WIDER POLICIES
Health Policy

Overview

This section provides a review of health policies which are relevant to homeless people, in England, Scotland and Wales.

Homelessness and Health

Access to appropriate primary health care is an important concern for homeless people, who are known to suffer higher levels of mental and physical ill-health.

However, homeless people are much less likely to be registered with a GP than the rest of the population.

Relevant Policies

Health policy is fully devolved to The Scottish Executive and Welsh Assembly. England, Scotland and Wales therefore each have their own policies toward improving the health for homeless people.

The national health organisations in England, Scotland and Wales all appear to have given substantial thought to the subject of health and homelessness.

English Health Policy

The government has recently introduced three initiatives, which aim to lessen health inequalities, including among homeless people. These are:

• Personalised Medical Services (PMS)  
• The National Enhanced Service for Homeless People (NES)
• Alternative Provider Medical Services (APMS)

These new arrangements allow for - and indeed, encourage - the development of health services to meet the needs of homeless people but they guarantee neither the volume nor the quality of such provision.  Rather, this depends on whether the local health providers (including GPs) and/or the voluntary sector actually initiate developments within these three schemes.

The new Alternative Provider Medical Services initiative provides an additional opportunity, namely for voluntary organisations working with homeless people to take direct action themselves to ensure that their health needs are met.

Scottish Health Policy

• Health and homelessness standards and the Homelessness Task Force's final report: Homelessness: an action plan for prevention and effective response (2002): A comprehensive framework has been put in place, which includes a set of national standards and the requirement that all Health Boards develop health and homelessness action plans.   This should ensure both the volume and the quality of health provision for homeless people.

Welsh Health Policy

The Welsh approach combines elements of the Scottish and English approaches.  Like in England, the following initiatives have been introduced:

• National Enhanced Service for Homeless People
• Alternative Provider Medical Services 

The Welsh approach also contains elements of the Scottish approach:

• Local Health Board Strategies: Local Health Boards are meant to consider the health needs of homeless people in their strategies.  One issue is whether this is actually happening in practice.

Commentary on Health Policy 

Government in England, Scotland and Wales should each consider a GP registration drive among homeless people.

To raise the awareness of Primary Care Trusts about the health needs of homeless people, the major national voluntary organisations working with the homeless should put together some authoritative material on the health needs of the homeless and how these best be met, for circulation to all Primary Care Trusts (England) and Health Boards (Wales).

The major national voluntary organisations working with the homeless should also take a lead in raising awareness of the APMS initiatives amongst the voluntary sector and developing guidelines to help such organisations both initiate and run such services schemes.

Page last modified on 22/06/2006 at 11:43