Steve Mckinlay | Let’s Hope Labour Puts People First

Foreword

This long blog came as a result of my recently being contacted by a freelance journalist which I had spoken to a couple of years ago. That contact initially came about via the late, great Jeremy Swain who died this year after many years of service to people suffering with all forms of homelessness. He and I communicated on this topic several times, and so I dedicate this to his memory, and I don’t doubt it would have been improved by him if he had gotten his hands upon it.

Ambitions of a (new) Labour government

Although there was a disappointing silence in their manifesto, there has been some coverage of a possible new Rough Sleeper Unit – raising hopes of new investment into ending homelessness on a scale not seen since New Labour’s work under the then Office of the Deputy Prime Minister.  Back then, as the nation planned for a new millennium, it was Louise Casey who was drafted in to reduce rough sleeping, and do not be surprised if – the now Dame – Casey is pulled in for one last dance by Keir Starmer to serve his new administration. 

I would warmly welcome this ambition, but there are some areas where careful thought is required. There are some key differences between the days of New Labour and today’s context.

‘Finite government funding’

First and foremost is simply the available resources.  Both Conservative and the Labour Party’s commitment to economic credibility saw them reiterate that there will be little new investment into public spending.  After 14 years of austerity, local authorities will still face a financial black hole, and the social supports that have been allowed to wither on the vine are unlikely to be resurrected quickly.  Clarity over where new funding will come from, and any trade offs which it will require, is needed.

Another difference is the evaluation of the Housing First pilot programmes in West Midlands, Liverpool City Region and Greater Manchester – hosted by the combined authorities in each of those areas.  The evaluation of these large scale pilots do showcase an effective approach for Rough Sleepers with the most complex needs, and will doubtless be on the table, as the Labour central administration seeks close working with their regional colleagues.  I do believe in its ethos, as a housing-rights based approach is fundamental in terms of taking progressive steps to reduce rough sleeping, homelessness, and temporary accommodation.  However, these localised pilots cost £28m over a three-year period – last summer this prompted a former Homelessness Minister to doubt the viability of the ‘open ended nature’ of the support in the context of ‘finite government funding’, and the new administration will naturally question if that is sustainable.

Put people first

This is why I believe we need to be open to learn from the pilots, and in particular something which has been labelled ‘the high-fidelity model’ of Housing First – which is where the commitment to open ended funding has been most strongly articulated by some (High Fidelity Principle 2: Flexible support is provided for as long as it is needed).

We must protect and build upon the country’s own, hard-earned health and welfare safety nets.  I believe that if a person’s additional support needs are ongoing and look to be enduring then it is in their interest to be first assessed under the Care Act as the most appropriate way to meet them – this means a much greater role for the Department of Health and Social Care, rather than the current reliance on the Department for Levelling Up, Housing, and Communities (now reverting to MHCLG) to ‘solve’ homelessness.  For many, an assumption is made that high thresholds for care will not be met and so needs are often only assessed, if at all, under the provisions of the Housing Act and the Homelessness Reduction Act. To recalibrate this, any national roll out is going to need to include very close cross-Government working, and pooled resources including the Ministry of Housing, Communities and Local Government, the Department of Health and Social Care, the Ministry of Justice, Home Office and the Department for Work and Pensions.  Easy to say, incredibly difficult to do and will need focussed support from the very top of government.

The ‘high-fidelity model’ comes heavily laden with some principles which dictate how the service is to be delivered – so much so that It sometimes seems that a focus on high-fidelity has led to a dogmatic obsession with the ‘model’ rather than the practical needs of the people that it aims to serve.    I am not even convinced by claims of an international evidence base for the ‘high-fidelity model’ of Housing First because the actual model that other countries would call Housing First simply wouldn’t comply with the high-fidelity model used to evaluate the Greater Manchester, Liverpool, and West Midlands pilots.  

Our country’s context is very different to that of others, including housing supply, the vital welfare safety nets for people who are unable to work, and precious help with rent costs.  Let’s not put our investment in a straitjacket – trusting service providers, with pragmatism, and high degrees of flexibility is what is required to take a fully person centred approach. 

This brings me to the range of interventions that need to be resourced to meet the needs of people with complex challenges, while not forgetting the absolute necessity of Prevention.

In the context of ‘finite government funding’, a national roll out of any rough sleeping intervention shouldn’t come at the expense of other parts of a homelessness safety net and a pragmatic homelessness prevention strategy.  I will be genuinely worried if money and attention is redirected into one, relatively expensive, model that we could actually end up with more people sleeping rough. This is because in a world of finite resources, reduced funding would be available to support people with more diverse needs, and extremely limited funding to stop them requiring homelessness support in the first place.

In fact, in order to function properly, it is clear that Housing First relies on other services. Quite a lot of the tenants in the pilots have had multiple tenancies and that is not a criticism – given their additional challenges it is to be expected.   However, one of the side effects of a requirement for greater choice and control (Principle 4: Individuals have choice and control),  means it is often many months until someone actually gets offered a property that best meets their needs.  For instance people might be keen to move to particular parts of a town or city when they are trying to break a habit or break away from some negative social connections.   

While they wait, or when a person’s tenancy breaks down in Housing First, they usually need other forms of supported accommodation, and again this can be for many months until a more appropriate Housing First tenancy is secured.

