Doctors reject idea of separate health centre for homeless people

Study indicates the homeless use hospital A&E services sixteen times more than the average

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Few homeless people have a functioning relationship with the basic healthcare services. Therefore they use hospital outpatient clinic services as much as sixteen times more often than the majority of people, say MD Agnes Stenius-Ayoade and social worker Elisabet Erkkilä.
      In a study to be published today, the two have looked into the state of health of 158 homeless people living in rooming houses in the cities of Helsinki, Espoo, and Vantaa.
     
Apart from being a common sight at hospital outpatient clinics, homeless people also resort to using the services of the capital area’s health centres more frequently than the rest of the population.
      The homeless visit health centres six times more often compared to an average person.
      Stenius-Ayoade and Erkkilä hope that there will be an increase in healthcare and problem prevention services geared towards the homeless.
      “With the homeless one should dismount; take the services to them”, the researchers say.
     
In Sweden the homeless have their own health centres. The Swedish model Stenius-Ayoade and Erkkilä do not welcome in Helsinki, however.
      “The risk is that second-rate services will be created for second-rate citizens”, Stenius-Ayoade says.
      Chief surgeon Jukka Toivonen from the Haartman Hospital agrees. He would rather see the homeless being treated as an equal patient group with the rest of the population.
      “I shy away from the idea of separating the homeless from the rest. I understand that with regard to certain substance abuse and mental health issues the homeless might benefit from a health centre of their own, but under no circumstances would I provide them with separate services for example for treatment of ordinary physical injuries”, Toivonen says.
     
According to Toivonen, homeless people are not problem patients at hospital outpatient clinics. Instead they suffer from the same complaints as the rest of the population. Also, with regard to intoxication or violence the homeless do not stand apart from the average hospital clientele.
      “Such characteristics do not specifically relate to being homeless. They are regrettably common even among the average citizens”, Toivonen explains.
     
Antti Iivanainen, the director of Helsinki's municipal health centres, does not get excited about the Swedish model either. According to Iivanainen, Helsinki is currently experimenting with taking healthcare services to the rooming houses where the homeless live.
     
In the Hietaniemenkatu Reception Centre, which opened in Helsinki’s Etu-Töölö district in June, there are now a doctor and two nurses working.
      “Soon a third nurse will be hired”, Iivanainen explains.
      In Iivanainen’s view the experiment has been positive and it has succeeded in reaching several homeless people, who before were totally without healthcare services. According to Iivanainen the trial may also ease off the pressure from the health centres and hospital outpatient clinics, and it is meant to be made permanent.
      “We will find the money from somewhere”, he promises.


Previously in HS International Edition:
  Poll: Helsinki residents support even distribution of housing for homeless (8.10.2008)
  Cold Snap: Enemy #1 of the street-people (8.3.2005)

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