropriate healthcare services.

The Liberal Democrats The manifesto does not have a special section devoted to homelessness as such but the following key points emerge as significant:
Statistics to properly reflect numbers of homeless In line with the Conservatives, the Liberal Democrats believe the homeless figures should include groups such as the hidden homeless who are “sofa-surfing” with friends or extended family
The principle of “hard-wiring” fairness into British society The Liberal Democrat stance is that by creating jobs, increasing access to therapy, providing much needed housing or making the tax system fairer, the conditions that contribute to making a person homeless are reduced.
The provision of more housing stock The Liberal Democrats plan to bring a quarter of a million empty homes back into use with 100,000 of these used as social homes, change the public sector borrowing rules so that councils can borrow against their rent revenues and can build more social housing – this could bring another 100,000 homes into being.
A commitment to changing the way that society views the “homeless” This will include how people with mental health issues and substance abuse issues are treated by the police and the health services- priority to preventative health measures, more opportunity to access cognitive and behavioural therapies, replace short sentences with rigorously enforced community service, help offenders with substance abuse or mental health issues into appropriate accommodation – with the result that the billion pound prison-building programme can be cancelled.

We look forward to seeing what the future may bring!
Margaret Shapland – Advice and Welfare

Despite relative prosperity during the last decade, one in five people in the UK have lived in poverty and the situation would get worse during this economic downturn if adequate measures are not taken to address the problem. It is therefore incumbent on all political parties to include concrete measures in their general election manifestos and spending proposals to achieve a lasting reduction in poverty in the UK. As we see it, ending poverty across all generations requires a combination of boosting incomes, investing in affordable housing and ensuring public services are of high quality and accessible to all, without discrimination.

18th February 2010

An Open Letter to:

Rt Hon A Darling MP, Chancellor of the Exchequer
Hon G Osborne MP, Shadow Chancellor
Hon Dr V Cable MP, Shadow Chancellor

A Fairer Society for All

The Get Fair coalition represents over sixty national organisations campaigning against poverty in the United Kingdom, from children and older people’s organisations, refugee, disability, housing, faith and community groups. Our collective concern is to ensure decent incomes and living standards, for a fairer society for all. The pre-Budget Report signalled spending priorities “driven by the values of fairness and opportunity”. We have since been warned that the next spending review will be the “toughest we have had for twenty years.” As we head towards the general election we fear the political parties will compete on who can go furthest making cuts in public expenditure. It is vital that we build consensus on protection measures for the most vulnerable and marginalised in society. In building a new economy out of the old, it remains imperative to address structural weaknesses that led to one in five living in poverty during the last decade of relative prosperity. We are therefore calling for a rigorous assessment of the impact on poverty reduction of the 2010 Budget, election manifesto commitments and Comprehensive Spending Review to follow. This is a time of unprecedented challenges in public expenditure and political leadership. Ending poverty across all generations requires a combination of boosting incomes, investing in affordable housing and ensuring public services are of high quality and accessible to all, without discrimination. It is incumbent on all political parties to include concrete measures in their general election manifestos and spending proposals to achieve a lasting reduction in poverty in the UK.

Yours sincerely

Vanessa Stanislas Chief Executive Disability Alliance
Niall Cooper National Coordinator Church Action on Poverty
Kate Wareing Director UK Poverty Oxfam
David Orr Chief Executive, National Housing Federation
Andrew Harrop Acting Charity Director, Age Concern and Help the Aged
Fergus Drake, Director UK programmes Save the Children
Donna Covey Chief Executive, Refugee Council
Seyi Obakin Chief Executive, Centrepoint
Toby Blume Chief Executive Urban Forum
Matthew Scott Director, Community Sector Coalition
Leslie Morphy Chief Executive, Crisis
Richard Mortimer Deputy General Secretary The United Reformed Church
Revd Jonathan Edwards General Secretary, Baptist Union of Great Britain
Dann Kenningham ATD Fourth World
Danny Curtin YCW National President