SPGB Snippets: Rough reality (2026)

From the Socialist Party of Great Britain website 

July 26, 2026

Andy Burnham pledged ‘to finally end long-term rough sleeping across the UK’. He previously aimed to prevent rough sleeping in Manchester by 2020, and in 2019 the Conservative Party manifesto committed to ending ‘the blight of rough sleeping’. Instead, in 2025 the number of people estimated to sleep rough on a single night in England was the highest recorded, at nearly 4,800.

Rough sleeping is not just about housing. Rough sleepers are among the most marginalised and victimised in capitalist society. Support services, however ‘well-funded’, can only ever offer limited palliatives as they are working within a system that pushes people into homelessness – why previous attempts to end rough sleeping have failed, despite Burnham’s ambition.

SPGB Snippets: Sleeping on the street (2026)

From the Socialist Party of Great Britain website

July 1, 2026

The government has just repealed the Vagrancy Act of 1824, which made rough sleeping a crime. There are about a million empty homes in England alone with more than a quarter of them empty for more than six months. So there is absolutely no need for anyone to sleep rough.

In London, there are over 47.000 homes that have been empty for more than six months, enough to house the estimated 13,000 people sleeping rough there each year, and the 200,000 living in temporary accommodation.

In this supposedly relatively wealthy country, the possibility of providing decent homes for everyone is perfectly feasible, but capitalism’s profit motive prevents it from happening.

Homelessness For Sale (2012)

From the May 2012 issue of the Socialist Standard

The extent of homelessness is often used as a gauge for the state of the economy as a whole. In an economic downturn, people are less able to hold down jobs, keep up with payments on rent or other bills, or have savings they can fall back on. Often, a combination of factors like these will push people towards losing their homes. Figures released in early March show 12,830 new cases of homelessness being accepted by local councils between October and December 2011 – a rise of 18% since the same time the previous year. In London, there was an average 36% increase over the same period, with the biggest rise in Hounslow at 245% (1). Predictably, sleeping rough has also increased. According to government figures, the number of people rough sleeping rose 23% between Autumn 2010 and Autumn 2011 (2). Undoubtedly it’s no coincidence that the increase in homelessness is one consequence of the economic crisis.

When someone loses their home, if they are unable to stay with family or friends, they will often end up in temporary hostel accommodation. Most of these places are funded and regulated by the government’s Supporting People programme, which is run by local councils. According to Homeless Link, there are around 9,000 bed spaces in English direct access hostels, those which provide emergency accommodation on the day someone becomes homeless (3). The economic crisis has not only led to increased demand for these services, but also to greater restrictions on who can receive help from them. Councils are now more choosy about who they agree to spend their funding on. In particular, they are more likely to enforce ‘local connection’ policies. These allow only those with a connection to an area to receive certain services, such as hostel accommodation. This means that if someone becomes homeless in an area they have only recently moved to, or where they have no close relatives, then they won’t receive help through that area’s council and will have to try elsewhere.

Another restriction which is increasingly affecting services is the length of time someone can live in a hostel. Over the last ten years, the maximum length of stay in many hostels has reduced from indefinitely to two years, to six months, to 28 days, sometimes less. One reason for this is to prevent people from becoming institutionalised. The longer someone stays in a hostel, the more they become acclimatised to being stuck-in-a-rut. Another reason is to increase the turnover at hostels to free up bed spaces for other people who become homeless. And because of the housing shortage, when someone’s time in a hostel runs out, they are more likely to move to other temporary accommodation than to their own new flat. There are around 33,000 bed spaces in this kind of second-stage accommodation (3).

The services offered in hostels will vary. Most provide a small, sparsely furnished bedroom, with shared bathrooms. Some hostels will have a canteen, while others are self-catering. Some will have strict rules on, for example, visitors or alcohol use, or when residents can come and go. Most direct access hostels will be staffed 24 hours a day, while others may only have staff working nine-to-five.

