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Barriers to healthcare

August 01 2024
© Luis Saatchi © Luis Saatchi

Thoughts on the difficulties and stigma people experiencing homelessness face when trying to access healthcare. By Mat Amp

There is this pervasive view in and around the girdle of middle England that casts people on the ‘dole’ and the ‘sick’ as scroungers who are sucking up tax dollars to live the life of Riley. Of course, the plethora of one-size-fits all TV shows that focus on the most unfit and dysfunctional of families don’t help that stereotype. Nor does the portrayal of vulnerable people in the media as work shirkers hell-bent on ringing every dollar out of the ‘hard working man’.

Part of the dynamic is the creation of a desire in the public’s will to exact some sort of revenge on these people who they perceive to be getting something for nothing. Political parties desperately chasing votes, create organisations and campaigns to tackle this ‘fraud’ that often ends up costing way more than they ever end up saving.

This is apart from the fact that encouraging neighbours to dob on each other is reminiscent of policies enacted by Stalin in Russia as he went about locking up and exiling hordes of the country’s population. That may sound dramatic, but how the fuck is it ever going to be right to police your neighbour’s behaviour. Obviously, you don’t turn a blind eye if your nextie is trafficking 12-year-olds into sex slavery but dobbing them in for getting a few illicit dollars back from the tax man is too much. Far too much.

People’s attitude to vulnerable people is one of the major reasons why people in vulnerable positions continue to encounter problems with the system. There is no political will to change these things because they impact a minority of people who tend not to vote. And it is a very British attitude to tell people to stop bitching and moaning when they point to the problems they face in life.

As someone who is in treatment for active addiction, I too often encounter practical barriers to accessing healthcare. For example, I am in full time employment and part of my job is travelling to other cities in the UK for several days at a time. This can make it difficult to pick up my prescription for an opiate substitute: because it has to be picked up on a certain day and if it isn't picked up within the following two days your prescription is terminated and you have to see a doctor and get rescripted.

Also, I can't use the online booking system to book appointments because I have a rolling appointment with my case worker and the system can only handle one appointment at a time. This means I have to book appointments via the phone system and before I got a phone contract I was on a pay-by-the-minute phone, where being put on hold for 20 to 30 minutes could cost me up to £10. When I had an abscess and was desperate to see someone, I spent £14 trying to get through but ran out of credit before I did. I didn't get seen and the abscess got out of control until I needed emergency surgery.

The practical hurdles you face can make you feel vaguely paranoid, like the system is against you, although technically it isn't paranoia, is it, if your fear is justified? And it is in this state that many people experiencing homelessness turn up to medical appointments. We are ready to be slapped down and we often think we deserve to be. So even if we did have the confidence and composure to speak up for ourselves, we wouldn't because deep down inside we are sure we don't deserve to be treated with care and respect. People who think they are not worth caring for need a little bit extra in the form of reassurance, compassion and care. We are easily dismissed but like a parched cactus in the desert we wait for that small drop of rain that will sustain us for the hard dry months ahead.


© Chris Bird

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October – November 2024 : Change

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