From hospital to hostel

Nottinghamshire Council has come under fire over the past few months for taking the scissors to its budget for vulnerable and homeless people. Having originally earmarked a cut of £4.2 million from its £12.5 million supporting people budget, the council was severely criticised by homelessness charities. They said hostels would have to shut down, with homeless people being forced out of the streets.

However last week Nottinghamshire said it had a cunning plan – to nab £1 million of its public health budget and put it towards its housing-related support fund. This action may stave off some of the devastation hacking back the homelessness budget will bring, but will fall well short of the money that is needed to keep homelessness services going.

It is also a sign of the times – the housing sector is raring to get a slice of the more readily protected health funding. As the Care Bill promotes the integration of social services, health and housing local government is left with a huge financial hole due to Treasury cuts. The sector is hoping for health budgets to filter down into housing.

The movement towards topping up supporting people-funded services with health funding has some sense. SP services help keep people off the streets, out of hospital and therefore bring savings to health budgets. SP money, which funds warden services for elderly people and projects to keep people off drugs, means not as many people use acute – and more expensive – health services.

If the council’s plan is to top up housing support services with health funding, the logic is there. But there will have to be a lot more bravery about where to hack back in health budgets if councils want to stop vital housing services going under over the next four years.

Savings can be made in closing sexual health clinics or cutting services that stop people dying earlier from disease. But the biggest savings have to come from larger redistribution of health cash. Closing hospital wards will never be popular with politicians. But as more and more research shows hospitals are not the place for most people to end their lives, there is more and more reason to allow patients be treated at home.

Taking this cash and giving it to much-needed services currently funded by supporting people could stop the decimation of housing support services.

Small and piecemeal funding switchovers will do little in the long run to save housing services in Nottingham and other councils where funding has been cut to the bone. A more courageous shift from central government to say goodbye to hospital wards is needed in time to stop those services currently kept alive through SP funding disappearing.