As there’s a wide variation in the services available, the quality of hostels will also differ. The worst places – bed-and-breakfast accommodation – don’t offer enough help to residents to qualify for Supporting People funding or monitoring. Instead, they only receive funding through Housing Benefit claims, which brings in less money. As well as lacking in support, these places are often run-down, overcrowded and intimidating, making it much harder for anyone living there to improve their lives. Often, criminal behaviour becomes a coping strategy for people living with fewer opportunities. Some people cope with the pressures of homelessness by drinking alcohol or using drugs heavily. According to Homeless Link, around half of those living in direct access hostels are affected by problematic drug use (4). Presumably a greater proportion of people in bed-and-breakfast accommodation will have histories of substance misuse or criminal behaviour.

Most people who move into hostels adjust to the environment fairly quickly, although this means sacrificing a lot of independence and privacy, and coping as best they can. Even the better hostels can be noisy, unclean and frightening places to be. They can also be sociable and positive. Moving in to a hostel can be an opportunity to access support which might be difficult to find without the contacts and experience of hostel staff. And all hostel residents have been forced into the position of needing help. Virtually everyone living in a hostel will be reliant on state benefits for their income. Many will be refugees learning to manage in an unfamiliar country. Hostel residents are also likely to need advice or guidance about debt issues, mental health problems, training or employment, as well as help with finding long-term housing.

Despite the best efforts of both staff and residents, people can become trapped in hostel accommodation. If someone has rent arrears from a previous council or housing association flat, then they are unlikely to be rehoused until those arrears have been paid off. People who lack basic skills or who have health problems may find themselves stuck in hostel accommodation because there is a shortage of suitable supported accommodation. The longer someone stays in hostel accommodation, the more they end up relying on it. The economic situation has created an increase in demand for hostels and other homeless services, but it’s also cutting them back.

Since April 2011, councils have reduced spending on Supporting People funded projects by an average of 10.3%. Homeless services were hit hardest by the cuts with 47 local authorities deciding to decommission some services (5). This has led to increased competition between hostel and other housing projects wanting to qualify for dwindling Supporting People funding. To qualify for this money, the organisation which runs each project must show in detail what support it provides. If there isn’t enough evidence on paper, then funding will be withdrawn. The service would then either close or have to survive with only the same limited funding as bed-and-breakfast accommodation. To avoid this, staff are swamped by paperwork used to justify their existences. In some hostels, staff are required to account for how they spend every minute on shift, under the threat of funding being withheld for any time not spent productively. And, of course, those projects which can offer to run the service cheapest are more likely to win funding. Supporting People requirements have also made hostels and supported housing projects more target-driven. Hostels risk funding cuts if particular percentages of those leaving the service don’t improve their ‘economic wellbeing’, physical or mental health, or substance misuse. The effect of this on hostel staff is that the needs of individual homeless people become less important than making sure that the paperwork and statistics are in order. To use Marxist terminology, the paperwork is fetishised.

The increasing regulation of hostels, and the competition between providers for funding, mean that homeless services are now more corporate and businesslike than they were twenty or thirty years ago. Then, hostels and advice agencies were seen more as an embarrassment, as somewhere shameful to send those who have been failed by society. Now, the emphasis is different. The upside of this is that many hostels are more comfortable and relaxed than they may have been in the past, and those who have been homeless are stigmatised less by society as a whole. But, is it a good thing that homelessness has become almost acceptable?

Capitalism is a society of haves and have-nots, of winners and losers. Homeless people are at the unlucky end of the social scale. Many other people are only one wage packet away from being drawn towards homelessness. So, to accept that homelessness is just a part of life is to accept the capitalist system which traps us all.

Hostels, supported housing and other homeless services may help some people to progress, but they can’t solve the problem of homelessness itself. And nor do they aspire to. Instead, homelessness is a business opportunity for capitalist organisations to feed from. Every problem created by capitalism – debt, lack of opportunity, lack of skills, addiction, crime – has become a consumer demand for a service. Homeless people are customers, who staff are supposed to think of as targets and outcomes to be recorded and collated. And in the cut-throat competition for funding, homeless services are integrating further with the market-driven dynamics of the economy. Homelessness for sale.

