Review

Homeless, alone too

HOMELESSNESS, HEALTH CARE AND WELFARE PROVISION
Kevin Fisher & John Collins (eds)
Routledge, 1993, £12.99

This book grew out of the editors’ experiences of working with homeless people in the East End of London. It is a compilation of different perspectives from contributors who have all had extensive professional involvement with homeless people and the issues around homelessness. It highlights the plight of single homeless people and describes in detail the difficulties they may face in gaining access to health services.

Two central themes run throughout the book. The first is the right of all homeless people to have equal access to health care. The second is the recognition that only when the need for adequate and accessible housing is met will health substantially improve.

The first chapter sets the scene with a useful overview of the impact of recent social policy on single homeless people in London. Two subsequent chapters describe the issues surrounding access and the kind of health problems experienced by homeless people.

This is a book to dip in to. There are chapters on the specific problems of mental health, alcohol and youth homelessness and a valuable analysis of different models for delivering health care to single homeless people. A final chapter examines the development of health care programmes for homeless people in the US.

One reservation is the absence of any serious debate about how homelessness and inadequate health care affect people from minority ethnic communities. The pictures on the book’s cover are unfortunate in reinforcing traditional stereotypes of homelessness as essentially rooflessness among a predominantly white population.

For those wishing to project into the future, the book’s conclusions may prove disappointing. But in the current state of acclimatisation to the health service’s purchaser/provider ethos, outlining any distinct future vision is fraught with difficulties.

The book provides a valuable ‘state of the art’ summary for those involved in service planning, provision and research, and for those working in the field it will confirm existing knowledge. But it is to be hoped that it will not only appeal to the converted as it has something important to say to a broader audience and deserves a wider readership.