Rising homelessness shows the damage caused by welfare cuts

Homelessness has now risen by 34% since 2010, with measures including the benefit cap and the bedroom tax blamed by the Joseph Rowntree Foundation and Crisis.

As the economy continues to recover and as George Osborne declares that Britain is "on the mend", it will become even more important to remember those left behind. Today's Joseph Rowntree Foundation/Crisis report reminds us of one of the most worrying trends of recent years, that of rising homelessness. The study found that the number sleeping rough rose again last year by 6% in England and by 13% in London. Over the same period, the number in temporary accommodation increased by 10%, with a 14% rise in B&B placements. In total, homelessness has increased by 34% in the last three years (having fallen in the previous six), with 185,000 now affected in England.

While emphasising the long-term structural problem of the mismatch between housing demand and supply (the subject of my interview with Sadiq Khan this week), the report also makes it clear that the coalition's benefit cuts have made the situation worse. It states: "welfare benefit cuts, as well as constraints on housing access and supply, are critical to overall levels of homelessness." In London, in particular, the introduction of the £20,000 housing benefit cap, and the £26,000 total benefit cap, has made it "more difficult to secure new private tenancies for those on low incomes."

The report is also sharply critical of the bedroom tax, warning that "the size criteria is far too restrictive, and fails to make allowances for households where health and other factors mean it is unreasonable to expect household members to share a room." It adds: "Most fundamentally, in many parts of the country, social landlords simply do not have sufficient stock available to transfer tenants willing to move to smaller accommodation, and in some cases have estimated that it would take from five to thirteen years to transfer all the tenants affected."

The DWP has responded by insisting that "There is no evidence that people will be made homeless as a result of the benefit cap, the removal of the spare room subsidy or any of our welfare reforms." It added: "We have ensured councils have £190m of extra funds this year to help claimants and we are monitoring how councils are spending this money closely."

But the Discretionary Housing Payments funded by the coalition do not even come close to filling the gap in support. As the report points out, "the issues raised are more deep-seated than can be adequately dealt with by a declining discretionary top-up budget that assumes that these problems are very short-term." It reports that the bedroom tax was "viewed by most of our local authority interviewees as the most 'overwhelming' of all of the welfare reform issues", with a severe rise in arrears, often among households that had never previously fallen behind with their rent. It is further confirmation of why it was morally right, as well as politically astute, of Labour to pledge to abolish the bedroom tax if elected.

While some might expect the crisis to ease as the economy grows at its strongest rate since the crisis, the report warns that the reverse is the case. It points out that policy decisions, most notably welfare cuts, "have a more direct bearing on levels of homelessness than the recession in and of itself." In this regard, it notes that most of those interviewed expect a "new surge in homelessness" as welfare cuts continue to bite and as specialist homelessness funding programmes come to an end. But judging by its response today, the coalition is content to remain in denial.

The number sleeping rough rose last year by 6% in England and by 13% in London. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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David had taken the same tablets for years. Why the sudden side effects?

Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot.

David had been getting bouts of faintness and dizziness for the past week. He said it was exactly like the turns he used to get before he’d had his pacemaker inserted. A malfunctioning pacemaker didn’t sound too good, so I told him I’d pop in at lunchtime.

Everything was in good order. He was recovering from a nasty cough, though, so I wondered aloud if, at the age of 82, he might just be feeling weak from having fought that off. I suggested he let me know if things didn’t settle.

I imagined he would give it a week or two, but the following day there was another visit request. Apparently he’d had a further turn that morning. The carer hadn’t liked the look of him so she’d rung the surgery.

Once again, he was back to normal by the time I got there. I quizzed him further. The symptoms came on when he got up from the sofa, or if bending down for something, suggesting his blood pressure might be falling with the change in posture. I checked the medication listed in his notes: eight different drugs, at least two of which could cause that problem. But David had been taking the same tablets for years; why would he suddenly develop side effects now?

I thought I’d better establish if his blood pressure was dropping. I got him to stand, and measured it repeatedly over a period of several minutes. Not a hint of a fall. And nor did he now feel in the slightest bit unwell. I was stumped. David’s wife had been watching proceedings from her armchair. “Mind you,” she said, “it only happens mid-morning.”

The specific timing made me pause. I asked to see his tablets. David passed me a carrier bag of boxes. I went through them methodically, cross-referencing each one to his notes.

“Well, there’s your trouble,” I said, holding out a couple of the packets. One was emblazoned with the name “Diffundox”, the other “Prosurin”. “They’re actually the same thing.”

Every medication has two names, a brand name and a generic one – both Diffundox and Prosurin are brand names of a medication known generically as tamsulosin, which improves weak urinary flow in men with enlarged prostates. Doctors are encouraged to prescribe generically in almost all circumstances – if I put “tamsulosin” on a prescription, the pharmacist can supply the best value generic available at that time, but if I specify a brand name they’re obliged to dispense that particular one irrespective of cost.

Generic prescribing is good for the NHS drug budget, but it can be horribly confusing for patients. Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot. And while the box always has the generic name on it somewhere, it’s much less prominent than the brand name. With so many patients on multiple medications, all of which are subject to chopping and changing between generics, it’s no wonder mix-ups occur. Couple that with doctors forever stopping and starting drugs and adjusting doses, and you start to get some inkling of quite how much potential there is for error.

I said to David that, at some point the previous week, two different brands of tamsulosin must have found their way into his bag. They looked for all the world like different medications to him, with the result that he was inadvertently taking a double dose every morning. The postural drops in his blood pressure were making him distinctly unwell, but were wearing off after a few hours.

Even though I tried to explain things clearly, David looked baffled that I, an apparently sane and rational being, seemed to be suggesting that two self-evidently different tablets were somehow the same. The arcane world of drug pricing and generic substitution was clearly not something he had much interest in exploring. So, I pocketed one of the aberrant packets of pills, returned the rest, and told him he would feel much better the next day. I’m glad to say he did. 

This article first appeared in the 13 March 2018 issue of the New Statesman, Putin’s spy game