Clive Hendry

 References:

(1)   http://england.shelter.org.uk/news/march_2012/homelessness_up_18

(2)   http://www.communities.gov.uk/publications/corporate/statistics/roughsleepingautumn2011

(3)   http://homeless.org.uk/hostels#.T4qJydniKfs

(4)   http://homeless.org.uk/sites/defaultfiles/SNAP%202011%20final.pdf, page 45

(5)   http://www.insidehousing.co.uk/care/services-cut-for-46000-vulnerable-people/6521072.article

Homelessness and Health (2015)

From the March 2015 issue of the Socialist Standard

  Homelessness isn’t just a housing issue. Struggling without a home usually also means struggling with poor health, and being unable to find enough support.

If asked what the three most important aspects of our lives are, most of us would say something like having reasonable health, somewhere comfortable to live and people we’re close to. But what happens if we have none of these? Poor health may rule out employment, which means having to rely on benefit payments, which limits what accommodation is affordable. And our health needs may mean that many types of housing are inaccessible or impractical. If we don’t have friends or family in a position to help, we would expect the health service, councils, and other organisations to provide a safety net. However, the support services industry has failed to provide for the complex needs of people with both health and housing problems. This is despite a definite relationship between homelessness and poor health. Research from St Mungo’s Broadway and Homeless Link found that 73 percent of homeless people have a physical health problem, and 80 percent have mental health issues (p.3). To what extent poor health is a cause or an effect of homelessness is hard to determine; for most homeless people, it’s probably both. What is clearer is that many people struggle to access often insufficient help from services lacking enough staff and resources.

The definition of homelessness includes people in many different situations. The most extreme, and visible, aspect of homelessness is sleeping rough on the streets. A conservative estimate of the number of rough sleepers in England was 2,414 in 2013. Many more people are in various types of temporary housing, including homeless hostels, bed-and-breakfast accommodation, and staying with friends or relatives. Ten years ago, Crisis estimated that there were 380,000 of these ‘hidden homeless’, which is more than the total population of Leicester (p.3).

Despite their varying circumstances, all homeless people will have an unsettled way of life which exacerbates other problems, especially health. The most obvious, and stark, way of summing up the additional health concerns affecting homeless people is by looking at mortality rates. The average age at death of a homeless person is 47 years old, compared to 77 for the wider population. Homeless women, on average, live until they’re only 43, whereas in the wider population, women tend to live longer than men (p.2, Homelessness: A Silent Killer, Crisis, 2011).

One reason why homeless peoples’ wellbeing suffers is because of difficulties with accessing healthcare. Although there are no upfront charges to use NHS services, and prescription fees are waived for people on a low income, the bureaucracy of the NHS makes it hard for homeless people to navigate the system. The usual way to access healthcare is to make an appointment with your GP, who can then make referrals to hospitals or clinics for particular treatment. To register with a GP, you need a stable address, which creates the first barrier for homeless people. Without easy access to a GP, medical conditions could go undiagnosed or untreated. As a result, when a homeless person’s health deteriorates, they are more likely to approach a hospital directly.

A&E

Homeless people attend Accident & Emergency, or Casualty, departments six times more often than the general population (p.2, Healthcare for the Homeless, Deloitte Centre For Health Solutions, 2012). The numbers of homeless people attending A&E has been flagged up in the context of unbearable pressures on hospitals. The efficiency of A&E departments is measured against the government target of 95 percent of patients being treated within four hours, lowered from 98 percent in 2010. This winter, the mainstream media reported on how many hospitals have failed to meet this target. At the start of 2015, only 86.7 percent of patients in England were seen within four hours (BBC News, 14/1/15), with worse figures in other parts of the UK. Eight hospitals declared ‘major incidents’ because demand on A&E units had increased to more than could be managed.

