Public Health (1990), 104, 109-116 © The Society of Public Health, 1990
Health Service Planning for the Homeless
Population- Availability and Quality of Existing
Information
J. Connelly, P. Roderick and C. Victor
Department of Public Health, St. Mary's Hospital, Praed Street, London W2
Introduction
The number of households in Britain accepted by the local authorities as eligible for
permanent rehousing and placed in temporary accommodation has doubled from 11,000 to
22,000 between 1983 and 1986 and continues to increase. ~'2 About one third of these
households are in Greater London, a situation that has been referred to as the 'crisis of
homelessness'. 3
Concern has been expressed, however, about the paucity of accurate information and the
lack of co-ordination of its dissemination to relevant bodies. The critics of the present
information system include the London Authorities Working Party into Homelessness
(ALA/LBA), Shelter, the Health Visitors' Association, the Maternity Alliance, SHAC and
the London Food Commission. 4-7
We describe here the available sources of data on the size, composition and turnover of
this homeless population, with particular reference to the situation in London, and also
outline the difficulties faced in collecting accurate data. The quality and relevance to the
health authorities of the available information is discussed.
The Legislative Framework
Any discussion on homelessness must begin with an understanding of the legal framework
within which the vast majority of those 'accepted as homeless' are placed.
The Housing Act 1985 Part III incorporated the 1977 Housing (Homeless Persons) Act.
Part III lays a statutory duty on local authorities to provide permanent accommodation for
persons who qualify as being in 'priority need' or 'vulnerable'. The categories of priority
need are:
(a) Pregnant women.
(b) Parents with dependant children residing with them.
(c) Victims of domestic violence.
(d) Someone homeless as a result of an emergency such as fire, flood or other disaster.
The 'vulnerable' classification involves a measure of local discretionary power but
includes those vulnerable as a result of old age, mental illness or handicap or physical
disability. In addition, persons may be nominated as being 'vulnerable by other special
reason' and, for example, some local authorities would include people with the Acquired
Immune Deficiency Syndrome.
For a local authority to accept a homeless person or family, two other tests are
applied over and above being in priority need or vulnerable. First, there should be no
evidence that the applicant is 'intentionally homeless'. The local authority, through its
Housing Department, or (in London) the Homeless Persons Unit (HPU), investigates
applicants to ensure that the processes that have or will result in the applicant being