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Ireland already has some medical deserts - and it’s been getting worse
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Leah Farrell
Opinion
Opinion 10% of homeless families have been made homeless for a second time
Families exiting homelessness are increasingly accommodated in the private rental sector. But if the landlord decides to sell up – the family becomes homeless again, writes Wayne Stanley.
EVERY DAY FOCUS Ireland hears from families of the emotional pain they experience in having to enter homelessness with their children.
Through our child support workers – we also hear directly from the children about how this impacts them.
The recent report ‘No Place Like Home’ by the Ombudsman for Children gave children who are homeless a chance to have their voices heard.
That report provides independent evidence that even with the excellent support of the frontline staff in homeless organisations like ours- the impact of homelessness is devastating.
The thought that any person, especially a child, may have to experience this for a second time should be beyond imagining.
Sadly, this is happening fairly often.
Last year around 10% of the families who entered homeless services had been homeless before.
How can this happen?
We know that around 70% of homeless families had their last stable home in privately rented accommodation.
There are broadly two trajectories for families when they lose their home.
When faced with homelessness, many families are initially supported by friends or extended family members and this temporarily prevents them from having to present to homeless services.
But such offers of accommodation generally result in very stressful situations of severe overcrowding, sometimes eventually the situation becomes unsustainable and as a last resort, the families present as homeless to their local authority.
For some families – this can happen in reverse too.
That is they become homeless and enter homeless services, but upon realising the grim reality of living in the hotel room or B&B, they manage to get an offer of temporary support from an extended family member and so they leave homeless accommodation.
They are still a homeless household but it is just that someone has taken them in to keep a roof over their heads.
Again the situations are usually overcrowded so it is not sustainable and sometimes it breaks down and the homeless family are then forced to return to emergency homeless accommodation again.
Before 2018, the above scenario would have been the case for the vast majority of the families that Focus Ireland identified as returning to homelessness.
However, over the last 18 months, the number of families who have exited homelessness into the private rented sector and returned to homeless services, has increased.
This is usually because the landlord is selling up or needs the property for a family member.
It is important to say that the majority of those who leave homelessness do not return. Their numbers far exceed those who do return.
But the impact on those families who do become homeless for a second time is devastating and that issue has come into sharper focus in the last year.
This means that for families who became homeless since May 2018, they are far less likely to get an offer of permanent social housing and thus the private rental market is usually their only option.
Solutions?
As is always the case when discussing homelessness, the only solution for these families is in the provision of secure homes.
Permanent social housing offered a clear trajectory out of homelessness into a secure home.
Local authorities need to look at the allocation of their housing stock. The administration of a scarce resource such as housing is fraught with difficulty and it is not to be underestimated.
Recent reports from Dublin City Council have evidenced that ending the priority for homeless families has had no impact on the number of families entering homelessness.
Prejudicial and stigmatising commentary such as ‘queue jumping’ or ‘gaming the system’ can also have a negative impact on families.
We need to ensure that when a family moves on from homelessness into the private rental market and then because of the insecurity in that market finds themselves homeless again – that the local authority prevents them from re-entering homeless services.
This could work in the case of HAP rentals in the same way that it does in another local authority rental system the Rental Accommodation Scheme (RAS).
If a RAS landlord chooses to sell up, the responsibility to secure appropriate alternative accommodation for the family falls to the local authority, rather than to the tenant.
Of course, the long-term response to homelessness is the provision of homes and repairing our broken housing system. This will require a new vision for housing but in the interim, we can and should do better for all those forced into homelessness.
Focus Ireland has warned that the deepening homelessness crisis will not be ended without a shift in government policy.
The most recent figures show a new record total of 10,305 people homeless. Much good work is being done but the crisis will continue unless there is a substantial increase in social housing provision – and a move away from a reliance on providing more emergency accommodation and hubs.
An honest reflection of the current situation must start from a recognition that the primary response to homelessness to date has been to build more emergency accommodation, rather than building more homes.
This approach will simply never work.
Since the homeless crisis began, Dublin has acquired thousands of extra emergency homeless beds but we now have fewer social houses than we did four years ago.
The delivery of social housing nationwide is also failing to meet demand.
It is clear that delivering more social housing would also help people who are struggling to find somewhere to live in the rental market, as it would directly result in freeing up many privately rented homes that are currently used for HAP tenancies.
To deliver any relief to homeless families, the government and local authorities must drive far more ambitious social housing targets and build new, viable communities on the scale required to address housing need.
Wayne Stanley is a policy analyst with Focus Ireland.
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What we need is a Whole System that works,
It’s time to drain the sespool of leaders and show them with your VOTES , who are the real bosses , they work for us ,NOT the other way around
@Karllye kripton: the politicians don’t decide what drugs get approved, to do so would drive healthcare to a dystopian system to be decided by public opinion rather than expert medical professionals, so I’m unsure how votes would achieve your desired effect
@Vocal Outrage: Unfortunately this isn’t true. Look at Orkambi. Deemed to be not cost effective by the NCPE. Recommended not for reimbursement. Simon Harris decides to fund it. Despite this money coming at the expense of various other cost effective treatments. I wish the general public were fully aware of what a self serving decision this was, and how much it has cost the HSE, for a very marginal benefit, when you look at the overall CF population. But it looks good in the press.