The four hour target will be prominent in the minds of all A&E staff, alongside the stress of the excessive workload. The constant pressure to process patients quickly means that underlying health problems could be ignored. And the shortage of hospital beds means that not enough people will be admitted to a ward. Consequently, homeless people, especially rough sleepers, often get discharged from A&E straight back into a situation unlikely to promote their recovery. So, when their health deteriorates again, they will probably return to hospital in the near future. People trapped in this cycle of needing to go back to A&E again and again are called ‘frequent flyers’. One in ten homeless people use A&E at least once a month (p.5, Healthcare for the Homeless, Deloitte Centre For Health Solutions, 2012), with some returning partly because they have nowhere else to go, and a hospital is somewhere warm, dry and reassuring.

Not all homeless people who come in to hospital fit this profile of repeat visitors not registered at a GP, though. Lots of people first become homeless at the same time that they enter hospital, usually as the result of a crisis. If someone has had a stroke or an amputation, then it may not be possible or practical for them to return to their previous home. Or, the trauma of being evicted may have pushed someone to attempt suicide.

On the ward

If a homeless person is admitted into hospital, they’re likely to stay there three times longer than the general population (p.2, Healthcare for the Homeless, Deloitte Centre For Health Solutions, 2012). This is partly because homeless people – especially the long-term homeless – often have multiple and complicated health problems, particularly liver damage, asthma, pneumonia, tuberculosis, epilepsy, diabetes, malnourishment, trench foot, wound infection and blood-borne viruses like hepatitis C, especially among intravenous drug users. Drugs and alcohol are often used as a coping strategy by homeless people, and heavy use can lead to cirrhosis of the liver, infections and dependency. This creates a vicious cycle where homelessness both leads to and is prolonged by addiction. 40 percent of homeless heavy alcohol users believe that a lack of stable housing is the main barrier to their recovery. Over a third of homeless people die due to alcohol or drug misuse (p.2, Homelessness: A Silent Killer, Crisis, 2011). The crisis of becoming homeless or struggling with homelessness as a way of life is also often linked with mental health problems. Someone with depression or schizophrenia is less likely to fit in to the expected routines which come with having a job and a ‘normal’ lifestyle. As a result, they are often pushed into homelessness, which will exacerbate their condition.

Another reason why homeless people remain in hospital longer than average is delays in discharging them. The aim is for a patient to leave hospital when they’re judged ‘medically fit’ to do so. They may still need longer to recover, but they can do this in the reassuringly familiar surroundings of their own home. This isn’t going to be possible if the patient is homeless. There have been many instances of homeless people being discharged from hospital in a taxi straight to a council office or a hostel, with no prior notice. This is particularly unsettling for the person, who has left the hospital without knowing whether they will get anywhere to stay, at a time when their health still makes them vulnerable. The practice of wards discharging homeless patients in this way has become less accepted in recent years. However, if a ward doesn’t discharge a patient because they don’t have anywhere suitable to go, then this creates the problem of ‘bed blocking’. When someone who is medically fit to leave hospital remains in a hospital bed, it prevents someone else from having it and creates additional expense.

Discharged where?

If a patient needs to be discharged to a care home, a nurse would refer them to a social worker to make the necessary arrangements. But only people with severely reduced capabilities qualify for this assistance. Presumably, if hospital social services departments and care homes had more staff and resources, they would be able to support more people, and the criteria for accessing them could be relaxed. As the situation is at the moment, many homeless people who would benefit from social services assistance aren’t eligible. Instead, it’s usually left to nurses to try and find accommodation to discharge a homeless person to. They may approach the local council, although the criteria for qualifying for statutory assistance excludes many single people except those judged extremely vulnerable. Even if a disabled homeless person is eligible for assistance under council criteria, then there still might not be anywhere appropriate for them. Temporary accommodation often means a placement in bed and breakfast accommodation, which is notoriously shabby and intimidating, and unsuitable for someone with poor mobility or little resilience. Council staff are aware that they are working within a frugal, inadequate system, and will try to compensate by interpreting their guidelines broadly and with some sympathy. So, temporary accommodation may be arranged in empty flats, care homes or hotels.