Each journey is different for each person, and the risk of reliance on one model is not just financial, it’s personal.   For instance, it stands to reason that if people, at a very early stage in their recovery journey from a life on the streets, move into their own flat they will more often be alone when they are using drugs, which can increase the risk of overdose for some.  

Similarly we should not underestimate the feelings of isolation some feel when they finally secure their new home.  This can lead to others gradually ‘taking-over’ the property – sometimes called cuckooing. For others isolation can result in a dangerous decline in their mental wellbeing.  People experiencing homelessness are much more likely to die by drug and alcohold harms and suicide, so it is important we are honest about the risks. We must provide a range of accommodation and support options to meet the different needs and risks that people can be faced with. 

Housing led

Across the three Housing First pilots, the biggest challenge they had was getting hold of decent properties.  When setting up the pilots, there was understandably a focus on recruiting the right people to provide such intensive support, and engaging wider stakeholders.  However, in some areas engaging with landlords seemed to be an afterthought.  In fact in some cases landlords seemed to be treated as being part of the problem rather than part of the solution and more time was focussed on developing high cost incentive and insurance schemes to persuade private landlords to make accommodation available.  As the term Housing First implies, housing providers should have been at the front of the process when designing the pilots, and this would have had the happy side effect of enabling better planning of capital expenditure too.  

Again, this was partly an unintended consequence of the ‘high-fidelity’ approach, as it has a requirement for an arbitrary split between the housing provider and support provider (Principle 3: Housing and support are separated). I struggle to see where the evidence for that comes from.  Government itself has commissioned a very similar programme to Housing First – the Rough Sleeping Accommodation Programme (RSAP).  In the North East it operates almost identically to Housing First, providing people with immediate access to a full tenancy, regardless of where they are in their journey from the street to their own front door. It has the same intensive levels of engagement and support, seeing caseloads of around six per support worker, and taking a harm reduction approach.  Here at Tyne Housing, we bought properties from the private sector, bringing them into social, supported use.  We provide both the landlord function, the housing management and the intensive support and it has not affected the outcomes; if anything, it can make things smoother if something goes wrong.  As a single point of contact we can work quickly with people to keep them safe and come up with a plan B when things are not going well. 

Start with Prevention

The importance of preventing homelessness cannot be ignored any longer.  Any relief model which diverts attention and resources away from prevention will be counter productive. The previous Office of the Deputy Minister oversaw a much broader programme of housing related support from 2003, called Supporting People.  Again, it was relatively expensive, but it took a broader interest in prevention of homelessness, commissioning locally a wider range of supported housing and visiting support for very diverse groups of people, and invested in people’s transition from supported housing into the mainstream.  It coincided with the greatest decline in rough sleeping in my lifetime and genuinely helped an array of people in a way that made sense to their own individual circumstances.  It was data rich, and fully evaluated – and something closer to this much greater ambition is what we need to see from a new government if they are serious about ending all forms of homelessness – rather than a narrow focus on rough sleeping.

The suggestion that a New Labour programme was extremely effective has not been an easy message to communicate over recent years to a Conservative administration.  However, with a (new) Labour government in place, then honest reflections about a large-scale supported housing and preventative programme is surely more possible, and should be the sole focus for all interested in ending homelessness.  Soon to be published is a useful reference point. “A Hand up not a Hand Out’: The Labour Governments and Street Homelessness, 1997-2010” is a thesis by David Christie and is a thorough attempt to articulate the New Labour approach to homelessness and social exclusion (aside of course from the government’s own 2009 CapGemini evaluation which showed a positive return on investment of the Supporting People programme).

The gradual decline of the Supporting People programme led to a vacuum of quality assured supported housing provision, which has been partly filled by housing investors looking to make a profit – at the expense of a commitment to quality standards.  However, good progress has been made to correct this with a new set of Consumer Standards for all registered providers of social housing, including a much higher expectation about how residents and tenants will be engaged and involved in their services.  

Importantly, the Supported Housing (Regulatory Oversight) Act came into effect last summer and is intended to drive up standards in all forms of supported housing.  As part of this, DLUHC were seeking to establish an Advisory Panel, and although there was a pause due to the General Election, it is imperative that the new administration picks this up and commits to it.  Getting a full range of voices, including that of lived experience, on that panel is also incredibly important as supported housing is all about the breadth of the people it serves across the country. 

In conclusion – a blueprint for prevention

  • Any new funding to support a better response to homelessness is welcome,  however focussing on the most visible forms of homelessness cannot come at the expense of more proactive, preventative solutions. 
  • Presenting a single model to busy Ministers looking for simple answers to complex problems comes with risk.  Investing in high quality supported accommodation brings long term returns on investment – and the greatest returns come from investing in prevention not crisis.
  • A full approach to the prevention and relief of homelessness must include developing more social housing, housing benefit that fully meets the cost of rent and a wide range of supported accommodation – the commissioning of which should be done locally.
  • Landlords must be seen as a fundamental part of the solution, aligning Revenue and Capital investment is crucial. 
  • To really invest in ending all forms of homelessness, a new government will need to understand the financial benefits of a much more comprehensive, cross-government programme that deals with all forms of housing related support, including preventing homelessness from occurring in the first place.

Much work has also been done to quantify a properly resourced supported housing programme, which meets the needs of everyone in our country.  I suggest a good starting point is by the National Housing Federation’s recent report, April 2024. https://www.housing.org.uk/resources/how-much-supported-housing-will-we-need-by-2040/