@Peter Wheen: my point exactly, when you make populist medical policy decisions like that, against professional advice, then other parts of the service will suffer. I guess I was referring to how it should be
My mum was seen by many consultants in a private hospital in Dublin for pains that eventually had her bed ridden. After 4 months of various tests and different pain killers she took very ill and rushed to hospital. A simple CT scan not done previuosly by any consultant showed she was riddled with cancer and died the next day. My trust in private hospitals was questioned from that day onwards..
@Tom Padraig: Perhaps rather than blaming the medication, you should consider the circumstances that lead to people requiring antidepressants as opposed to labelling it all a scam.
@Philip Kavanagh: He is not wrong. One example would be the number of teens on Meds to treat their “ADHD” because they once told mummy to fork orf after eating a bag of skittles and downing five cans of red bull.
@Philip Kavanagh: As evidenced by the experience of those involved in the Air Corps chemical scandal, many if not most people on ADs do not need them. However they are the current quick “fix” for clinicians and a very lucrative one for industry.
The overprescription of ADs is a scourge & a scandal. The increase in anxiety & depression is being driven by what we eat, what we drink and what we breath.
ADs are one of the current unsustainable answers to an already unsustainable problem, counselling is the other.
Treating depression & anxiety along with so called suicide prevention is a fooking industry at this point.
@Ronan Sexton: He is wrong. Some people need antidepressants for a specific period, others will be on them for life. Like for most illnesses, medication is only one of the range of treatments. To write it all of as a scam is dangerous and stupid.
@Philip Kavanagh: The numbers on antidepressants in Ireland is simply staggering. To believe that all these people actually have mental health illnesses is simply beyond belief.
We are mass medicating a massive portion of our population out of ignorance.
I suppose the matter of not wasting billions on whats planned to be a multi tier health system for our kids in the supposed “best new hospital in the world (if you are wealthy and can afford expensive health insurance)”, would allow us buy a couple of billions more worth of drugs.
Can I ask if Dr. O’Connor believes, like a recently published Cork based gastroenterologist, that IBS is a psychosomatic illness?
“More than 50 per cent of my outpatients have symptoms caused by psychosomatic conditions, such as irritable bowel syndrome, which cannot be elucidated or cured by the molecular biologists”
@James Brady: Not really IBS and the like is overwhelming Gastroenterology Depts in all our hospitals. If all Gastroenterologists think IBS is psychosomatic then the problem is not being dealt with properly and is a further drain on the same pot of resources.
It stands to reason that if spending on expensive drugs means less money for other hospital spending then if something else is using up funds like for huge numbers of unnecessary “arse covering” endoscopy that then further eats into the same pool of money.
@Chemical Brothers: It’s not unnecessary. It is necessary to investigate or you can’t say with confidence that pt has IBS as opposed to something more serious. IBS is a diagnosis of exclusion. If gastroenterologist is arranging endoscopy to investigate, they are likely looking to rule out conditions with overlapping presentations such as coeliac, crohns, ulcerative colitis. When all investigations are negative and the symptoms are still of concern, it is not unreasonable to attempt treatments which have evidence of working in these cohorts of patients such as specific diets etc.
@Stephen Chaney: Thanks for reply. Considering the large percentage of those diagnosed with IBS in outpatient clinics would an approach of trying diet first rather than an expensive, invasive, unpleasant endoscopy procedure with attendant risk be a better course of action?
Is the endoscopy first approach being driven more by fear of missing a cancer and being sued for same rather than what may be a simpler approach?
Genuinely just asking, have had cameras both ends with nothing sinister found but have subsequently had success with dietary measures but not necessarily measures that consultants are familiar with.
In the UK there are set targets for delivery – something like Cancer surgery within 4 weeks maximum. If we set our public hospitals targets and then offered the patient free private care if not met that would focus minds on efficiencies.
@Pat Redmond: or just pay hospitals (and drs etc) per procedure. The countries with the shortest waiting lists are those with systems based on insurance where hospitals are paid like that.
he makes some valid points, but the chances of Ireland producing a high quality low cost health service are slim. We don’t do low cost for things like that in this country.
Great article and much that needs to be said- just would like to suggest another option- we need to recognise that the price tag on patented medicines bears no relationship to the cost of bringing the drug to market- but is the price unilaterally set by Pharma and is based on the maximum profit it can bring to its shareholders- which for life saving or life enhancing drugs is very high indeed. We need to bring some balance of power to the negotiating table to prevent monopoly abuse- ultimately by replacing the monopoly with an alternative incentive such as grants for R&D.
Ireland already has some medical deserts - and it’s been getting worse
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