Presentation given by Frank Mills, Director Social Inclusion, South West Area Health Authority, Ireland at a FEANTSA seminar on "Cooperation & networking to address homelessness: What are key partners for national/regional authorities and how should they be involved?", co-hosted by the Norwegian Housing Bank and FEANTSA, June 2007

1. An evaluation of Health Service
involvement in Homeless
Strategies in Ireland
Frank Mills
National Planning Specialist
Social Inclusion
Health Service Executive
Ireland

2. Background
• Health Act 1953
• Housing Act 1988
• Child Care Act 1991

3. Homelsss Initiative 1998
• Homeless people dying on Streets
• Joint Initiative by Dublin City Council and
Eastern Health Board
• NGOs involvement
• Co-ordinated response
• 1999 New Post created within health
services

4. National Homeless Strategy
• 2000. Cross-department team.
• 2001. Homelessness – An Integrated
Strategy.
• Clarified responsibilities between health
services and local authorities.
• Local homeless forums
• Local action plans
• Funding committment

5. Homeless Preventative Strategy
2002
A strategy to prevent homelessness among:
• Patients leaving hospital and mental
health care;
• Adullt prisoners and young offenders
leaving custody;
• Young people leaving care.

6. Homeless Structures in Ireland
Cabinet Committee on Social Inclusion
↓
Cross Department Team on Social Inclusion
↓ ↓
National
Consultative
Committee on
Homelessness
Local Homeless Forum

7. Wider Context
• National Action Plan for Social Inclusion
2007-2016
• Towards 2016 – national partnership
Agreement
• National Development Plan

8. Targetted Health Services
• Health teams in emergency
Accommodation and Day centres –
doctor, nurse, chiropodist, counsellor.
• Dedicated outreach mental health team.
• Dedicated dental service.
• Outreach multi-disciplinary team
• Alcohol and rehabilitation service

9. Targetted Health Services
• System in place for fast-tracking eligibility
for health services.
• Protocols for discharge of homeless
people from hospitals.
• Linking of dedicated services – co-
ordinator, unified computer system.

10. Issues
• Deficiences in mainstream health services
highlighted.
• Dedicated Vs mainstream service
provision.
• Partnership and inter-sectoral working
vital.
• Shift from reliance on personalities to
service level agreements, protocols etc.

11. Interaction between homelessness
and health
• Health issues can lead to homelessness.
• Homelessness can lead to ill health and
exaccerbate ill health.
• Not possible to provide effective health
service while people remain homeless.

12. Policy implications
• More efective preventative measures.
• Move people quickly out of homelessness.
• Housing plus supports

13. Changing Environment in Ireland
• New national Integrated Homeless
Strategy being developed.
• Health services undergoing major
transformation.
These present challenges and opportunities.

14. New Homeless Strategy.
• Comprehensive evaluation and
consultation in relation to previous
strategy – all stakeholders including
service users.
• New strategy being drafted by Cross
Department team.
• Health Impact Assesssment and Poverty
Impact Assessment being conducted on
Draft strategy.

15. Vision for New Strategy.
• By 2010 long-term homelessness (more
than six months) and the need for people
to sleep rough will be eliminated.

16. Health Transformation.
Vision:
• “Everybody will have easy access to high
quality care and services that they have
confidence in and staff are proud to
provide”

17. Health Transformation
• Primary Care Teams and Networks.
• Work underway to ensure the needs of
homeless people are effectively met by
these teams

18. Conclusion
• Health services have had long involvement in
meeting needs of homeless people.
• Since 1998 this has been done in partnership.
• Since 2001 – clarity about precise
responsibilities of the differerent players.
• Partnership working can lead to win/win/win
outcome.
• Importance of Shared Vision.