If there isn’t an arrangement with the council, or if the homeless patient doesn’t qualify for assistance from them, then the usual option would be direct access hostel accommodation. However, hostels can be almost as intimidating as bed and breakfasts, and are unlikely to be accessible for disabled people. They may have stairs, shared bathrooms and kitchens which could make them unsuitable. If someone can get into a hostel, then they would usually be able to stay there until they can find long-term housing, such as a flat rented from the council or a housing association. This could still take many months, but at least they would have the benefit of staff support.

If a homeless patient is in the country unofficially and has no recourse to public funds, councils and housing providers are very unlikely to help. Not being able to claim benefits or work legally will mean that they can’t afford rented accommodation, including hostels and B&Bs, and will be left destitute.

Generally, the worse someone’s health is, the harder it is for them to get suitable accommodation, especially at short notice. The situation is eased once someone turns 55, as this is the age that sheltered housing usually becomes available. But for younger people, unless they have a profoundly limiting disability which makes them eligible for statutory support, there is very little available. In other words, there is a lack of accommodation for people whose needs are too high for usual homeless provision but too low for social services involvement. The types of people that would be worst affected by this gap in services are those who have had strokes, amputations, suicide attempts, a diagnosis of schizophrenia, or drug and alcohol addiction. Most would also suffer from depression.

The bottom line

Costs accrued by bed blocking and the complex medical issues of homeless people mean that the average cost of a hospital stay for a homeless person is nearly five times higher than that for other people. More precisely, a homeless person will cost the NHS almost £1,900 per hospital stay on average, compared with £391 for the general population (p.6, Healthcare for the Homeless, Deloitte Centre For Health Solutions, 2012). The NHS is always being pushed to reduce its spending to cope with funding cuts. So, it was recognised that investing in more support for homeless patients would reduce costs in the long run. Looked at this way, the homeless are an economic problem, rather than people in need. In 2013, the government announced funding of £10 million to improve support for homeless people being discharged from English hospitals. This involved recruiting specialist staff to arrange discharges into suitable accommodation with ongoing support. This led to reductions in both bed-blocking and frequent flyers. But this wasn’t enough for funding to be extended, and many of these services are no longer running. The solution was only temporary.

To some extent, a society can be judged on how well it treats its most vulnerable people. The problem of homelessness only arises in a society where adequate housing is only available to those who can afford it and, as we’ve seen, people with poor health face additional barriers. These difficulties reflect wider problems in society:

1. The bureaucracy of the NHS, councils and support services, which makes it hard for some people to access help in a more planned way. This problem can’t be solved just by ‘cutting red tape’ or simplifying procedures. The NHS, councils and support services all have to operate in the same economic market as any other institution, so they have to be run like any other. This involves bureaucracy to ration and restrict who qualifies to use them.
2. The lack of resources in hospitals, whether a shortage of beds, nurses, mental health staff, social workers or support workers. Again, this problem can’t be solved within capitalism because the economy can never support enough funding to meet everyone’s needs. Money tends to go where it can be re-invested to create more wealth, and the NHS isn’t an attractive investment for the elite. The economic downturn and climate of government spending cuts only highlight an ongoing problem.
3. The lack of accommodation which is both suitable for and available to disabled people. This is part of the overall housing shortage. It costs more to build or adapt accommodation for people with poor mobility, and landlords may be reluctant to invest the extra money if they don’t think it will end up profitable. When houses are built to be sold or rented, rather than because people need them, then anyone without enough money will struggle.

All of these problems are built in to the way our society is structured. When society is driven by economic forces, rather than what people want and need, then some people inevitably suffer. Increased funding, new services, or reformed procedures may help a few people in the short-term, but they can’t address the causes of the problem.

Clive Hendry