Doctors call for back up over homelessness

National Seniors Australia (NSA) and the nation’s doctors appear to be on the same page in supporting the provision of safe and secure housing so people can maintain their health and wellbeing. 

The Royal Australian College of General Practitioners (RACGP) says its member doctors are sick of not being able to satisfactorily link patients to proper housing and in a recently issued position statement called housing a “human right” and that every person “requires safe, stable, and secure housing to reach and maintain optimal health”. 

RACGP members say they are staffing the front line and need more support such as the following: 

• A “housing first” approach where secure, unconditional housing is the first step towards improved health and social outcomes. 

• The recognition of the complexity of the work of general practice, especially when caring for people living in poverty and experiencing homelessness. Access to general practice care, continuity of care, and longer consultations should be supported for people experiencing housing instability. 

• The explicit inclusion of GP expertise in policy spaces where decisions about housing and health are being made, and the increased integration of health and social care functions. General practice expertise needs to be embedded into policymaking and program planning to support people experiencing homelessness and housing instability. 

• Adequate funding of general practice is essential to ensure that all Australians can access essential healthcare, not just those who can afford to pay.

In its position statement, the RACGP says many health conditions are consequences of homelessness. People experiencing homelessness experience significantly higher rates of death, disability, and chronic illness than the general population. 

These include:

• Mental health problems 
• Substance abuse 

• Poor nutrition and poor dental health. 

People experiencing homelessness also have significantly less access to health services than the broader population for a number of reasons, including financial hardship, lack of transportation, lack of identification or Medicare Card, and difficulty maintaining appointments or treatment regimens. 

The doctors’ housing advocacy emphasises: 

• No person experiencing homelessness should be expected to meet health or recovery goals without first being housed. The RACGP advocates for streamlined, efficient, and simple processes to enable patients to access housing support services. 

• General practice should be resourced to provide effective healthcare for people experiencing homelessness and housing insecurity. 

Often GPs and emergency departments are the only parts of the health system that are accessible for these populations. With appropriate resourcing and support, general practice can be a place to recognise housing stress and to coordinate patient-centred care to improve outcomes for people experiencing homelessness and housing instability. 

Additional support can be delivered via existing funding channels, including the Medicare Benefits Schedule (MBS), allocation of Primary Health Network funding towards homelessness supports, or new allocation of Federal Government grants. 

Better integration of health and social care in the community: When GPs recognise complex social situations including homelessness, they are often not supported to assist patients to access existing social care in the community. Poor information sharing, lack of remuneration for time spent on care management, and non-recognition of GP expertise in policy planning hinder what GPs could achieve. 

“GPs need to be able to assist patients to access community services. Funding should be available to enable GPs and their teams to coordinate wrap-around supports for these patients rather than relying on time-based face-to-face MBS consultation item numbers,” the RACGP position statement says.